RESUMO
COVID-19 manifests as a milder disease in children than adults, but the underlying mechanisms are not fully characterized. Here we assess the difference in cellular or humoral immune responses of pediatric and adult COVID-19 patients to see if these factors contribute to the severity dichotomy. Children's non-specific immune profile is dominated by naive lymphocytes and HLA-DRhighCX3CR1low dendritic cells; meanwhile, children show strong specific antibody and T cell responses for viral structural proteins, with their T cell responses differing from adults by having weaker CD8+TNF+ T cells responses to S peptide pool but stronger responses to N and M peptide pools. Finally, viral mRNA is more abundant in pediatric patients. Our data thus support a scenario in which SARS-CoV-2 infected children contribute to transmission yet are less susceptible to COVID-19 symptoms due to strong and differential responses to the virus.
Assuntos
Anticorpos Antivirais/imunologia , COVID-19/imunologia , Imunidade Humoral , RNA Viral , SARS-CoV-2/genética , Vacinas Sintéticas/imunologia , Adolescente , Adulto , Idoso , Anticorpos Antivirais/sangue , Brasil , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Criança , Pré-Escolar , Citocinas/sangue , Feminino , Humanos , Imunidade Inata , Masculino , Pessoa de Meia-Idade , RNA Mensageiro , Glicoproteína da Espícula de Coronavírus/imunologia , Linfócitos T , Proteínas Estruturais Virais/imunologia , Adulto Jovem , Vacinas de mRNARESUMO
We evaluated the case of a patient with Papillary Fibroelastoma (PFE) that presented embolization to the upper right limb. The patient was submitted to percutaneous embolectomy, with fragment removal. The diagnosis was confirmed by transthoracic echocardiogram and anatomopathological analysis of the fragment. The patient chose to undergo the conservative clinical treatment and the follow-up has shown good evolution with no disease recurrence to date. We decided to use this rare and interesting case with the objective of reviewing the current literature and discuss the best therapeutic management.
Assuntos
Embolia/etiologia , Fibroma/complicações , Neoplasias Cardíacas/complicações , Úmero/irrigação sanguínea , Idoso , Embolia/cirurgia , Feminino , Ventrículos do Coração/patologia , Humanos , Úmero/cirurgiaRESUMO
Avaliamos o caso de uma paciente portadora de fibroelastoma papilífero (FEP) que apresentou embolização para membro superior direito. A paciente foi submetida à embolectomia percutânea, com retirada do fragmento. O diagnóstico foi confirmado por ecocardiograma transtorácico e exame anatomopatológico. Optou-se pelo tratamento clínico conservador e acompanhamento da paciente, que mostrou boa evolução e não teve recorrência do quadro até o momento. Aproveitamos esse raro e interessante caso na intenção de revisar a literatura vigente e discutir a melhor conduta terapêutica.
We evaluated the case of a patient with Papillary Fibroelastoma (PFE) that presented embolization to the upper right limb. The patient was submitted to percutaneous embolectomy, with fragment removal. The diagnosis was confirmed by transthoracic echocardiogram and anatomopathological analysis of the fragment. The patient chose to undergo the conservative clinical treatment and the follow-up has shown good evolution with no disease recurrence to date. We decided to use this rare and interesting case with the objective of reviewing the current literature and discuss the best therapeutic management.
Evaluamos el caso de una paciente portadora de fibroelastoma papilar (FEP) que presentó embolización para miembro superior derecho. La paciente fue sometida a embolectomía percutánea, con retirada del fragmento. El diagnóstico fue confirmado por ecocardiograma transtoracico y examen anatomopatológico. Se optó por el tratamiento clínico conservador y seguimiento de la paciente, que mostró la buena evolución y no tuvo recurrencia del cuadro hasta el momento. Aprovechamos este raro e interesante caso en la intención de revisar la literatura vigente y discutir la mejor conducta terapéutica.