Am J Perinatol 2020; 37(08): 845-849
DOI: 10.1055/s-0040-1710512
Clinical Opinion
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

COVID-19 in Newborns and Infants—Low Risk of Severe Disease: Silver Lining or Dark Cloud?

Munmun Rawat
1  Department of Pediatrics, University at Buffalo, Buffalo, New York
,
Praveen Chandrasekharan
1  Department of Pediatrics, University at Buffalo, Buffalo, New York
,
Mark D. Hicar
1  Department of Pediatrics, University at Buffalo, Buffalo, New York
,
Satyan Lakshminrusimha
2  Department of Pediatrics, University of California, Davis, California
› Author Affiliations
Further Information

Publication History

19 April 2020

19 April 2020

Publication Date:
07 May 2020 (online)

Abstract

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.

Key Points

  • 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.

Authors' Contributions

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.


Note

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.