What Are Long-Term Pediatric COVID-19 Implications?

The evolving understanding of coronavirus 2019 (COVID-19) has thus far had a remarkable constant: young children have been relatively safe from the virus.

In continuing discussion around a case report of Montreal-based infants admitted to hospitals with SARS-CoV-2 infection, Fatima Kakkar, MD, MPH, of University of Sainte-Justine Center Hospital, discussed how infants have been surprisingly okay during infections.

“There’s something very unique in that infant age group, where either they’re not able to process the virus—they don’t have the receptors necessary to lead to viral replication, or their immune response is just so different than adults because they have their maternal antibodies,” she explained.

This is unlike any other viral or bacterial infection response in this age group, Kakkar said—in fact, it’s fairly common for infants to be particularly burdened by respiratory infections.

Now, though, headed into the second year of the pandemic, Kakkar and colleagues are aiming to accomplish year-plus follow-up assessment of younger patients, to interpret their immune and antibody responses, relative to their symptomatic reactions, to compare with more burdened COVID-19 adults.

“In general, the trends are that kids have done remarkably well,” Kakkar said. “Kids anywhere from 0-15 get mild illness, fever, really no long-term symptoms, but the adults are the ones who can get really severe—sometimes weeks, sometimes month of illness.”