Supplemental Digital Content is available in the text. Background: The outbreak of coronavirus disease 2019 (COVID-19) is becoming a global threat. However, our understanding of the clinical characteristics and treatment of critically ill pediatric patients and their ability of transmitting the coronavirus that causes COVID-19 still remains inadequate because only a handful pediatric cases of COVID-19 have been reported. Methods: Epidemiology, clinical characteristics, treatment, laboratory data and follow-up information and the treatment of critically ill infant were recorded. Results: The infant had life-threatening clinical features including high fever, septic shock, recurrent apnea, petechiae and acute kidney injury and persistent declined CD3+, CD4+ and CD8+ T cells. The duration of nasopharyngeal virus shedding lasted for 49 days even with the administration of lopinavir/ritonavir for 8 days. The CD3+, CD4+ and CD8+ T cells was partially recovered 68 days post onset of the disease. Accumulating of effector memory CD4+ T cells (CD4+TEM) was observed among T-cell compartment. The nucleic acid tests and serum antibody for the severe acute respiratory syndrome coronavirus 2 of the infant’s mother who kept intimate contact with the infant were negative despite no strict personal protection. Conclusions: The persistent reduction of CD4+ and CD8+ T cells was the typical feature of critically ill infant with COVID-19. CD4+ and CD8+ T cells might play a key role in aggravating COVID-19 and predicts a more critical course in children. The prolonged nasopharyngeal virus shedding was related with the severity of respiratory injury. The transmission of SARS-CoV-2 from infant (even very critical cases) to adult might be unlikely.
【저자키워드】 Coronavirus disease 2019, T cells, lymphopenia, Infant, Critical case, 【초록키워드】 COVID-19, Treatment, coronavirus disease, coronavirus, Clinical characteristics, children, severity, CD8+ T cells, Acute kidney injury, virus, Critically ill, outbreak, nasopharyngeal, nucleic acid test, Fever, Digital, Septic shock, Follow-up, serum antibody, T-cell, information, Critical, predict, clinical feature, CD8+ T cell, CD4+ T cell, mother, administration, Injury, Contact, critical cases, reduction, acute respiratory syndrome, Pediatric patient, laboratory data, life-threatening, CD4+, content, transmission of SARS-CoV-2, CD3+, effector memory, Pediatric case, Course, reported, the disease, unlikely, cause, declined, were recorded, was related, with COVID-19, 【제목키워드】 persistent, Ill,