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Can data from paediatric cohorts solve the COVID-19 puzzle?
Lien Anh Ha Do1,2, Jeremy Anderson1, Edward Kim Mulholland1,2,3
1Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Australia.
Plos Pathogens
|September 9, 2020
Summary
COVID-19 (coronavirus disease 2019) is more severe in adults than children due to biological differences. Nuclear factor kappa B (NF-kB) may explain severe COVID-19 in adults and PIMS-TS in children.
Area of Science:
- Virology
- Immunology
- Pediatrics
Background:
- COVID-19 (coronavirus disease 2019) presents with significantly greater severity in adults compared to children.
- The underlying biological mechanisms driving this disparity in COVID-19 clinical outcomes are not fully understood.
- Severe acute respiratory syndrome (SARS), caused by SARS-CoV-1 in 2003, offers a comparative model for understanding SARS-CoV-2 pathogenesis.
Purpose of the Study:
- To elucidate the biological reasons for differential COVID-19 severity between adult and pediatric populations.
- To hypothesize potential mechanisms explaining the observed age-related differences in COVID-19.
- To explore the role of specific molecular pathways, such as NF-kB, in COVID-19 pathogenesis.
Main Methods:
- Comparative analysis of recent virological and immunological data for COVID-19 in adults and children.
- Contrasting current COVID-19 data with historical data from SARS (2003).
- Formulating hypotheses based on the synthesis of available scientific literature.
Main Results:
- Significant differences in virological and immunological responses to SARS-CoV-2 between age groups.
- Identification of potential age-specific pathogenic pathways.
- NF-kB emerges as a potential key factor influencing disease severity.
Conclusions:
- NF-kB activation may be a critical determinant of severe COVID-19 manifestations in adults.
- NF-kB could also play a role in the rare pediatric inflammatory multisystem syndrome (PIMS-TS) associated with SARS-CoV-2.
- Further research is warranted to validate the role of NF-kB in age-dependent COVID-19 outcomes.
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