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10.1007/s12098-020-03322-y

http://scihub22266oqcxt.onion/10.1007/s12098-020-03322-y
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suck abstract from ncbi


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pmid32410003      Indian+J+Pediatr 2020 ; 87 (7): 537-546
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  • Pathophysiology of COVID-19: Why Children Fare Better than Adults? #MMPMID32410003
  • Dhochak N; Singhal T; Kabra SK; Lodha R
  • Indian J Pediatr 2020[Jul]; 87 (7): 537-546 PMID32410003show ga
  • 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.
  • |*Age Factors[MESH]
  • |Adaptive Immunity[MESH]
  • |Adult[MESH]
  • |Angiotensin-Converting Enzyme 2[MESH]
  • |Betacoronavirus/*pathogenicity[MESH]
  • |COVID-19[MESH]
  • |Child[MESH]
  • |China/epidemiology[MESH]
  • |Coronavirus Infections/epidemiology/immunology/*physiopathology/transmission[MESH]
  • |Disease Susceptibility[MESH]
  • |Humans[MESH]
  • |Influenza, Human/epidemiology/immunology/physiopathology/transmission[MESH]
  • |Middle East Respiratory Syndrome Coronavirus/pathogenicity[MESH]
  • |Pandemics[MESH]
  • |Peptidyl-Dipeptidase A/metabolism[MESH]
  • |Pneumonia, Viral/epidemiology/immunology/*physiopathology/transmission[MESH]
  • |Risk Factors[MESH]
  • |SARS-CoV-2[MESH]
  • |Severe acute respiratory syndrome-related coronavirus/pathogenicity[MESH]


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