COVID‐19 in children. II: Pathogenesis, disease spectrum and management

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

The global disruption of the COVID‐19 pandemic has impacted the life of every child either directly or indirectly. This review explores the pathophysiology, immune response, clinical presentation and treatment of COVID‐19 in children, summarising the most up‐to‐date data including recent developments regarding variants of concern. The acute infection with SARS‐CoV‐2 is generally mild in children, whilst the post‐infectious manifestations, including paediatric inflammatory multisystem syndrome temporally associated with SARS‐CoV‐2 (PIMS‐TS) and ‘long COVID’ in children, are more complex. Given that most research on COVID‐19 has focused on adult cohorts and that clinical manifestations, treatment availability and impacts differ markedly in children, research that specifically examines COVID‐19 in children needs to be prioritised.

Related collections

Most cited references 64

Record: found
Abstract: found
Article: found

Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

Dawei Wang, Bo Hu, Fangfang Zhu … (2020)

In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.

0 comments Cited 11162 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

A new coronavirus associated with human respiratory disease in China

Fan Wu, Su Zhao, Bin Yu … (2020)

Emerging infectious diseases, such as severe acute respiratory syndrome (SARS) and Zika virus disease, present a major threat to public health 1–3 . Despite intense research efforts, how, when and where new diseases appear are still a source of considerable uncertainty. A severe respiratory disease was recently reported in Wuhan, Hubei province, China. As of 25 January 2020, at least 1,975 cases had been reported since the first patient was hospitalized on 12 December 2019. Epidemiological investigations have suggested that the outbreak was associated with a seafood market in Wuhan. Here we study a single patient who was a worker at the market and who was admitted to the Central Hospital of Wuhan on 26 December 2019 while experiencing a severe respiratory syndrome that included fever, dizziness and a cough. Metagenomic RNA sequencing 4 of a sample of bronchoalveolar lavage fluid from the patient identified a new RNA virus strain from the family Coronaviridae, which is designated here ‘WH-Human 1’ coronavirus (and has also been referred to as ‘2019-nCoV’). Phylogenetic analysis of the complete viral genome (29,903 nucleotides) revealed that the virus was most closely related (89.1% nucleotide similarity) to a group of SARS-like coronaviruses (genus Betacoronavirus, subgenus Sarbecovirus) that had previously been found in bats in China 5 . This outbreak highlights the ongoing ability of viral spill-over from animals to cause severe disease in humans.

0 comments Cited 5582 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Autoantibodies against type I IFNs in patients with life-threatening COVID-19

Paul Bastard, Lindsey B. Rosen, Qian Zhang … (2021)

The genetics underlying severe COVID-19 The immune system is complex and involves many genes, including those that encode cytokines known as interferons (IFNs). Individuals that lack specific IFNs can be more susceptible to infectious diseases. Furthermore, the autoantibody system dampens IFN response to prevent damage from pathogen-induced inflammation. Two studies now examine the likelihood that genetics affects the risk of severe coronavirus disease 2019 (COVID-19) through components of this system (see the Perspective by Beck and Aksentijevich). Q. Zhang et al. used a candidate gene approach and identified patients with severe COVID-19 who have mutations in genes involved in the regulation of type I and III IFN immunity. They found enrichment of these genes in patients and conclude that genetics may determine the clinical course of the infection. Bastard et al. identified individuals with high titers of neutralizing autoantibodies against type I IFN-α2 and IFN-ω in about 10% of patients with severe COVID-19 pneumonia. These autoantibodies were not found either in infected people who were asymptomatic or had milder phenotype or in healthy individuals. Together, these studies identify a means by which individuals at highest risk of life-threatening COVID-19 can be identified. Science, this issue p. eabd4570, p. eabd4585; see also p. 404

0 comments Cited 1358 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Philip N Britton:

ORCID: https://orcid.org/0000-0002-2993-6000

philip.britton@health.nsw.gov.au

Journal

Journal ID (nlm-ta): J Paediatr Child Health

Journal ID (iso-abbrev): J Paediatr Child Health

Journal ID (doi): 10.1111/(ISSN)1440-1754

Journal ID (publisher-id): JPC

Title: Journal of Paediatrics and Child Health

Publisher: John Wiley & Sons Australia, Ltd. (Australia )

