COVID-19 in children. II: Pathogenesis, disease spectrum and management

Annaleise R Howard-Jones; David P Burgner; Nigel W Crawford; Emma Goeman; Paul E Gray; Peter Hsu; Stephanie Kuek; Brendan J McMullan; Shidan Tosif; Danielle Wurzel; Asha C Bowen; Margie Danchin; Archana Koirala; Ketaki Sharma; Daniel K Yeoh; Philip N Britton

doi:10.1111/jpc.15811

COVID-19 in children. II: Pathogenesis, disease spectrum and management

J Paediatr Child Health. 2022 Jan;58(1):46-53. doi: 10.1111/jpc.15811. Epub 2021 Oct 25.

Authors

Annaleise R Howard-Jones^{1

2}, David P Burgner^{3

4

5}, Nigel W Crawford^{4

5

6}, Emma Goeman⁷, Paul E Gray^{8

9}, Peter Hsu^{1

10}, Stephanie Kuek¹¹, Brendan J McMullan^{8

9}, Shidan Tosif^{4

5

6}, Danielle Wurzel^{4

11

12}, Asha C Bowen^{13

14}, Margie Danchin^{4

5

6}, Archana Koirala^{1

15

16}, Ketaki Sharma^{1

15}, Daniel K Yeoh^{13

17}, Philip N Britton^{1

18}

Affiliations

¹ Discipline of Child and Adolescent Health, University of Sydney, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
² NSW Health Pathology-Nepean, Nepean Hospital, Sydney, New South Wales, Australia.
³ Infectious Diseases Unit, Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.
⁴ Infection and Immunity Theme, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
⁵ Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
⁶ Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.
⁷ Department of Infectious Diseases and Microbiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
⁸ Department of Immunology and Infectious Diseases, Sydney Children's Hospital, Sydney, New South Wales, Australia.
⁹ School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
¹⁰ Department of Immunology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
¹¹ Department of Respiratory and Sleep Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.
¹² School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
¹³ Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia.
¹⁴ Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.
¹⁵ National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
¹⁶ Department of Infectious Diseases, Nepean Hospital, Penrith, New South Wales, Australia.
¹⁷ Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia.
¹⁸ Department of Infectious Diseases and Microbiology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.

Abstract

The global disruption of the COVID-19 pandemic has impacted the life of every child either directly or indirectly. This review explores the pathophysiology, immune response, clinical presentation and treatment of COVID-19 in children, summarising the most up-to-date data including recent developments regarding variants of concern. The acute infection with SARS-CoV-2 is generally mild in children, whilst the post-infectious manifestations, including paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) and 'long COVID' in children, are more complex. Given that most research on COVID-19 has focused on adult cohorts and that clinical manifestations, treatment availability and impacts differ markedly in children, research that specifically examines COVID-19 in children needs to be prioritised.

Keywords: COVID-19; PIMS-TS; SARS-CoV-2; management; virology.

Publication types

Review

MeSH terms

COVID-19* / complications
Child
Humans
Pandemics
Post-Acute COVID-19 Syndrome
SARS-CoV-2
Systemic Inflammatory Response Syndrome

Supplementary concepts

pediatric multisystem inflammatory disease, COVID-19 related