ReviewIndian journal of pediatrics2020
Pathophysiology of COVID-19: Why Children Fare Better than Adults?
Review in Indian journal of pediatrics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05576714 (Investigation of Prognostic Biomarkers, Host Factors and Viral Factors for COVID-19 Associated Encephalopathy/Encephalitis and Multi-systemic Inflammatory Syndrome in Children), which is not on this map. Cited by 166 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Investigation of Prognostic Biomarkers, Host Factors and Viral Factors for COVID-19 Associated Encephalopathy/Encephalitis and Multi-systemic Inflammatory Syndrome in Children
Who cites it
166 citing papers in PubMed, 2 syntheses or guidelines pooled it, 342 citations in OpenAlex.
- Do we need to vaccinate every child against COVID-19: What evidence suggests-A systematic review of opinions.Frontiers in public health · 2022Pooled it
- Acute and chronic exposure to air pollution in relation with incidence, prevalence, severity and mortality of COVID-19: a rapid systematic review.Environmental health : a global access science source · 2021Pooled it
- Trial
- Article
- Clinical Characteristics and Cytokines of Children With Lower Respiratory Tract Infection Caused by Influenza A After COVID-19.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2026Article
- Growth and Development Status of Children Post-COVID-19 Infection: Cross-Sectional Questionnaire Study.Asian/Pacific Island nursing journal · 2025Article
- Short and long-term outcomes of children and adolescents hospitalized with COVID-19 or influenza: results of the AUTCOV study.Scientific reports · 2025Article
- Article
- Article
- Identification of Gene Signatures Associated with COVID-19 across Children, Adolescents, and Adults in the Nasopharynx and Peripheral Blood by Using a Machine Learning Approach.Current gene therapy · 2025Article
- Pediatric healthcare service utilization after the end of COVID-19 state of emergency in Northern Italy: a 6-year quasi-experimental study using interrupted time-series analysis.Frontiers in public health · 2025Article
- Radiologic analysis of CT imaging patterns and clinical correlations in hospitalized pediatric COVID-19 patients.Frontiers in radiology · 2025Article
- Coronavirus disease 2019 infection severity among different variants in children under 2-years old in Brazil.Clinics (Sao Paulo, Brazil) · 2025Article
- Clinical Manifestations of Acute COVID-19 in Previously Healthy Pediatric Patients Diagnosed by Rapid Antigen Screening in a Community-Based, Outpatient Primary Care Pediatrics Practice.Children (Basel, Switzerland) · 2024Article
- Review
- Article
- Long COVID in Children, Adults, and Vulnerable Populations: A Comprehensive Overview for an Integrated Approach.Diseases (Basel, Switzerland) · 2024Review
- Article
- Article
- Features of Appendix and the Characteristics of Appendicitis Development in Children with COVID-19.Biomedicines · 2024Article
106 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.