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Nicastro E, Verdoni L, Bettini LR, et al. COVID-19 in Immunosuppressed Children. Front Pediatr. 2021;9:629240doi: 10.3389/fped.2021.629240.
Nicastro, E., Verdoni, L., Bettini, L. R., Zuin, G., Balduzzi, A., Montini, G., Biondi, A., & D'Antiga, L. (2021). COVID-19 in Immunosuppressed Children. Frontiers in pediatrics, 9629240. https://doi.org/10.3389/fped.2021.629240
Nicastro, Emanuele, et al. "COVID-19 in Immunosuppressed Children." Frontiers in pediatrics vol. 9 (2021): 629240. doi: https://doi.org/10.3389/fped.2021.629240
Nicastro E, Verdoni L, Bettini LR, Zuin G, Balduzzi A, Montini G, Biondi A, D'Antiga L. COVID-19 in Immunosuppressed Children. Front Pediatr. 2021 Apr 29;9:629240. doi: 10.3389/fped.2021.629240. eCollection 2021. PMID: 33996683; PMCID: PMC8116542.
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Front Pediatr. 2021 Apr 29;9:629240. doi: 10.3389/fped.2021.629240. eCollection 2021.

COVID-19 in Immunosuppressed Children.

Frontiers in pediatrics

Emanuele Nicastro, Lucio Verdoni, Laura Rachele Bettini, Giovanna Zuin, Adriana Balduzzi, Giovanni Montini, Andrea Biondi, Lorenzo D'Antiga

Affiliations

  1. Pediatric Hepatology, Gastroenterology and Transplantation Unit, Hospital Papa Giovanni XXIII, Bergamo, Italy.
  2. Pediatric Unit, Hospital Papa Giovanni XXIII, Bergamo, Italy.
  3. MBBM Foundation, Pediatric Department, Hospital San Gerardo, University of Milano Bicocca, Monza, Italy.
  4. Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda, Ospedale Maggiore Policlinico di Milano, Milan, Italy.

PMID: 33996683 PMCID: PMC8116542 DOI: 10.3389/fped.2021.629240

Abstract

Following the spread of the SARS-CoV-2 infection and coronavirus disease 2019 (COVID-19) to a global pandemic, concerns have arisen for the disease impact in at-risk populations, especially in immunocompromised hosts. On the other hand, clinical studies have clarified that the COVID-19 clinical burden is mostly due to over-inflammation and immune-mediated multiorgan injury. This has led to downsizing the role of immunosuppression as a determinant of outcome, and early reports confirm the hypothesis that patients undergoing immunosuppressive treatments do not have an increased risk of severe COVID-19 with respect to the general population. Intriguingly, SARS-CoV-2 natural reservoirs, such as bats and mice, have evolved mechanisms of tolerance involving selection of genes optimizing viral clearance through interferon type I and III responses and also dampening inflammasome response and cytokine expression. Children exhibit resistance to COVID-19 severe manifestations, and age-related features in innate and adaptive response possibly explaining this difference are discussed. A competent recognition by the innate immune system and controlled pro-inflammatory signaling seem to be the pillars of an effective response and the premise for pathogen clearance in SARS-CoV-2 infection. Immunosuppression-if not associated with other elements of fragility-do not represent

Copyright © 2021 Nicastro, Verdoni, Bettini, Zuin, Balduzzi, Montini, Biondi and D'Antiga.

Keywords: SARS–CoV−2; autoimmune disease; cancer; immunosuppression; innate immunity; kidney transplant; liver transplant; rheumatologic diseases

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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