The course of COVID-19 in school-aged children depends on the state of humoral immunity against diphtheria

Authors

  • Halyna Pavlyshyn I. horbachevsky Ternopil National medical university, 1 maidan Voli, Ternopil, Ukraine
  • Olha Panchenko I. horbachevsky Ternopil National medical university, 1 maidan Voli, Ternopil, Ukraine
  • Kateryna Kozak I. horbachevsky Ternopil National medical university, 1 maidan Voli, Ternopil, Ukraine
  • Iryna Avramenko danylo halytsky Lviv National medical university, 69 Pekarska Str., Lviv, Ukraine
  • Olha Dyvonyak Ternopil municipal Children’s Communal hospital, 1a Clinichna Str., Ternopil, Ukraine

DOI:

https://doi.org/10.13112/PC.2023.9

Keywords:

children, COVID-19, diphtheria, humoral immunity

Abstract

Introduction: There is evidence that high titers of diphtheria antibodies are more often associated with an asymptomatic or less severe course of COVID-19. The aim of the study was to determine the features of the COVID-19 course in school-aged children depending on the state of postvaccination immunity against diphtheria toxin.
Methods. In total, 90 children aged 6 to 18 years were examined: 60 patients with confirmed SARS-CoV-2 infection and 30 children without signs of the disease (control group). There were 20 patients with a mild COVID-19 course, 31 patients with moderate disease severity and 9 patients with severe disease severity. All children were tested for the level of immunoglobulin G (IgG) against diphtheria toxin by immune-enzymatic analysis.
Results. Total serum immunoglobulin G against diphtheria toxin was 0.431 (0.113; 0.828) IU/mL. Antitoxic immunoglobulin G was 2.5 times higher in children in the control group than in patients with SARS-CoV-2 infection. A decreased level of immunoglobulin G was associated with increased disease severity. In children with specific IgG 0.01-0.2 IU/mL revaccination is recommended; therefore, 4.2% of the children in the control group, 6.8% with a mild COVID-19 course, 50% with moderate disease severity and 100% of children with severe COVID-19 needed a booster dose of diphtheria toxoid. A moderate negative correlation was observed between the level of immunoglobulin G against diphtheria toxin and ESR (r=-0.38, p=0.004), CRP (r=-0.32, p=0.021), D-dimer (r =-0.35, p=0.009), duration of hyperthermia (r=-0.49, p=0.003), and duration of treatment (r=-0.43, p=0.012).
Conclusions. Children with manifested SARS-CoV-2 infection had significantly lower levels of immunoglobulin G against diphtheria toxin compared to the control group, indicating a lower level of humoral immunity. Children with a mild course of COVID-19 had a significantly higher level of specific IgG against diphtheria toxin than those with a moderate and severe disease course.

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Published

2024-07-14

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Section

Original Scientific Paper

How to Cite

Pavlyshyn, H., Panchenko, O., Kozak, K., Avramenko, I., & Dyvonyak, O. (2024). The course of COVID-19 in school-aged children depends on the state of humoral immunity against diphtheria. Paediatria Croatica, 67(3-4). https://doi.org/10.13112/PC.2023.9

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