Pediatric COVID-19: Immunopathogenesis, Transmission and Prevention

Abstract

Children are unique in the context of the COVID-19 pandemic. Overall, SARS-CoV-2 has a lower medical impact in children as compared to adults. A higher proportion of children than adults remain asymptomatic following SARS-CoV-2 infection and severe disease and death are also less common. This relative resistance contrasts with the high susceptibility of children to other respiratory tract infections. The mechanisms involved remain incompletely understood but could include the rapid development of a robust innate immune response. On the other hand, children develop a unique and severe complication, named multisystem inflammatory syndrome in children, several weeks after the onset of symptoms. Although children play an important role in the transmission of many pathogens, their contribution to the transmission of SARS-CoV-2 appears lower than that of adults. These unique aspects of COVID-19 in children must be considered in the benefit–risk analysis of vaccination. Several COVID-19 vaccines have been authorized for emergency use in adolescents and clinical studies are ongoing in children. As the vaccination of adolescents is rolled out in several countries, we shall learn about the impact of this strategy on the health of children and on transmission within communities.

Natural Bioactive Molecules: An Alternative Approach to the Treatment and Control of COVID-19

“…Asymptomatic patients have less evidence of viral shedding, whereas critically ill patients seem to have higher viral shedding levels [ 30 ]. The virus is extremely virulent and was shown to have a lengthy spreading period in China, according to current trends in coronavirus illness epidemiology [ 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. In the first coronavirus pandemic in Wuhan, an epidemiological analysis of 425 coronavirus patients was conducted, where 56% of the infected individuals were male, with a median age of 59 years.…”

Elucidating T Cell and B Cell Responses to SARS-CoV-2 in Humans: Gaining Insights into Protective Immunity and Immunopathology

“…Other investigators that have also evaluated T cell responses in SARS-CoV-2 infected individuals have reported a few contrasting findings based on observations of divergent clinical trajectories and disparities in T cell responses that segregate with age and gender [ 14 , 15 ]. In general, most children experience a relatively milder disease course, while individuals over the age of 65 years display a propensity to develop severe complications related to COVID-19, which may be attributable, at least in some measure, to an uncoordinated adaptive immune response that is underpinned by a relative paucity of naïve T cells [ 15 , 16 , 17 , 18 ]. These observations imply a link between the degree of T cell “experience”, as well as aging-related impairments in the immune-regulatory mechanisms involved in SARS-CoV-2 infection-associated disease outcomes.…”

“… Potential downstream applications of profiling bulk or virus-specific T cells in the context of SARS-CoV-2 infection and/or after COVID-19 vaccination. Reference(s) [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ]. …”

Special Issue “Immune Ontogeny and Vaccination in Early Life: How the Non-Human Primate Model Can Help Expand the Current Knowledge in Pediatric Immunology and Infectious Diseases Research”

“…The mechanisms involved remain incompletely understood but could include the rapid development of a robust innate immune response. In this Special Issue, Blanchard-Rohner et al (Blanchard-Rohner et al, Pediatric COVID-19: clinical presentation, pathogenesis and prevention) discussed pediatric COVID-19 and the importance of vaccination as a strategy for global health [10]. The lessons learned and experience gained from the COVID-19 pandemic will be very important for the prevention and care of other infections affecting children, and for the pathogens that will cause future pandemics [10].…”

“…In this Special Issue, Blanchard-Rohner et al (Blanchard-Rohner et al, Pediatric COVID-19: clinical presentation, pathogenesis and prevention) discussed pediatric COVID-19 and the importance of vaccination as a strategy for global health [10]. The lessons learned and experience gained from the COVID-19 pandemic will be very important for the prevention and care of other infections affecting children, and for the pathogens that will cause future pandemics [10]. There is still, undoubtedly, a need to obtain insight into early-life immunity and the mechanisms governing it in physiology and infectious conditions.…”