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Background: Cytokine storm has been observed in some patients with SARS-CoV-2 due to excessive pro-inflammatory response. Foxp3+ regulatory T cells (Tregs) are a distinct population of CD4+ lymphocytes identified by their expression of transcription factor forkhead homeobox protein-3 (Foxp3). These cells down-regulate immune responses in inflammatory and autoimmune diseases. Objective: This pilot study was aimed to investigate the levels of CD4+CD25+Foxp3+ Tregs in children with SARS-CoV-2. Methods: frequency of Tregs was measured by flow cytometry in 20 patients with SARS-CoV-2, 6 months to 15 years old; 6 had COVID-19 and 14 had multisystem inflammatory syndrome in children (MIS–C). They were compared to 20 age- and sex-matched healthy children as a control group. Results: There was no significant difference between patients with SARS-CoV-2 infection and healthy control children in the frequency of Tregs (P=0.068). Decreased numbers of Tregs were found in only 10% of SARS-CoV-2 patients. Patients with severe SARS-CoV-2 were comparable to those with the moderate disease in terms of Tregs' levels. The frequency of Tregs correlated negatively with neutrophil counts in our series (p=0.036). Attempts of correlation with other inflammatory markers of SARS-CoV-2 were insignificant. Conclusion: Decreased levels of Tregs were found in only 10% of our SARS-CoV-2 infected children. The frequency did not correlate with the disease severity or levels of routine inflammatory markers of SARS-CoV-2. Thus, Tregs expression does not seem to have a role in the up-regulated immune response seen in moderate and severe SARS-CoV-2 infection. Our conclusions are limited by the sample size.
DOI
10.21608/ejpa.2021.199582
Keywords
CD4+CD25+Foxp3+ Tregs, COVID-19, MIS–C, SARS-CoV-2
Authors
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Professor of Pediatrics, Faculty of Medicine, Ain Shams University
Email
gehan.mostafa2000@yahoo.com
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Pediatric ICU, Ain Shams University
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Department of Pediatrics,
Faculty of Medicine, Ain Shams University,
Cairo, Egypt.
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-MiddleName
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Department of Clinical Pathology,
Faculty of Medicine, Ain Shams University,
Cairo, Egypt.
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-MiddleName
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Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo
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The Pediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt
Email
gh.a.haliem@hotmail.com
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-Link
https://ejpai.journals.ekb.eg/article_199582.html
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https://ejpai.journals.ekb.eg/service?article_code=199582
Publication Title
The Egyptian Journal of Pediatric Allergy and Immunology
Publication Link
https://ejpai.journals.ekb.eg/
MainTitle
Frequency of CD4+CD25+Foxp3+ regulatory T cells (Tregs) in peripheral blood of pediatric patients with SARS CoV-2 Infection: a pilot study