They also have been implicated in COVID-19 pathogenesis57 and the cytokine storm.57–61 Upregulation of PD-L1 and CD40, both associated with immune dysregulation and long COVID in children, further suggests altered immune signaling.62, 63 CDCP1, similarly elevated, has been linked to persistent post-infectious inflammation.64 It should be noted that increased T-cell surface markers maybe representative of higher of T-cell subpopulations in our exposed compared to unexposed neonates. Here, CD40 is linked to COVID-19.