Coronavirus Disease 2019 (COVID-19) in Children - What We Know So Far and What We Do Not

Balasubramanian, Sundaram; Rao, Neha Mohan; Goenka, Anu; Roderick, Marion; Ramanan, Athimalaipet V

doi:10.1007/s13312-020-1819-5

Cited by 174 publications

(186 citation statements)

References 29 publications

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“…Brodin [3] reports Korean data showing that 6.3% of all positive cases were children under 19 years of age. (reviewed also by [1,12,15,19,21,41]).…”

Section: Discussionmentioning

confidence: 99%

“…There is a growing body of evidence from different countries with COVID-19 pandemic that children are less frequently infected with SARS-CoV-2. Children are mostly asymptomatic or experience much milder symptoms than the adults [1,7,9,12,15,19,21,41], although a low percentage of the infected children developed the pediatric multi-system inflammatory syndrome [34]. Severe (2-3%) or critical illness (0.61%) has been reported in pediatric patients analyzed in two systematic reviews and meta-analysis of data from several countries [8,17].…”

Section: Introductionmentioning

confidence: 99%

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Children were less frequently infected with SARS-CoV-2 than adults during 2020 COVID-19 pandemic in Warsaw, Poland

Kuchar

Załęski

Wronowski

et al. 2020

Eur J Clin Microbiol Infect Dis

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Clinical data suggest that during the current COVID-19 pandemic, children are less prone than adults to SARS-CoV-2 infection. Our purpose was to determine the frequency of SARS-CoV-2 in children vs. adults during the 2020 pandemic in Warsaw, Poland, and to investigate whether RSV and/or influenza A/B infections were associated with SARS-CoV-2 infections. We present results of RT-PCR tests for SARS-CoV-2 performed in Warsaw, Poland. Some of the pediatric subjects were also PCRtested for RSV, and A and B influenza. We compared the test results from the four groups of symptomatic and asymptomatic subjects: 459 symptomatic pediatric patients (children 0-18 years old), 1774 symptomatic adults, 445 asymptomatic children, and 239 asymptomatic adults. 3.26% (15/459) of symptomatic pediatric patients were positive for SARS-CoV-2 in contrast to 5.58% (99/1774) of symptomatic adults (p = 0.0448). There were no SARS-CoV-2 positive cases in the group of asymptomatic children (0/445) and two positive cases in the group of asymptomatic adults (2/239), i.e., 0.83%. In the group of symptomatic pediatric patients, 17.14% (6/35) (p = 0.0002) were positive for RSV, 8.16% (4/49) were positive for influenza A, and 2.04% (1/49), thus 10.20% (5/49) (p = 0.0176) for influenza A/B. Children were less prone to SARS-CoV-2 infection than the adults during the COVID-19 pandemic in Warsaw. Higher percentage of symptomatic children was infected with RSV or influenza A/B than with SARS-CoV-2. This suggests a necessity for the testing for all these viruses for an early identification and isolation of SARS-CoV-2-positive patients for an ensuing 2020 autumn return of COVID-19.

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“…Brodin [3] reports Korean data showing that 6.3% of all positive cases were children under 19 years of age. (reviewed also by [1,12,15,19,21,41]).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Children were less frequently infected with SARS-CoV-2 than adults during 2020 COVID-19 pandemic in Warsaw, Poland

Kuchar

Załęski

Wronowski

et al. 2020

Eur J Clin Microbiol Infect Dis

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show abstract

“…Similarly, in our study group, none of the patients required intensive care and/or ventilation support, even the hospitalized one, and all of them recovered completely. Some hypothetical ideas were emerged regarding non-severity of the disease in childhood such as; lower exposure to viruses and air pollution due to being isolated at home mostly thanks to shutting down of the schools, lower smoking rates, higher viral co-infections which may lead to limit replication of SARS CoV-2, and possibly different distribution of ACE2 which acts as a receptor for virus entry into human cells [14].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Health Status of Children with Autoinflammatory Diseases During COVID-19 Pandemic

Haşlak

Yıldız

Adroviç

et al. 2020

Preprint

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Since concerns have been raised that comorbidity is a significant risk factor for Coronavirus Disease-2019 (COVID-19), there is an urgent need to perform studies which evaluate patients with chronic diseases such as autoinflammatory diseases (AIDs). We prepared a web-based survey investigating the clinical findings and contagion histories. Patients with AIDs, were included in the study. Confirmed COVID-19 cases, patients with contact history and patients with symptoms which were highly suggestive of COVID-19 were called via phone or recruited to a video or face to face appointment. Data of AIDs were obtained from their medical records, retrospectively. Laboratory and screening findings were confirmed by using our national health registry website and they were re-examined, if required. There were 404 patients (217 female) eligible for the enrollment. During pandemic, 375 (93%) were on colchicine treatment, and 48 (11.8%) were receiving biologic treatment. 24 out of 404 patients had admission to hospital due to COVID-19 suspicion. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were identified through rhino-pharyngeal swabs in 7 patients, 6 of whom were only on colchicine treatment. Only one patient with no finding of any severe respiratory complications has been hospitalized. All of them recovered completely. Among patients on biologic drugs, neither a symptom nor a positive polymerase chain reaction test was detected that would have been suggestive of COVID-19. In conclusion, pediatric patients with AIDs, those receive either biologic treatment or colchicine may not be at increased risk for either being infected or having worse disease course.

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“…In some papers, it has been proposed a different distribution of ACE2 receptors, the receptor of coronavirus, in children compared to adults [2], but if this is true and in which cells this occurs is not clear yet. It is well known that the respiratory tract and in particular the lung is the preferred target of coronavirus.…”

Section: Introductionmentioning

confidence: 99%

Is macrophages heterogeneity important in determining COVID-19 lethality?

Pagliaro

2020

Medical Hypotheses

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COVID-19 (coronavirus disease 2019) pandemic due to infection with SARS-CoV-2 has led to the death of thousands of adults worldwide. It is now clear that the hyper-inflammatory response triggered by SARS-CoV-2 plays a major role in disease severity and lethality of the infection. Macrophages are innate immune cells that sense and respond to infections by producing a plethora of inflammatory molecules and by interacting with other inflammatory cells. Therefore, macrophages may be diriment on eliminating pathogens and promoting organ repair. However, macrophages can be a major player of the so called cytokine storm and may be damaging to the tissues. It is believed that macrophage activation syndrome is induced by SARS-CoV to be lethal. Surprisingly and fortunately few children die from COVID-19. For instance, in Italy, out of more than 30.000 deaths for COVID-19, three are children. Therefore, we must wonder why? Are macrophages different in children compared to adults? In my opinion they are different. It has been demonstrated that macrophages populate the lung in three "developmental waves", and it has been suggested that similar waves may be observed in other important organs, such as the heart and kidney. It is most likely that macrophages heterogeneity is involved in determining the severity. There are no doubts that macrophages are important in determining life or death in these patients. Comparing macrophages of children with those of adults with different degrees of disease severity is, therefore, mandatory.

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Coronavirus Disease 2019 (COVID-19) in Children - What We Know So Far and What We Do Not

Cited by 174 publications

References 29 publications

Children were less frequently infected with SARS-CoV-2 than adults during 2020 COVID-19 pandemic in Warsaw, Poland

Children were less frequently infected with SARS-CoV-2 than adults during 2020 COVID-19 pandemic in Warsaw, Poland

Evaluation of Health Status of Children with Autoinflammatory Diseases During COVID-19 Pandemic

Is macrophages heterogeneity important in determining COVID-19 lethality?

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