ISSN (Print): 1034-4810

ISSN (Electronic): 1440-1754

Publication date (Electronic): 25 October 2021

Publication date PMC-release: 25 October 2021

Electronic Location Identifier: 10.1111/jpc.15811

Affiliations

[ ¹ ] Discipline of Child and Adolescent Health University of Sydney, The Children's Hospital at Westmead Sydney New South Wales Australia

[ ² ] NSW Health Pathology‐Nepean Nepean Hospital Sydney New South Wales Australia

[ ³ ] Infectious Diseases Unit Department of General Medicine, Royal Children's Hospital Melbourne Victoria Australia

[ ⁴ ] Infection and Immunity Theme Murdoch Children's Research Institute Melbourne Victoria Australia

[ ⁵ ] Department of Paediatrics The University of Melbourne Melbourne Victoria Australia

[ ⁶ ] Department of General Medicine Royal Children's Hospital Melbourne Victoria Australia

[ ⁷ ] Department of Infectious Diseases and Microbiology Royal Prince Alfred Hospital Sydney New South Wales Australia

[ ⁸ ] Department of Immunology and Infectious Diseases Sydney Children's Hospital Sydney New South Wales Australia

[ ⁹ ] School of Women's and Children's Health University of New South Wales Sydney New South Wales Australia

[ ¹⁰ ] Department of Immunology The Children's Hospital at Westmead Sydney New South Wales Australia

[ ¹¹ ] Department of Respiratory and Sleep Medicine The Royal Children's Hospital Melbourne Victoria Australia

[ ¹² ] School of Population and Global Health The University of Melbourne Melbourne Victoria Australia

[ ¹³ ] Department of Infectious Diseases Perth Children's Hospital Perth Western Australia Australia

[ ¹⁴ ] Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute University of Western Australia Perth Western Australia Australia

[ ¹⁵ ] National Centre for Immunisation Research and Surveillance The Children's Hospital at Westmead Sydney New South Wales Australia

[ ¹⁶ ] Department of Infectious Diseases Nepean Hospital Penrith New South Wales Australia

[ ¹⁷ ] Sir Peter MacCallum Department of Oncology The University of Melbourne Melbourne Victoria Australia

[ ¹⁸ ] Department of Infectious Diseases and Microbiology The Children's Hospital at Westmead Sydney New South Wales Australia

Author notes

[*] [* ] Correspondence:Dr Philip N Britton, Discipline of Child and Adolescent Health, University of Sydney, The Children's Hospital at Westmead, Westmead, NSW 2145, Australia. Fax: +612 98453291; email: philip.britton@ 123456health.nsw.gov.au

Author information

Annaleise R Howard‐Jones https://orcid.org/0000-0002-9756-2813

David P Burgner https://orcid.org/0000-0002-8304-4302

Brendan J McMullan https://orcid.org/0000-0001-5144-3416

Shidan Tosif https://orcid.org/0000-0003-0022-1009

Margie Danchin https://orcid.org/0000-0002-7624-5691

Archana Koirala https://orcid.org/0000-0002-2567-8825

Daniel K Yeoh https://orcid.org/0000-0002-6284-612X

Philip N Britton https://orcid.org/0000-0002-2993-6000

Article

Publisher ID: JPC15811

DOI: 10.1111/jpc.15811

PMC ID: 8662268

PubMed ID: 34694037

SO-VID: fff8b715-52ac-49b3-b406-ed44a18ce72c

License:

This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

History

Date revision received : 22 September 2021

Date received : 14 September 2021

Date accepted : 30 September 2021

Page count

Figures: 2, Tables: 1, Pages: 8, Words: 6315

Custom metadata

source-schema-version-number 2.0

edited-state corrected-proof

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.9 mode:remove_FC converted:10.12.2021

Keywords: covid‐19,management,pims‐ts,sars‐cov‐2,virology

Data availability:

Keywords: covid‐19, management, pims‐ts, sars‐cov‐2, virology

Comments

Comment on this article

scite_

Smart Citations

Citing PublicationsSupportingMentioningContrasting

View Citations

See how this article has been cited at scite.ai

scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.

COVID‐19 in children. II: Pathogenesis, disease spectrum and management

Read this article at

Abstract

Related collections

Novel Coronavirus Disease COVID-19

Most cited references 64

Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

A new coronavirus associated with human respiratory disease in China

Autoantibodies against type I IFNs in patients with life-threatening COVID-19

Author and article information

Contributors

Journal

Affiliations

Author notes

Author information

Article

History

Page count

Categories

Custom metadata

Comments

Comment on this article

Similar content 257

Cited by 50

Most referenced authors 4,007