Skip to main content
Top
Published in: Italian Journal of Pediatrics 1/2022

01-12-2022 | SARS-CoV-2 | Research

Incidental occurrence of neutropenia in children hospitalised for COVID-19

Authors: Francesco Folino, Camilla Menis, Giada Maria Di Pietro, Raffaella Pinzani, Paola Marchisio, Samantha Bosis

Published in: Italian Journal of Pediatrics | Issue 1/2022

Login to get access

Abstract

Background

Investigations on haematological alterations in paediatric COVID-19 have been focused mostly on lymphocytes and clotting profiles. Neutropenia has been occasionally reported and its course and impact on the disease have not been elucidated. The aim of this study was to describe the epidemiology, course, and impact of neutropenia in children with COVID-19 hospitalised in a tertiary care referral paediatric ward.

Methods

A single-centre retrospective study was conducted. Hospitalised children between 1 month and 18 years with confirmed COVID-19 and neutropenia were included and compared to non neutropenic patients. Complete blood picture with differential blood count, serum biochemistry, clotting profiles were performed; clinical data, length of hospitalisation, and prescription of drugs were collected.

Results

Twelve out of 95 patients (12.63%) with documented SARS-CoV-2 infection were neutropenic and met the inclusion criteria. The mean age was 161 days (range 38—490 days). The mean duration of symptoms in neutropenic children was 3.82 days, while the mean length of hospitalisation was 7.67 days. These findings were not significantly different in the two study groups. All patients had mild clinical manifestations and were discharged without sequelae.

