Evaluation of B-Cell Repertoire Among Recovered COVID-19 Pediatric Patients

Abstract

Abstract Background Severe acute respiratory syndrome-coronavirus 2 (SARS-COV-2) infection results in both innate and adaptive immune response. Humoral immunity towards SARS-COV2 is in part clinically translated into production of several SARS- COV2 antibodies. Objective To assess the status of B-cells subpopulation among pediatric patients recovered from COVID-19 infection and study the effect of the initial presentation of COVID 19 infection on the B cells subpopulation post recovery and also its status in MIS-C group. Patients and Methods This was a cross-sectional study that was conducted at the Pediatric Intensive Care Unit (PICU) and inpatient wards at Children’s Hospital, Ain Shams University. Thirty patients were recruited 6 months after being recovered and discharged from the Hospital. The clinical and routine laboratory data of these patients were reviewed and reported from the medical records. I evaluated history and clinical data in order to classify the patients into COVID-19 group and MIS-C group according to clinical picture and complications. Also, all patients were clinically evaluated to ensure absence of any medical illness and no current treatment. Complete blood picture and flowcytometric assessment of B cells, class switched memory B cells and plasmablasts were done for all patients. Results The ages of the studied patients ranged between 2 months and 18 years with a median (IQR) of 6.3 (2-9) years. They were 18 females (60%) and 12 males (40%).Fever was present in most of the patients (76.6%). Four patients (13.3%) had heart failure, five patients (16.7%) had mild pneumonia and 2 (6.6%) patients were only ventilated. Among the studied patients, there were 6 patients (20 %) with multi- system inflammatory syndrome in children-COVID 19 related (MIS-C). Our patients had normal CD19, class switched memory B-cell and plasmablast 6 months after recovery [17/30(56.6%) 22/30(73.3%)26/30%(86.6)] respectively. MISC- patients had a statistically significant lower CD19 level than those with COVID-19 infection. Conclusion The B cell subpopulation was not significantly affected post COVID with no significant variation between different presentation.