Journal Article Review Epublish
PubMed: 40370452 DOI: 10.3389/fimmu.2025.1440169
The underlying mechanism behind the different outcomes of COVID-19 in children and adults.
Front Immunol 16:1440169
Authors: Zifang Shang, Ling Huang, Shijie Qin
Affiliations
- Research Experiment Center, Meizhou People's Hospital, Meizhou Academy of Medical Sciences, Meizhou, Guangdong, China. Guangdong Engineering Technological Research Center of Clinical Molecular Diagnosis and Antibody Drugs, Meizhou People's Hospital, Meizhou, Guangdong, China.
- Department of Critical Medicine, Shenzhen Clinical Research Centre for Geriatrics, Shenzhen People's Hospital, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong, China.
- Innovative Vaccine and Immunotherapy Research Center, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China. Paediatric Research Institute, Shenzhen Children's Hospital, Shenzhen, China.
Abstract
Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has affected hundreds of millions of people globally, resulting in millions of deaths. During this pandemic, children have demonstrated greater resistance than adults, exhibiting lower infection rates, reduced mortality, and milder symptoms. Summarizing the differences in resistance between children and adults during COVID-19 can provide insights into protective mechanisms and potential implications for future treatments. In this review, we focused on summarizing and discussing the mechanisms for better protection of children in COVID-19. These protective mechanisms encompass several factors: the baseline expression of cell surface receptor ACE2 and hydrolase TMPRSS2, the impact of complications on COVID-19, and age-related cytokine profiles. Additionally, differences in local and systemic immune responses between children and adults also contribute significantly, particularly interferon responses, heterologous protection from non-COVID-19 vaccinations, and immune status variations influenced by micronutrient levels. The advantageous protection mechanisms of these children may provide insights into the prevention and treatment of COVID-19. Importantly, while age-related metabolic profiles and differential COVID-19 vaccine responses may contribute to protection in children, current comparative research remains limited and requires further investigation.
MeSH
Covid-19, Immune System Diseases, Immunity, Therapeutics, Prognosis, Child