Differences on Pyrexia Related Immune Responses between SARS-CoV-2 and Influenza-A-infected Children: A Retrospective Study

Abstract

Background: The ongoing pandemic of COVID‐19 has led to an unprecedented global crisis with problems of fragmentation in healthcare services in many severely affected countries. A key issue is distinguishing the clinical manifestations of COVID-19 from other respiratory infectious disease, especially in children and teens.Methods: To provide precise and comprehensive information on SARS-CoV-2 infected children, a total 62 hospitalized patients, aged from 1 to 14 years old and confirmed with the infection of either SARS-CoV-2 or influenza A virus, were enrolled from September 2019 to February 2020. The epidemiological, clinical and laboratory characteristics, as well as the outcomes of these pediatric patients were collected, followed by comparisons and regression analysis on clinical features and hematological parameters among the COVID-19 patients and the flu patients.Results: We reported that SARS-CoV-2 infected children showed less fever (43.33% vs 100%, p<0.001) with mild elevation of the body temperature (p<0.001), as well as attenuated inflammatory responses in comparison with patients with influenza A infection. We further showed the significant correlations between initial body temperature and multiple immune parameters (white blood cell counts and inflammatory markers) among SARS-CoV-2 infected children. Conclusions: Children with SARS-CoV-2 infection were more likely to have mild symptoms and relatively slow progression with a hypo-inflammatory response. Furthermore, the correlation results suggested that distinct immune responses were involved during SARS-CoV-2 infection.