%A Shokati Eshkiki,Zahra %A Shahriari,Arman %A Seyedtabib,Maryam %A Torabizadeh,Mehdi %A Assarehzadegan,Mohammad Ali %A Nashibi,Roohangize %A Khosravi,Maryam %A Neisi,Niloofar %A Mard,Seyed Ali %A Shayesteh,Ali Akbar %D 2021 %J Frontiers in Pediatrics %C %F %G English %K SARS-CoV-2,COVID-19,Immune response alteration,innate immune cells,adaptive immune cells %Q %R 10.3389/fped.2021.736013 %W %L %M %P %7 %8 2021-December-15 %9 Original Research %# %! Immune response imbalance in COVID‑19 patients %* %< %T Innate and Adaptive Immunity Imbalance With Severe COVID-19 Pneumonia in Children and Adults %U https://www.frontiersin.org/articles/10.3389/fped.2021.736013 %V 9 %0 JOURNAL ARTICLE %@ 2296-2360 %X Introduction: Little is known about the laboratory and radiological characteristics and clinical significance of peripheral immune alterations in patients with coronavirus disease 2019 (COVID-19). This study aims to clarify these aspects in children and adults with COVID-19.Methods: In this consecutive pilot study, COVID-19 patients with the confirmed pneumonia and real-time RT-PCR were recruited prospectively in June 2020. The clinical, chest CT, and laboratory features, such as lymphocyte subpopulations, were analyzed for each individual.Results: Forty confirmed COVID-19 patients, 11 severe children, 12 severe adults, and 17 critical adult patients, besides 20 healthy pediatrics and 14 healthy adults as controls, were enrolled prospectively. Adult patients, especially critical ones, had a much higher prevalence of laboratory and chest CT abnormalities. Data regarding immune cell subsets in children patients, compared with matched controls, had higher CD3+ CD8+ T cells (p = 0.004) and lower CD4+/CD8+ ratio (p = 0.042), while adult patients, compared with matched controls, had lower CD14+ monocytes (p = 0.032). Adult patients were also categorized as experiencing critical or severe illness on admission and, compared with severe patients, had lower total lymphocytes (p < 0.047), CD3+ T-lymphocytes (p < 0.002), and CD3+ CD8+ T cells (p = 0.001) and, on the other hand, had higher CD3+ CD4+ T cells (p = 0.012) and CD4+/CD8+ ratio (p = 0.003). Non survived adults, compared with survived patients, had significantly lower CD3+ T-lymphocyte (p = 0.005).Conclusion: Unlike adult patients, who compared with matched controls and had more comorbidities, higher frequency of severe clinical symptoms, laboratory abnormalities, and immune cells alteration, clinical manifestations of COVID-19 in children (compared with matched controls) were relatively mild, and fewer clinical complications were seen either, perhaps because of a milder inflammatory response following their peripheral innate and adaptive immune cell alteration pattern.