SARS-CoV-2 in children: spectrum of disease, transmission and immunopathological underpinnings
Data
2020Autor
Williams, Phoebe C.M.
Howard-Jones, Annaleise R.
Hsu, Peter
Palasanthiran, Pamela
Gray, Paul E.
McMullan, Brendan J.
Britton, Philip N.
Bartlett, Adam W.
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Resumo
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.
Palabras clave
SARS-CoV-2; COVID-19; Paediatrics; Transmission; ACE2; Multisystem inflammatory syndromeLink para o recurso
https://doi.org/10.1016/j.pathol.2020.08.001Collections
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