The evolving picture of SARS-CoV-2 and COVID-19 in children: critical knowledge gaps

Idele, Priscilla; Anthony, David; You, Danzhen; Luo, Chewe; Mofenson, Lynne M.

doi:10.1136/bmjgh-2020-003454

Cited by 17 publications

(17 citation statements)

References 30 publications

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“…This is an important alert because childhood and adolescence obesity rates are high in LA, particularly among those with lower income and socioeconomic status is associated with poor prognosis as well, as already mentioned 11,32,41,48 . It also remains to be determined if interactions with other infectious diseases, like tuberculosis, dengue and malaria—common in LA—can impact COVID‐19 severity in younger ages 24,48 …”

Section: Obesity and Covid‐19: Epidemiological Datamentioning

confidence: 97%

“…In LA, several countries (such as Paraguay, Brazil, Argentina, Guatemala and Panama) presented a significant proportion of COVID‐19 cases in those under 20 years of age 48 . Although children and adolescents pose a reduced risk of complications due to COVID‐19, some studies have shown that obesity was a major factor associated with poor prognosis in these individuals 48–50 . In the US, 61% of hospitalized children presented other comorbidities; obesity, asthma and neurologic diseases were the most frequent 48 .…”

Section: Obesity and Covid‐19: Epidemiological Datamentioning

confidence: 99%

“…Although children and adolescents pose a reduced risk of complications due to COVID‐19, some studies have shown that obesity was a major factor associated with poor prognosis in these individuals 48–50 . In the US, 61% of hospitalized children presented other comorbidities; obesity, asthma and neurologic diseases were the most frequent 48 . In a report from NYC, 22% of hospitalized children had obesity, and obesity was diagnosed in 67% of children that required mechanical ventilation 49 .…”

Section: Obesity and Covid‐19: Epidemiological Datamentioning

confidence: 99%

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Obesity and COVID‐19 in Latin America: A tragedy of two pandemics—Official document of the Latin American Federation of Obesity Societies

et al. 2020

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Summary In May 2020, Latin America became the epicenter of the COVID‐19 pandemic, a region already afflicted by social disparities, poor healthcare access, inadequate nutrition and a large prevalence of noncommunicable chronic diseases. Obesity and its comorbidities are increasingly prevalent in Latin America, with a more rapid growth in individuals with lower income, and currently a disease associated with COVID‐19 severity, complications and death. In this document, the Latin American Association of Obesity Societies and collaborators present a review of the burden of two pandemics in Latin America, discuss possible mechanisms that explain their relationship with each other and provide public health and individual recommendations, as well as questions for future studies.

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Section: Obesity and Covid‐19: Epidemiological Datamentioning

confidence: 97%

Section: Obesity and Covid‐19: Epidemiological Datamentioning

confidence: 99%

Section: Obesity and Covid‐19: Epidemiological Datamentioning

confidence: 99%

See 1 more Smart Citation

Obesity and COVID‐19 in Latin America: A tragedy of two pandemics—Official document of the Latin American Federation of Obesity Societies

et al. 2020

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“…However, there is now a growing body of evidence that children may also be less susceptible to SARS-CoV-2 infection. Specifically, a low rate of pediatric SARS-CoV-2 infections has been observed in multiple countries including China (2), Italy (3), the U.S.A (4), Spain (5, 6) and Poland (6, 7). However, this may be underrepresented since SARS-CoV-2 infections in children are frequently asymptomatic and may therefore go undetected in screening studies of symptomatic individuals (8).…”

Section: Introductionmentioning

confidence: 99%

Pediatric nasal epithelial cells are less permissive to SARS-CoV-2 replication compared to adult cells

Zhu

Chew

et al. 2021

Preprint

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Rationale: Young children (typically those <10 years old) are less susceptible to SARS-CoV-2 infection and symptoms compared to adults. However, the mechanisms that underlie these age-dependent differences remain to be determined and could inform future therapeutics for adults. Objective: To contrast the infection dynamics of SARS-CoV-2 in primary nasal epithelial cells from adults and children. Methods: Viral replication was quantified by plaque assay. The cellular transcriptome of infected and uninfected cells was assessed by RNA-seq. ACE2 and TMPRSS2 protein expression were quantified by Western Blot Measurements and Main Results: We report significantly higher SARS-CoV-2 replication in adult compared to pediatric nasal epithelial cells. This was restricted to SARS-CoV-2 infection, as the same phenomenon was not observed with influenza virus infection. The differentiational SARS-CoV-2 replication dynamics were associated with an elevated type I and III interferon response, and a more pronounced inflammatory response in pediatric cells. No significant difference between the two age groups was observed in the protein levels of ACE2 and TMPRSS2. Conclusions: Our data suggest that the innate immune response of pediatric nasal epithelial cells, and not differential receptor expression, may contribute to the reported reduced SARS-COV-2 infection and symptoms reported amongst children.

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“…Eight months after the outbreak of the COVID-19 pandemic, data on SARS-CoV-2 infection in children of different ethnicities and different ages are still lacking ( 20 ). In our study, to our knowledge the most numerous to provide ethnic, demographic, and epidemiological data from a purely pediatric population hospitalized for COVID-19 during the first wave of the pandemic, we analyze data from five provincial HUB Centers in the heart of the first epidemic wave in Northern Italy.…”

Section: Discussionmentioning

confidence: 99%

Impact of Ethnicity on COVID-19 Related Hospitalizations in Children During the First Pandemic Wave in Northern Italy

et al. 2021

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There is increasing evidence that black people and other minorities have a higher incidence of severe COVID-19 disease, but little is known about the situation of children, especially in Europe. In general children are less infected and if so, frequently show mild or asymptomatic disease, making conclusions difficult. We collected data on SARS-CoV-2 associated hospitalizations in a well-defined population of 550,180 children up to 15 years in five hub-centers during the “first wave” at the heart of the pandemic in Northern Italy. Among the 451,053 Italian citizens 80 were hospitalized as compared to 31 out of 99,127 foreign citizens, giving a significantly higher risk (odds ratio 1.76; 95% CI: 1.16–2.66) for the foreign children. The risk was highest for children of African ethnicity as compared to Italians with an odds ratio of 2.76 (95% CI: 1.56–4.87). None of the patients deceased. There was no significant difference in age (thou infants regardless of ethnicity had a 10-fold higher risk), sex, length of hospitalization or comorbidities, namely overweight. As bureaucratic, cultural and information barriers mostly affect preventive and adult services and considering that in contrast to other countries, in Italy pediatric care is guaranteed free of (out-of-pocket) charge to all people <16 years, and hospitals are densely spaced, access to health care seems to be a minor problem. Thus, other possible root causes are discussed. We believe that this is an unbiased starting point to understand and overcome the reasons for the higher risk those children experience.

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The evolving picture of SARS-CoV-2 and COVID-19 in children: critical knowledge gaps

Cited by 17 publications

References 30 publications

Obesity and COVID‐19 in Latin America: A tragedy of two pandemics—Official document of the Latin American Federation of Obesity Societies

Obesity and COVID‐19 in Latin America: A tragedy of two pandemics—Official document of the Latin American Federation of Obesity Societies

Pediatric nasal epithelial cells are less permissive to SARS-CoV-2 replication compared to adult cells

Impact of Ethnicity on COVID-19 Related Hospitalizations in Children During the First Pandemic Wave in Northern Italy

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