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Age-related differences in SARS-CoV-2 binding factors: An explanation for reduced susceptibility to severe COVID-19

Thomas Abrehart1, Randy Suryadinata2, Conor McCafferty3

  • 1Department of Paediatrics, the University of Melbourne, Parkville, Australia.

Paediatric Respiratory Reviews
|March 1, 2022
PubMed

Insights

Children infected with SARS-CoV-2 (COVID-19) experience less severe illness. Lower expression of angiotensin-converting enzyme 2 (ACE2) and TMPRSS2 in children may contribute to this reduced severity.

Area of Science:

  • Virology
  • Immunology
  • Pediatrics

Background:

  • Children infected with SARS-CoV-2 (COVID-19) generally experience less severe disease compared to adults.
  • Host factors influencing viral entry and replication play a critical role in disease outcomes.

Approach:

  • Systematic literature search of Medline, Embase, and PubMed databases.
  • Included studies evaluating angiotensin-converting enzyme 2 (ACE2), transmembrane serine protease 2 (TMPRSS2), and furin in children.
  • Assessed age-related differences in expression, methylation, and protein levels of these host proteins.

Key Points:

  • ACE2 expression increases with age, with variations in membrane-bound and soluble forms.
  • TMPRSS2 expression, influenced by androgens, is lower in pre-pubertal children.
  • Furin's role in SARS-CoV-2 entry requires further investigation.

Conclusions:

  • Lower expression of ACE2 and TMPRSS2 in children may partially explain the reduced incidence of severe COVID-19.
  • Significant study heterogeneity was noted, necessitating further research.
  • Understanding age-related host protein differences is crucial for pediatric COVID-19 research.
Abstract

Keywords:
ACE2COVID-19FurinPaediatricSARS-CoV-2TMPRSS2

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