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COVID-19 and the differences in physiological background between children and adults and their clinical consequences

L Kapustova1, O Petrovicova, P Banovcin

  • 1Clinic of Pediatric Pneumology and Phthisiology, Faculty of Medicine, Slovak Medical University, National Institute of Children's Diseases, Bratislava, Slovak Republic. zuzana.rennerova@nudch.sk and Clinic of Pneumology and Phthisiology, Clinic of Paediatrics, Department of Clinical Immunology and Allergology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Teaching Hospital in Martin, Martin, Slovak Republic. jesenak@gmail.com.

Physiological Research
|December 16, 2021
PubMed

Insights

Children exhibit milder COVID-19 outcomes due to a robust innate immune response and trained immunity. Factors like vaccine effects and vitamin D may also contribute to better pediatric outcomes from SARS-CoV-2 infection.

Area of Science:

  • Immunology
  • Pediatrics
  • Infectious Diseases

Background:

  • The SARS-CoV-2 pandemic has impacted all age groups globally.
  • Children represent a small percentage of COVID-19 cases, typically experiencing milder disease and higher survival rates than adults.

Purpose of the Study:

  • To investigate the underlying immunological mechanisms contributing to the milder course of COVID-19 in children.
  • To explore factors influencing the differential disease severity between pediatric and adult populations.

Main Methods:

  • Review of current literature on pediatric and adult immune responses to SARS-CoV-2.
  • Analysis of proposed mechanisms including innate and adaptive immunity, receptor expression, and effects of prior vaccinations and vitamin D.

Main Results:

  • Children generally possess a stronger innate immune response and trained immunity, enabling early infection control.
  • Adults with severe COVID-19 often show suppressed adaptive immunity and dysfunctional innate responses, potentially linked to immunosenescence.
  • Differences in SARS-CoV-2 receptor expression and the influence of live attenuated vaccines and vitamin D prophylaxis in younger children are noted.

Conclusions:

  • Pediatric resilience to severe COVID-19 may be attributed to enhanced innate immunity and trained immunity.
  • Further research in larger cohorts is necessary to validate proposed mechanisms and fully understand SARS-CoV-2 pathogenesis in children.

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