Publications by authors named "Carolina Davenport"

3 Publications

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Blood neutrophils from children with COVID-19 exhibit both inflammatory and anti-inflammatory markers.

EBioMedicine 2021 May 9;67:103357. Epub 2021 May 9.

División Infectología, Hospital General de Agudos Dr. Juan A. Fernández, Av. Cerviño 3356, CABA C1425, Argentina.

Background: Perhaps reflecting that children with COVID-19 rarely exhibit severe respiratory symptoms and often remain asymptomatic, little attention has been paid to explore the immune response in pediatric COVID-19. Here, we analyzed the phenotype and function of circulating neutrophils from children with COVID-19.

Methods: An observational study including 182 children with COVID-19, 21 children with multisystem inflammatory syndrome (MIS-C), and 40 healthy children was performed in Buenos Aires, Argentina. Neutrophil phenotype was analyzed by flow cytometry in blood samples. Cytokine production, plasma levels of IgG antibodies directed to the spike protein of SARS-CoV-2 and citrullinated histone H3 were measured by ELISA. Cell-free DNA was quantified by fluorometry.

Findings: Compared with healthy controls, neutrophils from children with COVID-19 showed a lower expression of CD11b, CD66b, and L-selectin but a higher expression of the activation markers HLA-DR, CD64 and PECAM-1 and the inhibitory receptors LAIR-1 and PD-L1. No differences in the production of cytokines and NETs were observed. Interestingly, the expression of CD64 in neutrophils and the serum concentration of IgG antibodies directed to the spike protein of SARS-CoV-2 distinguished asymptomatic from mild and moderate COVID-19.

Interpretation: Acute lung injury is a prominent feature of severe COVID-19 in adults. A low expression of adhesion molecules together with a high expression of inhibitory receptors in neutrophils from children with COVID-19 might prevent tissue infiltration by neutrophils preserving lung function.

Funding: This study was supported by the Ministry of Science and Technology (National Agency for Scientific and Technological Promotion, IP-COVID-19-0277 and PMO BID PICT 2018-2548), and University of Buenos Aires from Argentina (20020170100573BA).
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May 2021

[Validation of a simplified prediction rule to identify etiology in children with pneumonia].

Arch Argent Pediatr 2011 Dec;109(6):499-503

División Neumotisiología, Hospital General de Niños Pedro de Elizalde.

Introduction: Identifying on admission those children with bacterial pneumonia could reduce inappropriate antibiotic use. The BPS (Bacterial Pneumonia Score) is a clinical prediction rule that accurately identifies children with bacterial pneumonia. Because the interpretation of chest X-ray included in this model could be considered difficult, a simplified version was developed, but this version has not yet been validated in a different population.

Objective: To validate a simplified clinical prediction rule to identify children with an increased risk of having bacterial pneumonia.

Methods: Children aged under 5 years, hospitalized for pneumonia (viral or bacterial) were included. On admission, axillary temperature, age, absolute neutrophil count, bands, and chest radiograph were evaluated.

Results: We included 168 patients (23 with bacterial pneumonia and 145 with viral pneumonia). Those with bacterial pneumonia showed a score higher than those with viral pneumonia (5.3 ± 2.5 vs. 2.6 ± 2.02; p <0.001). A score =3 points was identified as the optimum cutoff value to predict bacterial pneumonia (aucROC= 0.79; 95% IC: 0.68-0.90), and was more frequent among patients with bacterial than viral pneumonia (19/23 vs. 42/145, p= 0.003; OR: 4.8; CI95%: 1.4-17.6), achieving 82.6% sensitivity, 50.3% specificity, 20.9% positive predictive value, 94.8% negative predictive value, 1.66 positive likelihood ratio and 0.35 negative likelihood ratio.

Conclusions: The evaluated simplified prediction rule showed a limited diagnostic accuracy on identifying children with bacterial pneumonia, being less accurate than the BPS.
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December 2011