Atypical Severe Organizing Pneumonia Following Coronavirus Disease 2019 in an Immunocompromised Teenager

Corvol, Harriet; Alimi, Aurélia; Prévost, Bertrand; Schnuriger, Aurélie; Pointe, Hubert Ducou Le; Rambaud, Jérôme; Tabone, Marie‐Dominique

doi:10.1093/cid/ciab657

Cited by 4 publications

(4 citation statements)

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“…Even if morbidity has been much lower for children than for adults, the pediatric population has not been completely spared (6)(7)(8)(9)(10)(11)(12)(13)(14). Children could also be severely affected, requiring hospitalizations and intensive care unit admission, although deaths rarely occur in children (15).…”

Section: Introductionmentioning

confidence: 99%

Risk factors for admission to the pediatric critical care unit among children hospitalized with COVID-19 in France

et al. 2022

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BackgroundCOVID-19 infection is less severe among children than among adults; however, some patients require hospitalization and even critical care. Using data from the French national medico-administrative database, we estimated the risk factors for critical care unit (CCU) admissions among pediatric COVID-19 hospitalizations, the number and characteristics of the cases during the successive waves from January 2020 to August 2021 and described death cases.MethodsWe included all children (age < 18) hospitalized with COVID-19 between January 1st, 2020, and August 31st, 2021. Follow-up was until September 30th, 2021 (discharge or death). Contiguous hospital stays were gathered in “care sequences.” Four epidemic waves were considered (cut off dates: August 11th 2020, January 1st 2021, and July 4th 2021). We excluded asymptomatic COVID-19 cases, post-COVID-19 diseases, and 1-day-long sequences (except death cases). Risk factors for CCU admission were assessed with a univariable and a multivariable logistic regression model in the entire sample and stratified by age, whether younger than 2.ResultsWe included 7,485 patients, of whom 1988 (26.6%) were admitted to the CCU. Risk factors for admission to the CCU were being younger than 7 days [OR: 3.71 95% CI (2.56–5.39)], being between 2 and 9 years old [1.19 (1.00–1.41)], pediatric multisystem inflammatory syndrome (PIMS) [7.17 (5.97–8.6)] and respiratory forms [1.26 (1.12–1.41)], and having at least one underlying condition [2.66 (2.36–3.01)]. Among hospitalized children younger than 2 years old, prematurity was a risk factor for CCU admission [1.89 (1.47–2.43)]. The CCU admission rate gradually decreased over the waves (from 31.0 to 17.8%). There were 32 (0.4%) deaths, of which the median age was 6 years (IQR: 177 days–15.5 years).ConclusionSome children need to be more particularly protected from a severe evolution: newborns younger than 7 days old, children aged from 2 to 13 years who are more at risk of PIMS forms and patients with at least one underlying medical condition.

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Section: Introductionmentioning

confidence: 99%

Risk factors for admission to the pediatric critical care unit among children hospitalized with COVID-19 in France

et al. 2022

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“…We observed an atypical respiratory course of severe SARS‐CoV‐2 infection in a 16‐year‐old adolescent, who was immunocompromised when infected with SARS‐CoV‐2. 44 This teenager was diagnosed with bone Ewing sarcoma, which was initially treated with chemotherapy and surgical resection. Given the partial response to this treatment, high‐dose chemotherapy followed by autologous hematopoietic stem cell transplantation (HSCT) was considered.…”

Section: Focus On Atypical Respiratory Manifestations Of Covid‐19 In ...mentioning

confidence: 99%

“…However, in childhood, most cancers require intensive treatment, which, if postponed, may be life‐threatening. We observed an atypical respiratory course of severe SARS‐CoV‐2 infection in a 16‐year‐old adolescent, who was immunocompromised when infected with SARS‐CoV‐2 44 . This teenager was diagnosed with bone Ewing sarcoma, which was initially treated with chemotherapy and surgical resection.…”

