Health
Scientists focus on the child’s immune system as they develop severe COVID
Eighteen months after the COVID-19 pandemic, delta variants have fostered a major recurrence of the disease, with many hospitals hitting tragic new lows.They are now Lose baby To coronavirus.
First reported COVID-related deaths in newborns Occurs in Orange County, Florida Infant died in Mississippi..Merced County, California Lost a child under 1 year old In late August.
“It’s very hard to see children suffering,” said Dr. Paul Offit, an infectious disease expert at the Philadelphia Children’s Hospital.
Until the delta variant was besieged this summer, almost all children seemed to have escaped the worst of COVID for reasons scientists didn’t fully understand.
There is no evidence that the delta variant causes more serious illness, but the virus is so infectious that many children are hospitalized. In most cases, the states have low immunization rates. According to the American Academy of Pediatrics, nearly 30% of COVID infections reported in the week ending September 9 were children.
Diagnosed doctor Over 243,000 cases for children That same week, the total number of COVID infections in children under the age of 18 since the onset of the pandemic 5.3 million, When At least 534 died..
Most children who suffer from long, crippled COVID symptoms get better. Doctors worry about those who don’t.
Experts say it’s a basic math problem. “If 10 times more children than the previous variant are infected with Delta, of course, 10 times more children will be hospitalized,” said Dr. Dimitri Cristakis, director of the Center for Child Health and Behavior. I am. Developed at Seattle Children’s Institute.
But the recent surge has given new urgency to questions that are wondering scientists throughout the pandemic: what prevents most children from getting seriously ill? And why does that protection sometimes fail?
“This is an urgent and complex question,” said Dr. Birkapojannis, senior medical director and infectious disease expert at the Eunice Kennedy Schreiber National Institute for Pediatric Health and Human Development.
“We use all the tools available and do everything we can to deal with it,” Capojannis said. “The answer cannot come immediately.”
Immune system research
For many pandemics, doctors could only speculate why the child’s immune system was so successful in rejecting the coronavirus.
Despite the surprising number of children hospitalized in the recent surge, young people are much less likely to become seriously ill. Less than 1% of children diagnosed with COVID are hospitalized and about 0.01% die. American Academy of Pediatrics.. Most children shrug the virus with a slight odor.
Increasing evidence is that the child’s innate immune system usually nip the infection early, preventing the virus from building a foothold, Unchecked multiplicationDr. Rael Yonker, an assistant professor of pediatrics at Massachusetts General Hospital, said.
In a series of studies published last year, a team of doctors.Betsy and Kevan Herold have discovered that children especially have Strong mucosal immunity, So-called the main player of this system is not blood, Mucous membrane It lines the nose, throat, and other parts of the body that frequently encounter bacteria.
More than just a mask:The key to the school ventilation system to keep children safe from COVID-19
These membranes act like layered stone walls that protect medieval cities from invaders. Betsy Herold, head of the pediatric infectious disease department at Albert, is made up of cells called epithelial cells, which are also found in many internal organs and are the major immune system called dendritic cells and macrophages. He said he was in line with the soldiers. Einstein Medical College.
Importantly, these cells are lined with proteins called pattern recognition receptors that act like sentries and continuously scan the landscape for abnormalities. When a sentry notices something foreign, like a new virus, it warns cells to start releasing a protein called interferon. This helps regulate the body’s immune response.
of August study of nature biotechnologyRoland Eils of the Berlin Institute of Health and his colleagues in Germany discovered that the upper respiratory tract of a child was “pre-activated” to fight the new coronavirus. Their airways are teamed with these sentries, including those that are well aware of the coronavirus.
This allows children to instantly activate the innate immune system and release interferon, which helps the virus shut down the virus before it establishes a foothold.
By comparison, adults have far fewer guards and take about two days to react to the virus, Eils said. By that time, the virus could have grown exponentially, making the fight much more difficult.
If innate immunity cannot control the virus, the body can fall back into the adaptive immune system. This is a second line of defense that adapts to each unique threat. The adaptive system, for example, creates antibodies that are tailored to each virus or bacterium that the body encounters.
Antibodies are part of the simplest immune response to measure and are therefore often cited as proxies for protection, but children do not seem to need much to fight COVID, Betsy Hero said. Ludo said.In fact, of Herold research Shows that children with COVID have fewer neutralizing antibodies than adults. (Both children and adults usually make enough antibodies to prevent a natural or future coronavirus infection after vaccination.)
The adaptive immune system is effective, but it can sometimes be more harmful than good.
Like soldiers killing companions with friendly fire, the overactive immune system can cause collateral damage and an inflammatory cascade that tramples healthy cells throughout the body as well as the virus.