Conclusions

We provided the first comprehensive study on neutropenia in mild paediatric COVID-19 infection. Our findings show that the main features of this haematological disorder in COVID-19 are analogous to the well-known transient benign neutropenia associated with other common viral infections. In our setting, neutropenia does not emerge as a potential negative prognostic factor in paediatric COVID-19.
Literature
2.
go back to reference Verity R, Okell LC, Dorigatti I, Winskill P, Whittaker C, Imai N, Cuomo-Dannenburg G, Thompson H, Walker PGT, Fu H, Dighe A, Griffin JT, Baguelin M, Bhatia S, Boonyasiri A, Cori A, Cucunubá Z, FitzJohn R, Gaythorpe K, Green W, Hamlet A, Hinsley W, Laydon D, Nedjati-Gilani G, Riley S, van Elsland S, Volz E, Wang H, Wang Y, Xi X, Donnelly CA, Ghani AC, Ferguson NM. Estimates of the severity of coronavirus disease 2019: a model-based analysis. Lancet Infect Dis. 2020;20(6):669–77. https://doi.org/10.1016/S1473-3099(20)30243-7 Epub 2020 Mar 30. Erratum in: Lancet Infect Dis. 2020 Apr 15;: Erratum in: Lancet Infect Dis. 2020 May 4;: PMID: 32240634; PMCID: PMC7158570.CrossRefPubMedPubMedCentral Verity R, Okell LC, Dorigatti I, Winskill P, Whittaker C, Imai N, Cuomo-Dannenburg G, Thompson H, Walker PGT, Fu H, Dighe A, Griffin JT, Baguelin M, Bhatia S, Boonyasiri A, Cori A, Cucunubá Z, FitzJohn R, Gaythorpe K, Green W, Hamlet A, Hinsley W, Laydon D, Nedjati-Gilani G, Riley S, van Elsland S, Volz E, Wang H, Wang Y, Xi X, Donnelly CA, Ghani AC, Ferguson NM. Estimates of the severity of coronavirus disease 2019: a model-based analysis. Lancet Infect Dis. 2020;20(6):669–77. https://​doi.​org/​10.​1016/​S1473-3099(20)30243-7 Epub 2020 Mar 30. Erratum in: Lancet Infect Dis. 2020 Apr 15;: Erratum in: Lancet Infect Dis. 2020 May 4;: PMID: 32240634; PMCID: PMC7158570.CrossRefPubMedPubMedCentral
5.
go back to reference Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, Zhang W, Wang Y, Bao S, Li Y, Wu C, Liu H, Liu D, Shao J, Peng X, Yang Y, Liu Z, Xiang Y, Zhang F, Silva RM, Pinkerton KE, Shen K, Xiao H, Xu S, Wong GWK, Chinese Pediatric Novel Coronavirus Study Team. SARS-CoV-2 Infection in Children. N Engl J Med. 2020;382(17):1663–5. https://doi.org/10.1056/NEJMc2005073 Epub 2020 Mar 18. PMID: 32187458; PMCID: PMC7121177.CrossRefPubMed Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, Zhang W, Wang Y, Bao S, Li Y, Wu C, Liu H, Liu D, Shao J, Peng X, Yang Y, Liu Z, Xiang Y, Zhang F, Silva RM, Pinkerton KE, Shen K, Xiao H, Xu S, Wong GWK, Chinese Pediatric Novel Coronavirus Study Team. SARS-CoV-2 Infection in Children. N Engl J Med. 2020;382(17):1663–5. https://​doi.​org/​10.​1056/​NEJMc2005073 Epub 2020 Mar 18. PMID: 32187458; PMCID: PMC7121177.CrossRefPubMed
9.
go back to reference Jiehao C, Jin X, Daojiong L, Zhi Y, Lei X, Zhenghai Q, Yuehua Z, Hua Z, Ran J, Pengcheng L, Xiangshi W, Yanling G, Aimei X, He T, Hailing C, Chuning W, Jingjing L, Jianshe W, Mei Z. A case series of children with 2019 novel coronavirus infection: clinical and epidemiological features. Clin Infect Dis. 2020;71(6):1547–51. https://doi.org/10.1093/cid/ciaa198 PMID:32112072;PMCID:PMC7108143.CrossRefPubMed Jiehao C, Jin X, Daojiong L, Zhi Y, Lei X, Zhenghai Q, Yuehua Z, Hua Z, Ran J, Pengcheng L, Xiangshi W, Yanling G, Aimei X, He T, Hailing C, Chuning W, Jingjing L, Jianshe W, Mei Z. A case series of children with 2019 novel coronavirus infection: clinical and epidemiological features. Clin Infect Dis. 2020;71(6):1547–51. https://​doi.​org/​10.​1093/​cid/​ciaa198 PMID:32112072;PMCID:PMC7108143.CrossRefPubMed
10.
go back to reference Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J, Wang Z, Li J, Li J, Feng C, Zhang Z, Wang L, Peng L, Chen L, Qin Y, Zhao D, Tan S, Yin L, Xu J, Zhou C, Jiang C, Liu L. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci. 2020;63(3):364–74. https://doi.org/10.1007/s11427-020-1643-8 Epub 2020 Feb 9. PMID: 32048163; PMCID: PMC7088566.CrossRefPubMedPubMedCentral Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J, Wang Z, Li J, Li J, Feng C, Zhang Z, Wang L, Peng L, Chen L, Qin Y, Zhao D, Tan S, Yin L, Xu J, Zhou C, Jiang C, Liu L. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci. 2020;63(3):364–74. https://​doi.​org/​10.​1007/​s11427-020-1643-8 Epub 2020 Feb 9. PMID: 32048163; PMCID: PMC7088566.CrossRefPubMedPubMedCentral
12.
go back to reference Karavanaki K, Polychronopoulou S, Giannaki M, Haliotis F, Sider B, Brisimitzi M, Dimitriou C, Scordias G, Marangou F, Stamatiadou A, Avlonitis S. Transient and chronic neutropenias detected in children with different viral and bacterial infections. Acta Paediatr. 2006;95(5):565–72. https://doi.org/10.1080/08035250500477537 PMID: 16825137.CrossRefPubMed Karavanaki K, Polychronopoulou S, Giannaki M, Haliotis F, Sider B, Brisimitzi M, Dimitriou C, Scordias G, Marangou F, Stamatiadou A, Avlonitis S. Transient and chronic neutropenias detected in children with different viral and bacterial infections. Acta Paediatr. 2006;95(5):565–72. https://​doi.​org/​10.​1080/​0803525050047753​7 PMID: 16825137.CrossRefPubMed
15.
