{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:12:32Z","timestamp":1753891952150,"version":"3.41.2"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T00:00:00Z","timestamp":1639526400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold>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.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold>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.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold>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 (<jats:italic>p<\/jats:italic>= 0.004) and lower CD4+\/CD8+ ratio (<jats:italic>p<\/jats:italic>= 0.042), while adult patients, compared with matched controls, had lower CD14+ monocytes (<jats:italic>p<\/jats:italic>= 0.032). Adult patients were also categorized as experiencing critical or severe illness on admission and, compared with severe patients, had lower total lymphocytes (<jats:italic>p<\/jats:italic>&amp;lt; 0.047), CD3+ T-lymphocytes (<jats:italic>p<\/jats:italic>&amp;lt; 0.002), and CD3+ CD8+ T cells (<jats:italic>p<\/jats:italic>= 0.001) and, on the other hand, had higher CD3+ CD4+ T cells (<jats:italic>p<\/jats:italic>= 0.012) and CD4+\/CD8+ ratio (<jats:italic>p<\/jats:italic>= 0.003). Non survived adults, compared with survived patients, had significantly lower CD3+ T-lymphocyte (<jats:italic>p<\/jats:italic>= 0.005).<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold>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.<\/jats:p>","DOI":"10.3389\/fped.2021.736013","type":"journal-article","created":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T11:01:49Z","timestamp":1639566109000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Innate and Adaptive Immunity Imbalance With Severe 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