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Coronavirus disease 2019 (COVID-19) in pediatric patients with autoimmune disorders
Parniyan Sadeghi1,2, Parmida Sadat Pezeshki2,3,4, Nima Rezaei5,6,7
1School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Children with autoimmune disorders face higher risks from Coronavirus disease 2019 (COVID-19). This review examines the impact of autoimmune conditions and treatments on pediatric COVID-19 outcomes, highlighting research gaps.
Area of Science:
- Pediatric Autoimmunology
- Infectious Diseases
- Immunology
Background:
- Children with autoimmune disorders are at increased risk for severe Coronavirus disease 2019 (COVID-19) compared to healthy children.
- Limited research exists on the pathophysiology and clinical outcomes of COVID-19 in pediatric patients with autoimmune conditions.
- Autoimmune diseases and their treatments, like corticosteroids, may heighten the risk of severe COVID-19 complications in children.
Purpose of the Study:
- To review current literature on the effects of autoimmune disease and related therapies on pediatric COVID-19.
- To identify evidence gaps and areas for future research concerning COVID-19 in immunocompromised children.
Main Methods:
- Literature review of existing studies on pediatric autoimmune disorders and COVID-19.
- Analysis of the impact of autoimmune disease type, severity, and medication on COVID-19 outcomes.
- Synthesis of information regarding immune system alterations in response to COVID-19 in this population.
Main Results:
- Children with autoimmune conditions generally experience more severe COVID-19 outcomes than healthy children.
- COVID-19 can cause immune system alterations, influenced by underlying autoimmune diseases and immunomodulatory drugs.
- While immunosuppressive medications may increase infection risk, they can also mitigate severe COVID-19 complications like cytokine storms.
Conclusions:
- Further research is crucial to fully understand COVID-19's impact on children with autoimmune disorders.
- Evaluating the interplay between autoimmune conditions, treatments, and COVID-19 outcomes is essential for clinical management.
- Addressing evidence gaps will improve care strategies for this vulnerable pediatric population.
Abstract:
Coronavirus disease 2019 (COVID-19) infection in pediatric patients with autoimmune disorders is an area of particular concern since autoimmune diseases can increase the risk of complications from the virus. However, as the infection rates were significantly higher in adults compared to children, this at-risk group of children was relatively underrepresented in COVID-19 research. The underlying inflammatory basis of autoimmune diseases and medications that affect the immune system, such as corticosteroids, could increase the risk of severe infection in this group of patients. COVID-19 could reportedly lead to a variety of alterations in the immune system. These alterations are plausibly dependent on the underlying immune-mediated diseases or prior use of immunomodulatory drugs. Patients administrating immunomodulatory agents, especially those with severe immune system dysregulation, can experience severe symptoms of COVID-19. Nonetheless, receiving immunosuppressive medications can benefit patients by preventing cytokine storm syndromes and lung tissue damage, threatening outcomes of COVID-19.
Conclusion:
In this review, we sought to evaluate the currently available literature on the impact of autoimmune disease and its related therapeutic approaches on the COVID-19 infection course of disease in children and reflect on the gaps in the evidence and the need for further research in this field.
What Is Known:
• The majority of children infected with COVID-19 demonstrate mild to moderate clinical manifestations compared to adults, whereas those children with pre-existing autoimmune conditions are at a greater risk for severe symptoms. •There is currently limited understanding of the pathophysiology and clinical outcomes of COVID-19 in pediatric patients with autoimmune disorders due to scattered reports and inadequate evidence.
What Is New:
• Generally, children with autoimmune disorders have more unfavorable outcomes than healthy children; yet, the severity is not extreme, and is highly dependent on their autoimmune disease type and severity, as well as the medication they are taking.
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