COVID-19 in Newborns and Infants—Low Risk of Severe Disease: Silver Lining or Dark Cloud?
19 April 2020
19 April 2020
07 May 2020 (online)
One hundred years after the 1918 influenza pandemic, we now face another pandemic with the severe acute respiratory syndrome–novel coronavirus-2 (SARS-CoV-2). There is considerable variability in the incidence of infection and severe disease following exposure to SARS-CoV-2. Data from China and the United States suggest a low prevalence of neonates, infants, and children, with those affected not suffering from severe disease. In this article, we speculate different theories why this novel agent is sparing neonates, infants, and young children. The low severity of SARS-CoV-2 infection in this population is associated with a high incidence of asymptomatic or mildly symptomatic infection making them efficient carriers.
There is a low prevalence of novel coronavirus disease in neonates, infants, and children.
The fetal hemoglobin may play a protective role against coronavirus in neonates.
Immature angiotensin converting enzyme (ACE2) interferes with coronavirus entry into the cells.
M.R. drafted the manuscript and approved the final manuscript as submitted; P.C. conceptualized, edited, and approved the manuscript; M.D.H. reviewed, edited, and approved the final manuscript as submitted; S.L. mentored, reviewed, and approved the final manuscript as submitted. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
M.R., P.C.: American Academy of Pediatrics, Neonatal Resuscitation Program; Department of Pediatrics, University at Buffalo, Buffalo, NY. M.R.: Dr. Henry C. and Bertha H. Buswell Fellowship—Salary Support. M.D.H.: University at Buffalo, SUNY Research Seed Grant Program COVID-19.
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