Results
A total of 40 children with COVID-19 infection were collected in this
study, accounting for 43% of males, and 17 children without COVID-19
infection, accounting for 71% of males (P=0.391). The average age of
patients with and without COVID-19 infection was (3±3) vs. (7±6) years,
respectively (P=0.039*). In the collected cases, the length of stay of
patients with and without COVID-19 infection was (6±3) vs (7±4) years,
respectively (P=0.515). There were no statistical differences in
clinical symptoms such as fever (31[78%] vs. 10[59%],
P=0.201), nasal congestion (18[45%] vs. 6[35%], P=0.568),
runny nose (21[53%] vs. 12[71%], P=0.251), cough (36[90%]
vs. 16[94%], P>0.999), expectoration (31[78%] vs.
15[88%], P=0.476), wheeze (6[15%] vs. 5[29%], P=0.275)
and diarrhea (1[3%] vs. 1[6%], P=0.511) between COVID children
and non-COVID children. There were no significant differences in CK-MB
(22.50±10.05 vs. 17.59±5.42, P=0.091), CK (150.81±193.20 vs.
180.50±180.07, P=0.281), neutrophil ratio (40.36±19.64 vs. 43.85±16.36,
P=0.481), lymphocyte ratio (48.28±19.26 vs. 43.04±15.02, P=0.322), WBC
(10.35±5.74 vs. 10.60±5.60, P=0.813) and CRP (1.19±2.18 vs. 0.74±1.73,
P=0.232) between COVID children and non-COVID children. The expressions
of ALT (33.74±54.19 vs. 15.44±5.41, P=0.005**), AST (53.67±40.95 vs.
31.96±10.40, P=0.004*), and LDH (379.62±145.04 vs. 289.93±85.97,
P=0.013*) in the COVID-19 group were higher than those in the
non-COVID-19 group, eosinophilic granulocyte ratio (EOS%) (1.21±1.46
vs. 2.06±2.00, P=0.028*) was lower than those in the non-COVID-19 group
(Table 1).
The expression of angiotensin molecules (ACE, ACE2) and
neuropeptide-related molecules (SP, VIP, GRP, ASCL1) in peripheral blood
of COVID-19 and non-COVID-19 infected groups were detected by ELISA. The
results showed that the expression of ACE and ACE2 in the peripheral
blood of children in the COVID-19 group was not significantly higher
than that in the non-COVID-19 group (P=0.749; P=0.319, respectively),
and the level of ACE2 in severe
COVID-19 patients was lower than that in non-COVID-19 patients and
moderate COVID-19 patients (P=0.036*; P=0.029*, respectively). The level
of ASCL1 in COVID-19 patients was lower than that in non-COVID-19
patients (p=0.039*), and the level of ASCL1 in severe COVID-19 patients
was lower than that in non-COVID-19 patients (p= 0.021*). There were no
significant changes in VIP, SP and GRP expression in COVID-19 and
non-COVID-19 groups (P=0.373,
P=0.401, P=0.464, respectively) (Figure 1).
ACE was positively correlated with WBC (r=0.359, P=0.023*), but was not
significantly correlated with N% (r=0.003, P=0.987), L% (r=0.039,
P=0.810), PLT (r=0.025, P=0.877), CRP (r=0.099, P=0.543), ALT (r=0.094,
P=0.563), AST (r=0.116, P=0.476), LDH (r=-0.081, P=0.621) (Figure 2).
ACE2 was positively correlated with PLT (r=0.345, P=0.029*) and
negatively correlated with N% (r=-0.314, P=0.049*), but was not
significantly correlated with L% (r=0.311, P=0.051), WBC (r=0.278,
P=0.083), CRP (r=-0.139, P=0.394), ALT (r=0.102, P=0.532), AST (r=0.089,
P=0.584), LDH (r=-0.037, P=0.821) (Figure 3).
ASCL1 respectively with N % (r = -0.534, p < 0.001* * *),
CRP(r =-0.522, p < 0.001 * * *) negatively correlated, L % (r
= 0.572, P < 0.001 * * *) and AST (r = 0.496, p = 0.001 * *)
were positively correlated. There was no significant correlation with
WBC, PLT, ALT, LDH (r=-0.092, P=0.573; r=0.059, P=0.720; r=0.291,
P=0.069; r=0.216, P=0.182, respectively) (Figure 4).
GRP and VIP were not significantly correlated with N% (r=0.169,
P=0.297; r=-0.087, P=0.595, respectively), L% (r=-0.147, P=0.364;
r=0.093, P=0.567, respectively), WBC (r=0.067, P=0.682; r=-0.130,
P=0.424, respectively), PLT (r=-0.074, P=0.649; r=-0.173, P=0.286,
respectively), CRP (r=0.221, P=0.172; r=0.133, P=0.412, respectively),
ALT (r=0.197, P=0.223; r=-0.085, P=0.604, respectively), AST (r=-0.140,
P=0.391; r=0.120, P=0.461, respectively), and LDH (r=0.026, P=0.875;
r=0.048, P=0.768, respectively) (Figure 5,6).
SP was positively correlated with L% (r=0.329, P=0.038*), but was not
significantly correlated with N% (r=-0.310, P=0.051), WBC (r=0.028,
P=0.866), PLT (r=-0.046, P=0.780), CRP (r=-0.188, P=0.246), ALT
(r=0.080, P=0.625), AST (r=-0.007, P=0.967), LDH (r=0.068, P=0.677)
(Figure 7).