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COVID-19 in children: Heterogeneity within the disease and hypothetical pathogenesis

Narissara Suratannon1,2, Willem A Dik2,3, Pantipa Chatchatee4

  • 1Pediatric Allergy &Clinical Immunology Research Unit, Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, Thailand.

Asian Pacific Journal of Allergy and Immunology
|September 29, 2020
PubMed

Insights

Children typically experience mild coronavirus disease 2019 (COVID-19), but severe illness and multisystem inflammatory syndrome in children (MIS-C) can occur, particularly in those with comorbidities or genetic predispositions.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Immunology

Background:

  • Coronavirus disease 2019 (COVID-19) in children usually presents with mild, self-limiting symptoms.
  • Severe COVID-19 and multisystem inflammatory syndrome in children (MIS-C) can occur, especially in younger children or those with underlying health conditions.
  • MIS-C shares similarities with Kawasaki disease shock syndrome and may be linked to genetic predisposition and an overactive immune response to SARS-CoV-2.

Purpose of the Study:

  • To review the clinical presentations of mild and severe COVID-19 in children.
  • To describe the clinical characteristics of multisystem inflammatory syndrome in children (MIS-C).
  • To explore potential immunobiological mechanisms underlying protection in children and the development of MIS-C.

Main Methods:

  • Literature review of clinical phenotypes of COVID-19 and MIS-C in pediatric populations.
  • Discussion of immunobiological factors influencing disease course and MIS-C development.
  • Synthesis of current understanding regarding SARS-CoV-2 infection in children.

Main Results:

  • Children exhibit a spectrum of COVID-19 severity, from mild to severe disease.
  • MIS-C is a distinct clinical entity in children following SARS-CoV-2 infection, characterized by inflammation.
  • Genetic factors and immune system overactivity play a role in severe COVID-19 and MIS-C pathogenesis.

Conclusions:

  • Understanding the varied clinical presentations of COVID-19 in children is crucial.
  • MIS-C represents a significant post-infectious complication requiring further investigation.
  • Further research into the immunobiology of pediatric SARS-CoV-2 infection is needed to inform prevention and treatment strategies.

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