Why Children Have Fewer Cases of COVID Infection? Part II

By: Sheila Kun RN, BSN, MS, CPN, FCCP
Salesian Cooperator

The hypothesis that children have stronger immunity against COVID 19 infection is very interesting and rather convincing. Any parent could tell you that children tend to get sicker with common colds. Some of those common colds are caused by seasonal corona viruses. Another theory is that because children are so frequently infected with theses common respiratory viruses, but they might have antibodies that provide cross protection. I was laughing when I read this point; it makes sense that if the common colds are caused by corona viruses and with the onset of the COVID 19, it seems like our immune system say: “I have seen you before, you are the cousin of the other Corona viruses I have successfully fought you off last year.” Hence, when they recognize the corona virus, even though this time is the COVID 19 and not the exact virus, they mount an immune response and attempt to fight off the virus.

Many COVID-19 complications may be caused by a condition known as cytokine release syndrome or a cytokine storm. This is when an infection triggers your immune system to flood your bloodstream with inflammatory proteins called cytokines. They can kill tissue and damage your organs. When a cytokine storm occurs, it is your body’s OVER-REACTION to the viral infection. It is linked to serious morbidity and mortality. Children’s immune system is different, they don’t tend to produce cytokine storms, and therefore, they have less severe consequences of the infection.

To summarize the key points about why children have less COVID 19 infection and tend to have less severe consequences:

  • Children’s ACE2 expression is reduced in children (less receptors to the spike)
  • Their antibodies to other seasonal corona viruses.
  • They have better endothelial and clotting functions.
  • They have reduced instances of cytokine storms.

When I shared this information with parents, they all expressed appreciation that children’s exposure to the viral and how they react to the virus is different than the adults. In practice, I witnessed the same; many adult family members came down with the infection, and the child is not infected. For those who were infected, most of them had mild symptoms. The only group of children that was more at risk is children with Down Syndrome. We don’t know why they are at a higher risk for more severe conditions. This is an area of tremendous interest to the pediatric researchers. I am sure we will have more information in the future. Stat tune.

Your homework from the Care Ministry this week: get your vaccine if it is your turn.

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