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[Pediatric COVID-19 - Pathophysiology, immune responses, genetic predispositions, hyperinflammatory syndrome]

Géraldine Blanchard-Rohner1, Jana Pachlopnik Schmid2, Fabio Candotti3

  • 1Unité d'immunologie-vaccinologie pédiatrique, Service de pédiatrie générale, Département de la femme, de l'enfant et de l'adolescent, HUG, 1211 Genève 14.

Revue Medicale Suisse
|February 18, 2021
PubMed

Insights

Children initially seemed spared from SARS-CoV-2, but multisystem inflammatory syndrome in children (MIS-C) emerged. This syndrome suggests an immune overreaction, with its mechanisms and risk factors still under investigation.

Area of Science:

  • Pediatric immunology
  • Infectious diseases
  • Viral pathogenesis

Background:

  • The SARS-CoV-2 pandemic initially appeared to spare children from severe illness.
  • However, a novel inflammatory condition, multisystem inflammatory syndrome in children (MIS-C), emerged in spring 2020.
  • The characteristics of MIS-C suggest an immunologic response rather than direct viral damage.

Purpose of the Study:

  • To review current knowledge on the immune response to SARS-CoV-2 in pediatric populations.
  • To summarize the understanding of multisystem inflammatory syndrome in children (MIS-C).
  • To explore potential immunologic mechanisms and risk factors for MIS-C.

Main Methods:

  • Literature review of studies on SARS-CoV-2 infection in children.
  • Analysis of clinical data and immunological findings related to MIS-C.
  • Synthesis of existing research on pediatric inflammatory responses to viral infections.

Main Results:

  • Children mount distinct immune responses to SARS-CoV-2 compared to adults.
  • MIS-C presents with significant inflammation affecting multiple organ systems.
  • The interval between SARS-CoV-2 infection and MIS-C onset points to a post-infectious immune dysregulation.

Conclusions:

  • MIS-C is a serious post-infectious complication in children, likely driven by immune system dysregulation.
  • Further research is needed to fully elucidate the pathophysiology and identify risk factors for MIS-C.
  • Understanding the pediatric immune response to SARS-CoV-2 is crucial for managing MIS-C.

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