2160. Mucosal Antiviral Cytokine Responses Are Impaired in Children and Adolescents with Severe COVID-19

Abstract Background The factors associated with severe COVID-19 in pediatric patients remain poorly understood. We sought to determine whether mucosal innate immunity cytokines were disease severity children and adolescents acute COVID-19. Methods Single-center, prospective study including < 21 years of age hospitalized because symptomatic from 3/2020 1/2021, age, sex race matched pre-pandemic (2016-2019) healthy controls. Nasopharyngeal (NP) samples obtained at enrollment for measurement SARS-CoV-2 viral loads by rt-PCR cytokine concentrations using a 92-plex inflammation/antiviral panel (Olink). Disease was assessed the need supplemental oxygen or PICU admission, classified as non-severe based on these two parameters. Statistical analyses performed R studio Benjamini-Hochberg applied adjust multiple comparisons. Results Of 75 (median IQR age: 3.4 [0.2-15.3] years), 28 (37%) (19 PICU; 25 oxygen) 47 (63%) non-severe. Children predominantly male had an underlying condition more frequently than those (79% vs 49% respectively; p< 0.01, Table 1). comparable between groups, yet significantly higher C-reactive protein (p=0.04), frequent lymphopenia (p=0.03) cardiac involvement received directed therapies commonly (p< 0.001). Comparative identified 24 that different versus 45 those, IFN-γ (p=0.004), CXCL10 (p=0.01), CXCL11 (p=0.02) CCL19 lower (Fig 1.Demographic clinical characteristics COVID-19*Bolded p-values indicates statistical significance. Abbreviations: N, number. CRP, C-Reactive protein; PICU, intensive care unit.**Other following conditions: prematurity, endocrine conditions, immunocompromising trisomy complex care. Ł Lymphopenia defined ALC <4,500 cells/μl infants, <1,500 cells /μl >12 months Continuous variables displayed medians 25%-75% interquartile ranges (IQR), Mann-Whitney test used differences groups; Kruskal-Wallis & Dunn’s correction three groups (p-values*). Categorical data expressed numbers proportions (in parenthesis) analyzed Fisher’s exact Chi square test. Figure 1.Nasal antiviral/regulatory according Conclusion Mucosal decreased These findings suggest impaired immune responses might favor progression children. Disclosures Amy Leber, PhD, BioFire: Advisor/Consultant|BioFire: Grant/Research Support|Biorad: Advisor/Consultant|Cepheid: Support Octavio Ramilo, MD, Adagio: Advisor/Consultant|Bill Melinda Gates Foundation: Support|Janssen: Advisor/Consultant|Janssen: Support|Lilly: Advisor/Consultant|Merck: Support|NIH: Support|Pfizer: Advisor/Consultant|Pfizer: Honoraria|Sanofi: Advisor/Consultant|Sanofi: Honoraria Asuncion Mejias, MsCS, AstraZeneca: Honoraria|Janssen: Support|Merck: Support|Roche: Advisor/Consultant|Sanofi-Pasteur: Honoraria.