Greenan-Barrett, James;
Ciurtin, Coziana;
(2022)
COVID-19 in immunocompromised children and adolescents.
Journal of Pediatric Infectious Diseases
, 41
(10)
e424-e427.
10.1097/INF.0000000000003605.
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Abstract
At the onset of the coronavirus disease 2019 (COVID-19) pandemic, children were thought to be at low risk for infection, severe disease and death, while the impact of immunocompromise on disease manifestations was unknown. As the prevalence of the disease increased, studies have reported severe disease phenotypes, such as Multisystem Inflammatory Syndrome in Children (MIS-C) or Pediatric Inflammatory Multisystem Syndrome, respiratory failure and death, and have reported outcomes in immunocompromised cohorts. While it is impossible to know the true rates of infection, due to asymptomatic carriage and variable testing policies, European surveillance data from August 2020 to October 2021 reported 2692 pediatric cases per 100,000 with rates of hospitalization, intensive care unit (ICU) admission and death of 1.17%, 0.08% and 0.01%, respectively. The very low rates of severe outcomes in children compared to adults are thought to be partly due to higher levels of cross-reactive humoral immunity to other coronaviruses, lower rates of comorbidities (eg, obesity, diabetes and respiratory disease) and lower expression of angiotensin-converting enzyme 2, the receptor used by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to enter cells.
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