SARS-CoV-2 in children: spectrum of disease, transmission and immunopathological underpinnings
As the SARS-CoV-2 pandemic unfolds across the globe, consistent themes are emerging with regard to aspects of SARS-CoV-2 infection and its associated disease entities in children. Overall, children appear to be less frequently infected by, and affected by, SARS-CoV-2 virus and the clinical disease C...
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| Published in | Pathology Vol. 52; no. 7; pp. 801 - 808 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Elsevier B.V
01.12.2020
Royal College of Pathologists of Australasia. Published by Elsevier B.V |
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| Online Access | Get full text |
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| Abstract | As the SARS-CoV-2 pandemic unfolds across the globe, consistent themes are emerging with regard to aspects of SARS-CoV-2 infection and its associated disease entities in children. Overall, children appear to be less frequently infected by, and affected by, SARS-CoV-2 virus and the clinical disease COVID-19. Large epidemiological studies have revealed children represent less than 2% of the total confirmed COVID-19 cases, of whom the majority experience minimal or mild disease that do not require hospitalisation. Children do not appear to be major drivers of SARS-CoV-2 transmission, with minimal secondary virus transmission demonstrated within families, schools and community settings. There are several postulated theories regarding the relatively low SARS-CoV-2 morbidity and mortality seen in children, which largely relate to differences in immune responses compared to adults, as well as differences in angiotensin converting enzyme 2 distribution that potentially limits viral entry and subsequent inflammation, hypoxia and tissue injury. The recent emergence of a multisystem inflammatory syndrome bearing temporal and serological plausibility for an immune-mediated SARS-CoV-2-related disease entity is currently under investigation. This article summarises the current available data regarding SARS-CoV-2 and the paediatric population, including the spectrum of disease in children, the role of children in virus transmission, and host-virus factors that underpin the unique aspects of SARS-CoV-2 pathogenicity in children. |
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| AbstractList | As the SARS-CoV-2 pandemic unfolds across the globe, consistent themes are emerging with regard to aspects of SARS-CoV-2 infection and its associated disease entities in children. Overall, children appear to be less frequently infected by, and affected by, SARS-CoV-2 virus and the clinical disease COVID-19. Large epidemiological studies have revealed children represent less than 2% of the total confirmed COVID-19 cases, of whom the majority experience minimal or mild disease that do not require hospitalisation. Children do not appear to be major drivers of SARS-CoV-2 transmission, with minimal secondary virus transmission demonstrated within families, schools and community settings. There are several postulated theories regarding the relatively low SARS-CoV-2 morbidity and mortality seen in children, which largely relate to differences in immune responses compared to adults, as well as differences in angiotensin converting enzyme 2 distribution that potentially limits viral entry and subsequent inflammation, hypoxia and tissue injury. The recent emergence of a multisystem inflammatory syndrome bearing temporal and serological plausibility for an immune-mediated SARS-CoV-2-related disease entity is currently under investigation. This article summarises the current available data regarding SARS-CoV-2 and the paediatric population, including the spectrum of disease in children, the role of children in virus transmission, and host-virus factors that underpin the unique aspects of SARS-CoV-2 pathogenicity in children. |
| Author | Palasanthiran, Pamela McMullan, Brendan J. Britton, Philip N. Williams, Phoebe C.M. Howard-Jones, Annaleise R. Hsu, Peter Gray, Paul E. Bartlett, Adam W. |
| Author_xml | – sequence: 1 givenname: Phoebe C.M. orcidid: 0000-0003-2250-0594 surname: Williams fullname: Williams, Phoebe C.M. organization: Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, NSW, Australia – sequence: 2 givenname: Annaleise R. orcidid: 0000-0002-9756-2813 surname: Howard-Jones fullname: Howard-Jones, Annaleise R. organization: Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead, NSW, Australia – sequence: 3 givenname: Peter surname: Hsu fullname: Hsu, Peter organization: Department of Allergy and Immunology and Kids Research, The Children's Hospital at Westmead, NSW, Australia – sequence: 4 givenname: Pamela surname: Palasanthiran fullname: Palasanthiran, Pamela organization: Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, NSW, Australia – sequence: 5 givenname: Paul E. surname: Gray fullname: Gray, Paul E. organization: Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, NSW, Australia – sequence: 6 givenname: Brendan J. orcidid: 0000-0001-5144-3416 surname: McMullan fullname: McMullan, Brendan J. organization: Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, NSW, Australia – sequence: 7 givenname: Philip N. surname: Britton fullname: Britton, Philip N. organization: Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead, NSW, Australia – sequence: 8 givenname: Adam W. orcidid: 0000-0002-7532-9316 surname: Bartlett fullname: Bartlett, Adam W. email: adam.bartlett@health.nsw.gov.au organization: Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Randwick, NSW, Australia |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32888706$$D View this record in MEDLINE/PubMed |
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| Title | SARS-CoV-2 in children: spectrum of disease, transmission and immunopathological underpinnings |
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