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Infant Study Reveals Divergent Immune Responses to RSV and COVID-19 With Treatment Implications

Rapid, single-cell blood profiling in hospitalized infants uncovered virus-specific signatures that can guide care.

Overview

  • Published in Science Translational Medicine, the St. Jude and Jackson Laboratory study analyzed blood from 19 RSV cases, 30 SARS-CoV-2 cases, and 17 healthy controls collected within 24 hours of admission.
  • Both infections showed similar interferon-driven antiviral signaling despite striking downstream differences across immune cell types.
  • RSV in infants was marked by low systemic inflammation, depleted and less functional natural killer cells, reduced interferon-gamma, and epigenetic reprogramming with dampened IL-1B and NF-κB activity.
  • Infant SARS-CoV-2 cases displayed broad proinflammatory activation across cell types, including elevated TNF-alpha and increased NF-κB pathway activity.
  • The authors caution against routine steroid use for RSV in infants and note that targeted anti-inflammatory therapy may benefit severe pediatric COVID-19.