Case report: PDF OnlyImmune monitoring of a child with autoimmune hepatitis and type 1 diabetes during COVID-19 infectionYuksel, Muhammeda,,b,,c; Akturk, Hacerb; Arikan, Cigdema,,b,,cAuthor Information aPaediatric Gastroenterology-Hepatology/Liver Transplantation Centre, Koç University bKoç University Paediatric infectious diseases cKoç University Research Center for Translational Medicine (KUTTAM)-Liver Immunology Lab, Istanbul, Turkey Received 10 May 2020 Accepted 14 May 2020 Correspondence to Cigdem Arikan, MD, Koç University School of Medicine, Pediatric GI and Hepatology, Liver Transplantation Center, Istanbul, Turkey, Tel: +90 533 6227698; fax: +90 (0) 212 311 34 10; e-mail: email@example.com European Journal of Gastroenterology & Hepatology: June 16, 2020 - Volume Publish Ahead of Print - Issue - doi: 10.1097/MEG.0000000000001804 Free PAP Metrics Abstract Immunocompromised patients may be at increased risk to develop COVID-19 during the 2019 β-coronavirus infection. We present the unique opportunity we had to monitor the liver, IL-6 and immune cell course before, during and after COVID-19 in a boy with autoimmune hepatitis (AIH) and type 1 diabetes (T1D). CD4+ and CD8+ T cells frequencies decreased because of prednisolone, followed by a plateauing increase whereas CD19+CD20+ B cell increased strongly and was unaffected by COVID-19 infection. Moreover, the percentage of activated CD8+ T cells expressing HLA-DR (CD8+HLA-DR+) increased during COVID-19 and subsided after its clearance. Total regulatory T cells (Tregs: CD4+CD25+CD127lowFOXP3+) remained stable. Although activated Tregs (CD4+CD45RA-FOXP3high) strongly increased upon prednisolone, it decreased afterwards. Furthermore, regulatory B cells (Bregs: CD19+CD20+CD24highCD38high) declined sharply owing to prednisolone. Serum IL-6 remained undetectable at all times. We demonstrated for the first time immune monitoring in a child with AIH and T1D before, during and after COVID-19. We hypothesize that continuing with low level of prednisolone without azathioprine may have abrogated activated Tregs, Bregs and IL-6 production and therefore permitting the activation of CD8+ T cells, clearing the virus. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.