Altered COVID-19 immunity in children with asthma by atopic status

• Published in: The journal of allergy and clinical immunology. Global Vol. 3; no. 2; p. 100236
• Main Authors: Tong, Sherry, Scott, Jordan C., Eyoh, Enwono, Werthmann, Derek W., Stone, Addison E., Murrell, Amelie E., Sabino-Santos, Gilberto, Trinh, Ivy V., Chandra, Sruti, Elliott, Debra H., Smira, Ashley R., Velazquez, Jalene V., Schieffelin, John, Ning, Bo, Hu, Tony, Kolls, Jay K., Landry, Samuel J., Zwezdaryk, Kevin J., Robinson, James E., Gunn, Bronwyn M., Rabito, Felicia A., Norton, Elizabeth B.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2024; Elsevier
• Subjects: Asthma; children; cockroach; immunity; Original article; RSV; SARS-CoV-2; I + V; AIM; cockroach; ARCHS; NME; Treg; I; immunity; SABA; N; Asthma; COVID-19; SARS-CoV-2; ACT; FVC; CRA; S; RSV; children; MIP; Tfh; FEV1; Ind
• ISSN: 2772-8293; 2772-8293
• DOI: 10.1016/j.jacig.2024.100236

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes a spectrum of clinical outcomes that may be complicated by severe asthma. Antiviral immunity is often compromised in patients with asthma; however, whether this is true for SARS-CoV-2 immunity and children is unknown. We aimed to evaluate SARS-CoV-2 immunity in children with asthma on the basis of infection or vaccination history and compared to respiratory syncytial viral or allergen (eg, cockroach, dust mite)-specific immunity. Fifty-three children from an urban asthma study were evaluated for medical history, lung function, and virus- or allergen-specific immunity using antibody or T-cell assays. Polyclonal antibody responses to spike were observed in most children from infection and/or vaccination history. Children with atopic asthma or high allergen-specific IgE, particularly to dust mites, exhibited reduced seroconversion, antibody magnitude, and SARS-CoV-2 virus neutralization after SARS-CoV-2 infection or vaccination. TH1 responses to SARS-CoV-2 and respiratory syncytial virus correlated with antigen-respective IgG. Cockroach-specific T-cell activation as well as IL-17A and IL-21 cytokines negatively correlated with SARS-CoV-2 antibodies and effector functions, distinct from total and dust mite IgE. Allergen-specific IgE and lack of vaccination were associated with recent health care utilization. Reduced lung function (forced expiratory volume in 1 second ≤ 80%) was independently associated with (SARS-CoV-2) peptide-induced cytokines, including IL-31, whereas poor asthma control was associated with cockroach-specific cytokine responses. Mechanisms underpinning atopic and nonatopic asthma may complicate the development of memory to SARS-CoV-2 infection or vaccination and lead to a higher risk of repeated infection in these children.