Immune responses to SARS-CoV-2 infection in hospitalized pediatric and adult patients

Djamilatou Adom, Stacey R. Dillon, Jinfeng Yang, Hao Liu, Abdulraouf Ramadan, Kushi Kushekhar, Samantha Hund, Amanda Albright, Maykala Kirksey, Titilayo Adeniyan, Katherine E. Lewis, Lawrence Evans, Rebecca Wu, Steven D. Levin, Sherri Mudri, Jing Yang, Erika Rickel, Michelle Seaberg, Katherine Henderson, Chelsea J. GudgeonMartin F. Wolfson, Ryan M. Swanson, Kristine M. Swiderek, Stanford L. Peng, Keli L. Hippen, Bruce R. Blazar, Sophie Paczesny

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Children and youth infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have milder disease than do adults, and even among those with the recently described multisystem inflammatory syndrome, mortality is rare. The reasons for the differences in clinical manifestations are unknown but suggest that age-dependent factors may modulate the antiviral immune response. We compared cytokine, humoral, and cellular immune responses in pediatric (children and youth, age <24 years) ( n = 65) and adult ( n = 60) patients with coronavirus disease 2019 (COVID-19) at a metropolitan hospital system in New York City. The pediatric patients had a shorter length of stay, decreased requirement for mechanical ventilation, and lower mortality compared to adults. The serum concentrations of interleukin-17A (IL-17A) and interferon-γ (IFN-γ), but not tumor necrosis factor-α (TNF-α) or IL-6, were inversely related to age. Adults mounted a more robust T cell response to the viral spike protein compared to pediatric patients as evidenced by increased expression of CD25 + on CD4 + T cells and the frequency of IFN-γ + CD4 + T cells. Moreover, serum neutralizing antibody titers and antibody-dependent cellular phagocytosis were higher in adults compared to pediatric patients with COVID-19. The neutralizing antibody titer correlated positively with age and negatively with IL-17A and IFN-γ serum concentrations. There were no differences in anti-spike protein antibody titers to other human coronaviruses. Together, these findings demonstrate that the poor outcome in hospitalized adults with COVID-19 compared to children may not be attributable to a failure to generate adaptive immune responses.

Original languageEnglish (US)
Article numbereaay4799
JournalScience Translational Medicine
Issue number564
StatePublished - Oct 7 2020

Bibliographical note

Publisher Copyright:
Copyright © 2020 The Authors, some rights reserved.


  • Adolescent
  • Adult
  • Antibodies, Neutralizing/immunology
  • Antibodies, Viral/blood
  • Betacoronavirus/physiology
  • COVID-19
  • Child
  • Coronavirus Infections/blood
  • Cytokines/blood
  • Female
  • Hospitalization
  • Humans
  • Immunoglobulin G/metabolism
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral/blood
  • SARS-CoV-2
  • Spike Glycoprotein, Coronavirus/metabolism
  • Treatment Outcome

PubMed: MeSH publication types

  • Research Support, Non-U.S. Gov't
  • Journal Article
  • Research Support, N.I.H., Extramural


Dive into the research topics of 'Immune responses to SARS-CoV-2 infection in hospitalized pediatric and adult patients'. Together they form a unique fingerprint.

Cite this