View ORCID ProfileJonathan Baruch Steinman, Fok Moon Lum, Peggy Pui-Kay Ho, View ORCID ProfileNaftali Kaminski, and Lawrence Steinman
doi: https://doi.org/10.1073/pnas.2012358117
Abstract
The reduced development of COVID-19 for children compared to adults provides some tantalizing clues on the pathogenesis and transmissibility of this pandemic virus. First, ACE2, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor, is reduced in the respiratory tract in children. Second, coronavirus associated with common colds in children may offer some protection, due to cross-reactive humoral immunity and T cell immunity between common coronaviruses and SARS-CoV-2. Third, T helper 2 immune responses are protective in children. Fourth, surprisingly, eosinophilia, associated with T helper 2, may be protective. Fifth, children generally produce lower levels of inflammatory cytokines. Finally, the influence of the downturn in the global economy, the impact of living in quarters among families who are the most at risk, and factors including the openings of some schools, are considered. Those most disadvantaged socioeconomically may suffer disproportionately with COVID-19.
Competing interest statement: N.K. has consulted with Biogen Idec, Boehringer Ingelheim, Third Rock, Pliant, Samumed, NuMedii, Indaloo, Theravance, LifeMax, Three Lake Partners, RohBar, and reports a grant from Veracyte. N.K. has patents on New Therapies in Pulmonary Fibrosis and Peripheral Blood Gene Expression Biomarkers. All these consultations are outside of this work. L.S. has consulted with Roche, Novartis, Tolerion, Atreca, TG Therapeutics, and Atara Biopharma. All these consultations are outside of the scope of this work.
https://www.pnas.org/content/early/2020/09/02/2012358117#ack-1
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