go back to reference Fioredda F, Calvillo M, Bonanomi S, Coliva T, Tucci F, Farruggia P, Pillon M, Martire B, Ghilardi R, Ramenghi U, Renga D, Menna G, Barone A, Lanciotti M, Dufour C. Congenital and acquired neutropenia consensus guidelines on diagnosis from the neutropenia committee of the marrow failure syndrome group of the AIEOP (Associazione Italiana Emato-Oncologia Pediatrica). Pediatr Blood Cancer. 2011;57(1):10–7. https://doi.org/10.1002/pbc.23108 Epub 2011 Mar 29 PMID: 21448998.CrossRefPubMed Fioredda F, Calvillo M, Bonanomi S, Coliva T, Tucci F, Farruggia P, Pillon M, Martire B, Ghilardi R, Ramenghi U, Renga D, Menna G, Barone A, Lanciotti M, Dufour C. Congenital and acquired neutropenia consensus guidelines on diagnosis from the neutropenia committee of the marrow failure syndrome group of the AIEOP (Associazione Italiana Emato-Oncologia Pediatrica). Pediatr Blood Cancer. 2011;57(1):10–7. https://​doi.​org/​10.​1002/​pbc.​23108 Epub 2011 Mar 29 PMID: 21448998.CrossRefPubMed
18.
go back to reference Parri N, Lenge M, Buonsenso D, Coronavirus Infection in Pediatric Emergency Departments (CONFIDENCE) Research Group. Children with Covid-19 in Pediatric Emergency Departments in Italy. N Engl J Med. 2020;383(2):187–90. https://doi.org/10.1056/NEJMc2007617 Epub 2020 May 1. PMID: 32356945; PMCID: PMC7206930.CrossRefPubMed Parri N, Lenge M, Buonsenso D, Coronavirus Infection in Pediatric Emergency Departments (CONFIDENCE) Research Group. Children with Covid-19 in Pediatric Emergency Departments in Italy. N Engl J Med. 2020;383(2):187–90. https://​doi.​org/​10.​1056/​NEJMc2007617 Epub 2020 May 1. PMID: 32356945; PMCID: PMC7206930.CrossRefPubMed
19.
go back to reference Romani L, Chiurchiù S, Santilli V, Bernardi S, Haywood Lombardi M, Scarselli A, Villani A, CiofiDegliAtti ML, Campana A, D’Argenio P. COVID-19 in Italian paediatric patients: The experience of a tertiary children’s hospital. Acta Paediatr. 2020;109(11):2311–2. https://doi.org/10.1111/apa.15465 Epub 2020 Sep 9. PMID: 32640088; PMCID: PMC7361435.CrossRefPubMed Romani L, Chiurchiù S, Santilli V, Bernardi S, Haywood Lombardi M, Scarselli A, Villani A, CiofiDegliAtti ML, Campana A, D’Argenio P. COVID-19 in Italian paediatric patients: The experience of a tertiary children’s hospital. Acta Paediatr. 2020;109(11):2311–2. https://​doi.​org/​10.​1111/​apa.​15465 Epub 2020 Sep 9. PMID: 32640088; PMCID: PMC7361435.CrossRefPubMed
21.
go back to reference Zheng F, Liao C, Fan QH, Chen HB, Zhao XG, Xie ZG, Li XL, Chen CX, Lu XX, Liu ZS, Lu W, Chen CB, Jiao R, Zhang AM, Wang JT, Ding XW, Zeng YG, Cheng LP, Huang QF, Wu J, Luo XC, Wang ZJ, Zhong YY, Bai Y, Wu XY, Jin RM. Clinical characteristics of children with coronavirus disease 2019 in Hubei, China. Curr Med Sci. 2020;40(2):275–80. https://doi.org/10.1007/s11596-020-2172-6 Epub 2020 Mar 24. PMID: 32207032; PMCID: PMC7095065.CrossRefPubMed Zheng F, Liao C, Fan QH, Chen HB, Zhao XG, Xie ZG, Li XL, Chen CX, Lu XX, Liu ZS, Lu W, Chen CB, Jiao R, Zhang AM, Wang JT, Ding XW, Zeng YG, Cheng LP, Huang QF, Wu J, Luo XC, Wang ZJ, Zhong YY, Bai Y, Wu XY, Jin RM. Clinical characteristics of children with coronavirus disease 2019 in Hubei, China. Curr Med Sci. 2020;40(2):275–80. https://​doi.​org/​10.​1007/​s11596-020-2172-6 Epub 2020 Mar 24. PMID: 32207032; PMCID: PMC7095065.CrossRefPubMed
24.
go back to reference White A, Mukherjee P, Stremming J, Sherlock LG, Reynolds RM, Smith D, Asturias EJ, Grover TR, Dietz RM. Neonates hospitalized with community-acquired SARS-CoV-2 in a Colorado neonatal intensive care unit. Neonatology. 2020;117(5):641–5. https://doi.org/10.1159/000508962 Epub 2020 Jun 4. PMID: 32498065; PMCID: PMC7316651.CrossRefPubMed White A, Mukherjee P, Stremming J, Sherlock LG, Reynolds RM, Smith D, Asturias EJ, Grover TR, Dietz RM. Neonates hospitalized with community-acquired SARS-CoV-2 in a Colorado neonatal intensive care unit. Neonatology. 2020;117(5):641–5. https://​doi.​org/​10.​1159/​000508962 Epub 2020 Jun 4. PMID: 32498065; PMCID: PMC7316651.CrossRefPubMed
32.
go back to reference Raba AA, Abobaker A, Elgenaidi IS, Daoud A. Novel coronavirus infection (COVID-19) in children younger than one year: A systematic review of symptoms, management and outcomes. Acta Paediatr. 2020;109(10):1948–55. https://doi.org/10.1111/apa.15422 Epub 2020 Jul 6. PMID: 32557789; PMCID: PMC7323350.CrossRefPubMed Raba AA, Abobaker A, Elgenaidi IS, Daoud A. Novel coronavirus infection (COVID-19) in children younger than one year: A systematic review of symptoms, management and outcomes. Acta Paediatr. 2020;109(10):1948–55. https://​doi.​org/​10.​1111/​apa.​15422 Epub 2020 Jul 6. PMID: 32557789; PMCID: PMC7323350.CrossRefPubMed
Metadata
Title
Incidental occurrence of neutropenia in children hospitalised for COVID-19
Authors
Francesco Folino
Camilla Menis
Giada Maria Di Pietro
Raffaella Pinzani
Paola Marchisio
Samantha Bosis
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Italian Journal of Pediatrics / Issue 1/2022
Electronic ISSN: 1824-7288
DOI
https://doi.org/10.1186/s13052-022-01234-5

Other articles of this Issue 1/2022

Italian Journal of Pediatrics 1/2022 Go to the issue