Differences on Pyrexia Related Immune Responses Between COVID-19 and Influenza A Children

Abstract Background: Coronavirus disease-2019 has brought rapid challenge to the current health care system raising millions of infected patients globally. The clinical manifestations of asymptomatic patients especially children and young people will contribute to the management of current pandemic.Methods: To provide precise and comprehensive information on the less symptomatic COVID-19 children, total 62 hospitalized children aged 1-14 years with confirmation infection of either SARS-CoV-2 or influenza A were enrolled for past half of year from September 2019 to February 2020. The epidemiological, demographic, clinical, radiologic and laboratory findings were extracted from the electronic medical records of the patients. Results: We reported less fever (43.33% vs 100%, p<0.001) with lower body temperature (p<0.001) and hypoinflammatory responses occurred in COVID-19 children in comparison with influenza infection. We further showed the significant correlations between initial body temperature and multiple immune parameters to imply the role of thermoregulation on asymptomatic COVID-19 children. Conclusions: COVID-19 children were more likely to have mild symptoms and relatively slow progression. Furthermore, correlations between initial body temperature and immunological functional parameters suggested that non-susceptibility of children to SARS-CoV-2 virus may lie in the low sensitivity on thermal regulation of immune activation.