Pathophysiology of COVID-19 : Why Children Fare Better than Adults?
The world is facing Coronavirus Disease-2019 (COVID-19) pandemic, which is causing a large number of deaths and burden on intensive care facilities. It is caused by Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) originating in Wuhan, China. It has been seen that fewer children contract COVID-19 and among infected, children have less severe disease. Insights in pathophysiological mechanisms of less severity in children could be important for devising therapeutics for high-risk adults and elderly. Early closing of schools and day-care centers led to less frequent exposure and hence, lower infection rate in children. The expression of primary target receptor for SARS-CoV-2, i.e. angiotensin converting enzyme-2 (ACE-2), decreases with age. ACE-2 has lung protective effects by limiting angiotensin-2 mediated pulmonary capillary leak and inflammation. Severe COVID-19 disease is associated with high and persistent viral loads in adults. Children have strong innate immune response due to trained immunity (secondary to live-vaccines and frequent viral infections), leading to probably early control of infection at the site of entry. Adult patients show suppressed adaptive immunity and dysfunctional over-active innate immune response in severe infections, which is not seen in children. These could be related to immune-senescence in elderly. Excellent regeneration capacity of pediatric alveolar epithelium may be contributing to early recovery from COVID-19. Children, less frequently, have risk factors such as co-morbidities, smoking, and obesity. But young infants and children with pre-existing illnesses could be high risk groups and need careful monitoring. Studies describing immune-pathogenesis in COVID-19 are lacking in children and need urgent attention.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2020 |
---|---|
Erschienen: |
2020 |
Enthalten in: |
Zur Gesamtaufnahme - volume:87 |
---|---|
Enthalten in: |
Indian journal of pediatrics - 87(2020), 7 vom: 14. Juli, Seite 537-546 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Dhochak, Nitin [VerfasserIn] |
---|
Links: |
---|
Themen: |
ACE-2 |
---|
Anmerkungen: |
Date Completed 02.07.2020 Date Revised 07.12.2022 published: Print-Electronic Citation Status MEDLINE |
---|
doi: |
10.1007/s12098-020-03322-y |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM309927889 |
---|
LEADER | 01000naa a22002652 4500 | ||
---|---|---|---|
001 | NLM309927889 | ||
003 | DE-627 | ||
005 | 20231225135003.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231225s2020 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1007/s12098-020-03322-y |2 doi | |
028 | 5 | 2 | |a pubmed24n1033.xml |
035 | |a (DE-627)NLM309927889 | ||
035 | |a (NLM)32410003 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Dhochak, Nitin |e verfasserin |4 aut | |
245 | 1 | 0 | |a Pathophysiology of COVID-19 |b Why Children Fare Better than Adults? |
264 | 1 | |c 2020 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 02.07.2020 | ||
500 | |a Date Revised 07.12.2022 | ||
500 | |a published: Print-Electronic | ||
500 | |a Citation Status MEDLINE | ||
520 | |a The world is facing Coronavirus Disease-2019 (COVID-19) pandemic, which is causing a large number of deaths and burden on intensive care facilities. It is caused by Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) originating in Wuhan, China. It has been seen that fewer children contract COVID-19 and among infected, children have less severe disease. Insights in pathophysiological mechanisms of less severity in children could be important for devising therapeutics for high-risk adults and elderly. Early closing of schools and day-care centers led to less frequent exposure and hence, lower infection rate in children. The expression of primary target receptor for SARS-CoV-2, i.e. angiotensin converting enzyme-2 (ACE-2), decreases with age. ACE-2 has lung protective effects by limiting angiotensin-2 mediated pulmonary capillary leak and inflammation. Severe COVID-19 disease is associated with high and persistent viral loads in adults. Children have strong innate immune response due to trained immunity (secondary to live-vaccines and frequent viral infections), leading to probably early control of infection at the site of entry. Adult patients show suppressed adaptive immunity and dysfunctional over-active innate immune response in severe infections, which is not seen in children. These could be related to immune-senescence in elderly. Excellent regeneration capacity of pediatric alveolar epithelium may be contributing to early recovery from COVID-19. Children, less frequently, have risk factors such as co-morbidities, smoking, and obesity. But young infants and children with pre-existing illnesses could be high risk groups and need careful monitoring. Studies describing immune-pathogenesis in COVID-19 are lacking in children and need urgent attention | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Review | |
650 | 4 | |a ACE-2 | |
650 | 4 | |a Adaptive immunity | |
650 | 4 | |a Innate immunity | |
650 | 4 | |a Pathogenesis | |
650 | 4 | |a SARS-CoV2 | |
650 | 7 | |a Peptidyl-Dipeptidase A |2 NLM | |
650 | 7 | |a EC 3.4.15.1 |2 NLM | |
650 | 7 | |a ACE2 protein, human |2 NLM | |
650 | 7 | |a EC 3.4.17.23 |2 NLM | |
650 | 7 | |a Angiotensin-Converting Enzyme 2 |2 NLM | |
650 | 7 | |a EC 3.4.17.23 |2 NLM | |
700 | 1 | |a Singhal, Tanu |e verfasserin |4 aut | |
700 | 1 | |a Kabra, S K |e verfasserin |4 aut | |
700 | 1 | |a Lodha, Rakesh |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Indian journal of pediatrics |d 1945 |g 87(2020), 7 vom: 14. Juli, Seite 537-546 |w (DE-627)NLM000070742 |x 0973-7693 |7 nnns |
773 | 1 | 8 | |g volume:87 |g year:2020 |g number:7 |g day:14 |g month:07 |g pages:537-546 |
856 | 4 | 0 | |u http://dx.doi.org/10.1007/s12098-020-03322-y |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 87 |j 2020 |e 7 |b 14 |c 07 |h 537-546 |