• Proc. Natl. Acad. Sci. U.S.A. · Oct 2020

    Review

    Reduced development of COVID-19 in children reveals molecular checkpoints gating pathogenesis illuminating potential therapeutics.

    • Jonathan Baruch Steinman, Fok Moon Lum, Peggy Pui-Kay Ho, Naftali Kaminski, and Lawrence Steinman.
    • Department of Pediatrics, Columbia University, New York, NY 10032.
    • Proc. Natl. Acad. Sci. U.S.A. 2020 Oct 6; 117 (40): 24620-24626.

    AbstractThe 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.Copyright © 2020 the Author(s). Published by PNAS.

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