SARS-CoV-2 Liability: The Hidden Mystery Behind Its Presentation in Children

Coronavirus disease 2019 (COVID-19) is now of global concern because of its rapid dissemination across the globe. It is unclear whether COVID-19 is as hazardous as previous coronavirus outbreaks, though there are many overlapping similarities between these viruses. An important similar feature includes the virus's pathogenicity in pediatric populations. Additionally, genetic factors are recognized as important contributors to infectious disease susceptibility. Further understanding of this area can help make sense of the pathogenesis of COVID-19 and the varying clinical spectrums of the disease. The available data suggests that COVID-19 most likely produces mild symptoms in a healthy pediatric population regardless of their age, and recovery appears to occur without serious sequelae in the vast majority. However, the available data regarding the detailed repercussions of COVID-19 in children is very limited. To date, only some theoretical issues could be responsible for the COVID-19 susceptibility in pediatric patients, including a more intact but mature immune system within the respiratory system, possible role of viral interference in pediatric populations that are more often infected with common respiratory viruses, possible role of gut-lung axis, and a respiratory system with different amounts of cellular receptors for COVID-19 virus. Moreover, there is little data available on the genetic risk factors for COVID-19, and future research should aim to cover this gap in knowledge. This chapter aims to summarize the recently published data on the impact of COVID-19 in the pediatric population and to systematically review the available evidence of genetic risk factors for COVID-19.