The DOI matches its Crossref record; 82 of the 82 references it cites were found in a registry or an index.
Pathophysiology of COVID-19: Why Children Fare Better than Adults?
Open accessAbstract
The world is facing Coronavirus Disease-2019 (COVID-19) pandemic, which is causing a large number of deaths and burden on intensive care facilities. It is caused by Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) originating in Wuhan, China. It has been seen that fewer children contract COVID-19 and among infected, children have less severe disease. Insights in pathophysiological mechanisms of less severity in children could be important for devising therapeutics for high-risk adults and elderly. Early closing of schools and day-care centers led to less frequent exposure and hence, lower infection rate in children. The expression of primary target receptor for SARS-CoV-2, i.e. angiotensin converting enzyme-2 (ACE-2), decreases with age. ACE-2 has lung protective effects by limiting angiotensin-2 mediated pulmonary capillary leak and inflammation. Severe COVID-19 disease is associated with high and persistent viral loads in adults. Children have strong innate immune response due to trained immunity (secondary to live-vaccines and frequent viral infections), leading to probably early control of infection at the site of entry. Adult patients show suppressed adaptive immunity and dysfunctional over-active innate immune response in severe infections, which is not seen in children. These could be related to immune-senescence in elderly. Excellent regeneration capacity of pediatric alveolar epithelium may be contributing to early recovery from COVID-19. Children, less frequently, have risk factors such as co-morbidities, smoking, and obesity. But young infants and children with pre-existing illnesses could be high risk groups and need careful monitoring. Studies describing immune-pathogenesis in COVID-19 are lacking in children and need urgent attention.
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Cited by
COVID-19: neonatal–perinatal perspectives
On behalf of the Harvard Neonatal-Perinatal Fellowship COVID-19 Working Group, Barrero-Castillero, A., Beam, K. S., Bernardini, L. B., Ramos, E. G. C., Davenport, P. E., Duncan, A. R., Fraiman, Y. S., Frazer, L. C., Healy, H., et al. (2021) · Journal of Perinatology · doi:10.1038/s41372-020-00874-x · Cited by 92
Shek, D. T. L., Zhao, L., Dou, D., Zhu, X., & Xiao, C. (2021) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2021.01.011 · Cited by 80
Metadata
- Authors
- Dhochak, N., Singhal, T., Kabra, S. K., & Lodha, R.
- Venue
- The Indian Journal of Pediatrics
- Published
- 2020-05-14
- Volume
- 87
- Issue
- 7
- Pages
- 537-546
- ISSN
- 0019-5456 (ISSN-L)
- 0973-7693
- OpenAlex
- W3025210114
- Cited by
- 339
- References
- 82
- FWCI
- 8.84
- Type
- journal article
- Language
- en
- Open access
- bronze
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