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BMC Cancer

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Open Access 01-12-2024 | COVID-19 | Research

Immunophenotype of lymphocytes and real-world outcome of COVID-19 infection in children with hematology and oncology

Authors: Na Zhang, Zhen Wang, Hong Li, Kai Chen, Hong-sheng Wang, Jing-bo Shao, Sha-yi Jiang, Xiao-wen Zhai, Hui Jiang

Published in: BMC Cancer | Issue 1/2024

Abstract

Background

Patients with immunocompromise were suspected to encounter a high risk for severe coronavirus disease 2019 (COVID-19) infection on early period; however, data is lacking nowadays and immune response remain unclear.

Methods

In this retrospective study, internet questionnaire survey and medical records were acquired in pediatric hematology oncology patients. Clinical severity, immunological characteristics, and outcomes were analyzed from December 1, 2022 to January 31, 2023 at the 3rd year of pandemic in China.

Results

A total of 306 patients were included, with 21 patients (6.9%) asymptomatic, 262 (85.6%) mild severity, 17 (5.6%) moderate severity, 5 (1.6%) severe severity, and 1 (0.3%) critical severity. Seventy-eight (25.5%) patients were on intensive chemotherapy, and 32.0% children were on maintenance chemotherapy. Delays in cancer therapy occurred in 86.7% patients. Univariable analysis revealed active chemotherapy (P < 0.0001), long duration of symptom (P < 0.0001), low lymphocytes count (P = 0.095), low CD3 + and CD8 + T cell count (P = 0.013, P = 0.022), high percentage of CD4 + TCM (P = 0.016), and low percentage of transitional B cells (P = 0.045) were high risk factors for severe COVID-19 infection. Cox regression model showed that the absolute lymphocytes count (P = 0.027) and long duration of symptom (P = 0.002) were the independent factors for severity. Patients with CD8 + dominant and B cell depletion subtype wasn’t related with severity, but had higher percentage of CD8 + effector memory T cells (TEM) and terminally differentiated effector memory T cells (TEMRA) (P < 0.001, P < 0.001), and a longer COVID-19 duration (P = 0.045).

Conclusion

The severity was relatively mild in children with immunodeficiencies in the third year of COVID-19 pandemic. Low lymphocyte count and long duration of symptom were the independent risk factors with COVID-19 severity. Delays in cancer care remain a major concern and the long outcome is pending.

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Title: Immunophenotype of lymphocytes and real-world outcome of COVID-19 infection in children with hematology and oncology
Authors: Na Zhang
Zhen Wang
Hong Li
Kai Chen
Hong-sheng Wang
Jing-bo Shao
Sha-yi Jiang
Xiao-wen Zhai
Hui Jiang
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: COVID-19
Hematology
Cytostatic Therapy
Published in: BMC Cancer / Issue 1/2024
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-024-12262-1

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