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Published on: November 5, 2021
Coronavirus Disease 2019 Infection among Children: Pathogenesis, Treatment, and Outcome
Krishna Rao Gurugubelli1, Ballambattu Vishnu Bhat2
1Department of Biochemistry, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India.
Insights
Children infected with COVID-19 often have milder symptoms than adults, but their role in transmission is unclear. Early isolation is crucial for newborns born to mothers with COVID-19.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Coronavirus disease 2019 (COVID-19) poses risks, particularly to neonates and children.
- Pediatric COVID-19 cases are generally milder than adult cases, with the reasons for this difference remaining unclear.
- The developing immune systems and frequent respiratory infections in children may influence their response to COVID-19.
Purpose of the Study:
- To review the epidemiology and molecular pathogenesis of COVID-19 in pediatric populations.
- To explore aspects including vertical transmission, imaging, complications, and treatment options for pediatric COVID-19.
- To highlight the need for vaccines and effective antiviral drugs for COVID-19.
Main Methods:
- Literature review of COVID-19 in neonates and children.
- Analysis of molecular pathogenesis, focusing on the angiotensin-converting enzyme 2 receptor and inflammatory mediators.
- Examination of prognostic factors and therapeutic strategies, including corticosteroids and antiviral agents.
Main Results:
- COVID-19 infection in children typically presents with milder symptoms and better prognosis compared to adults.
- Asymptomatic pediatric cases may significantly contribute to the overall transmission of the virus.
- Multisystem inflammatory syndrome in children is a notable complication, linked to cytokine release syndrome.
Conclusions:
- While intrauterine transmission of COVID-19 lacks strong evidence, neonates require isolation from infected mothers.
- Further research into pediatric COVID-19 pathogenesis and host- P.I. response is warranted.
- Development of pediatric-specific vaccines and antiviral therapies is a critical need.
Abstract:
Coronavirus disease 2019 (COVID-19) is a contagious disease that may lead to respiratory distress syndrome and even death. Neonates and children are most vulnerable population to COVID-19 infection; however, the infection is usually milder and has a better prognosis in pediatric patients compared with adults. It remains unclear why pediatric population is less symptomatic than adults. Children frequently experience respiratory infections and their immune system is in developing stage. However, large proportion of the asymptomatic pediatric population may contribute to transmission. This review explored several aspects of COVID-19 infection such as its epidemiology, its molecular pathogenesis with respect to angiotensin-converting enzyme 2 receptor and inflammatory mediators, intrauterine vertical transmission, imaging findings, and complications like cytokine release syndrome (multisystem inflammatory syndrome in children). We also looked at prognostic factors and treatment modalities like corticosteroids, RNA replicate inhibitors, protease inhibitors, Bruton tyrosine kinase inhibitor, that is, acalabrutinib and convalescent plasma therapy. Since there is no strong evidence for the intrauterine transmission, early isolation should be performed to protect a neonate from a COVID-19 infected mother. Development of vaccine and an effective antiviral drug are the need of the hour.
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