Section: Focus On Atypical Respiratory Manifestations Of Covid‐19 In ...mentioning

confidence: 99%

COVID‐19 and pediatric pulmonology: Feedback from an expert center after the first year of the pandemic

Corvol

Prévost

Aubertin

et al. 2022

Pediatric Pulmonology

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The coronavirus disease 2019 (COVID‐19) outbreak has evolved with different waves corresponding to subsequent severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) mutations. While the most severe cases have been observed in the elderly and in individuals with underlying comorbidities, severe pediatric and young adult cases have been observed, as well as post‐infectious inflammatory syndromes and persistent symptoms leading to long‐COVID. This manuscript describes the experience of a pediatric respiratory unit during the first year of the pandemic and reviews the corresponding literature with a special emphasis on children and young people with underlying conditions, such as immunosuppression, sickle cell disease, and cystic fibrosis.

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“…The function of these immune cells influences the progression of OP, as revealed by the typical severe OP that develops after COVID‐19 in an immunocompromised teenager. 8 Immune cells possess the ability to perceive diverse signals in the microenvironment and subsequently activate specific immune functions. A correlation exists between the immune response and significant alterations in tissue metabolism, such as nutrient depletion, increased oxygen consumption and the production of reactive nitrogen and oxygen intermediates.…”

Section: Introductionmentioning

confidence: 99%

Integrated multi‐omics profiling landscape of organising pneumonia

Tang,

Chu,

et al. 2024

Clinical & Translational Med

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BackgroundOrganising pneumonia (OP) is one of the most common and lethal diseases in the category of interstitial pneumonia, along with lung cancer. Reprogramming of lipid metabolism is a newly recognized hallmark of many diseases including cancer, cardiovascular disorders, as well as liver fibrosis and sclerosis. Increased levels of ceramides composed of sphingosine and fatty acid, are implicated in the development of both acute and chronic lung diseases. However, their pathophysiological significance in OP is unclear. The aim of this study was to investigate the role of lipid metabolism reprogramming in OP, focusing on inflammation and fibrosis.MethodsComprehensive multi‐omics profiling approaches, including single‐cell RNA sequencing, Visium CytAssist spatial transcriptomics, proteomics, metabolomics and mass spectrometry, were employed to analyze the tissues. OP mice model was utilized and molecular mechanisms were investigated in macrophages.ResultsThe results revealed a significant association between OP and lipid metabolism reprogramming, characterized by an abnormal expression of several genes related to lipid metabolism, including CD36, SCD1, and CES1 mainly in macrophages. CD36 deficiency in alveolar macrophages, led to an increased expression of C16/24 ceramides that accumulated in mitochondria, resulting in mitophagy or mitochondrial dysfunction. The number of alveolar macrophages in OP was significantly reduced, which was probably due to the ferroptosis signaling pathway involving GSH/SLC3A2/GPX4 through CD36 downregulation in OP. Furthermore, macrophage secretion of DPP7 and FABP4 influenced epithelial cell fibrosis.ConclusionsCD36 inhibited the ferroptosis pathway involving SLC3A2/GPX4 in alveolar macrophages of OP tissue by regulating lipid metabolism, thus representing a new anti‐ferroptosis and anti‐fibrosis effect of CD36 mediated, at least in part, by ceramides.HighlightsOur findings reveal a significant association between organising pneumonia and lipid metabolism reprogramming and will make a substantial contribution to the understanding of the mechanism of organising pneumonia in patients.

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Atypical Severe Organizing Pneumonia Following Coronavirus Disease 2019 in an Immunocompromised Teenager

Cited by 4 publications

References 9 publications

Risk factors for admission to the pediatric critical care unit among children hospitalized with COVID-19 in France

Risk factors for admission to the pediatric critical care unit among children hospitalized with COVID-19 in France

COVID‐19 and pediatric pulmonology: Feedback from an expert center after the first year of the pandemic

Integrated multi‐omics profiling landscape of organising pneumonia

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