In some COVID patients, uncontrolled inflammation causes life-threatening blood clots, Acute respiratory distress syndromeThis happens when fluid builds up in the air sacs of the lungs, making it difficult to breathe, Betsy Herold said. Both are common causes of death in adult COVID patients.
Children usually get rid of the coronavirus very quickly, so they usually avoid this kind of dangerous inflammation, she said.
research Professor Jeremy Luban of the University of Massachusetts School of Medicine shows that healthy children supply large amounts of a type of peacekeeping cell called innate lymphoid cells.
Children are born with many of these cells, but the number decreases with age. And Luban said that both children and adults with COVID tend to have low numbers of these repair cells.
Men also have fewer repair cells than women, which may help explain why men are at higher risk of dying from COVID than women.
Both children and adults can develop “long COVID”. 10% of young adults and up to 22% over 70 years old..the study Four% NS 11% The child’s symptoms persist.
Unanswered questions
Kevan Herold, who teaches immunobiology at Yale School of Medicine, said scientists have few clues as to what’s wrong with certain children with COVID.
Studies show that children experience so many recent respiratory infections within the first few years that they have a stronger innate immune system than adults, and the immune system for subsequent attacks. May irritate.
But not all kids shrug COVID easily, Eils said. Newborns do not live long enough to prepare their immune system for battle. He said that even infants may not respond strongly.
At New Orleans Children’s Hospital, half of COVID patients are under the age of four, said Dr. Mark Klein, an infectious disease specialist and attending physician.
“We gave birth to 7- and 9-week-old babies in a ventilated ICU,” Kline said. “There was a 3-month-old person who needed ECMO, an extracorporeal membrane oxygenation. This is a device similar to the heart-lung machine used in open heart surgery.
Even previously healthy children can die of respiratory infections from COVID to influenza and respiratory syncytial virus.
But research has found it 30% NS 70% of children When hospitalized with COVID, there were underlying conditions that increased risk, such as Down’s syndrome, obesity, lung disease, diabetes, and immunodeficiency. Premature babies are at increased risk as well as children who have been treated for cancer.
One thing that all hospitalized children have in common is that few people are vaccinated, said Dr. Mary Taylor, director of pediatrics at the University of Mississippi Medical Center.
“There is really no way to know which kids in COVID will get sick with a cold and which kids will get seriously ill,” Taylor said. “It’s a very helpless feeling for a family to feel that they can’t do anything for their children.”
Although the scientists have identified Genetic mutation Related to Severe COVID, These variants are very rare.
Scientists have succeeded in finding out why certain adults succumb to COVID.
For example, some cases of severe COVID in adults are associated with falsely induced antibodies that target interferon rather than coronavirus.August study Science Immunology We reported that such “autoantibodies” contributed 20% of deaths from COVID.
Autoantibodies are extremely rare in children and young adults, but are unlikely to explain why some young people die from the disease, said the study’s co-author, a pediatric immunologist at the Ruben Catholic University in Belgium. One Dr. Isabel Mates said.
Nevertheless Hospitalization is decreasing Nationally, some of the most serious consequences of infection are now emerging.
Two months after the delta surge, southern hospitals see a second wave of rare but life-threatening children called Pediatric Multisystem Inflammatory Syndrome (MIS-C).
Unlike children who develop COVID pneumonia, which is the main cause of hospitalization for children, children with MIS-C usually have a mild or asymptomatic infection, but become very ill after about a month. It develops symptoms such as nausea, vomiting, rash, fever, and diarrhea. Some people develop blood clots and dangerous low blood pressure. According to the report, more than 4,661 children were diagnosed with MIS-C and 41 died. Centers for Disease Control and Prevention..
Iowa:Children make up almost a quarter of the new COVID-19 cases in the state
Scientists do not yet know the exact cause of MIS-C, but studies by Yonker at Massachusetts General Hospital suggest that viral particles can leak from the intestine into the bloodstream, causing systemic system reactions throughout the body. doing.
It is too early to determine if the children who survived MIS-C will survive Suffering from permanent health problemsSaid Dr. Lee Howard, a pediatric infectious disease expert at Vanderbilt University Medical Center.
August study Lancet Delta has shown to double the risk of hospitalization for adults, and scientists aren’t sure if that applies to children, said Dr. Anthony Fauci, the country’s top infectious disease official.
“At this point, we’re certainly not sure if our children have a more serious illness, but we’re watching for it,” he said.
Fauci urged parents to vaccinate themselves and children over the age of 12 to protect their children. For children who are too young for COVID shots, “The best way to keep children safe is to be surrounded by vaccinated people.”
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