ReviewThe Pediatric infectious disease journal2022
Why Does the Severity of COVID-19 Differ With Age?: Understanding the Mechanisms Underlying the Age Gradient in Outcome Following SARS-CoV-2 Infection.
Review in The Pediatric infectious disease journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 3 syntheses or guidelines pooled it, 87 citations in OpenAlex.
- Risk Factors for Pediatric Critical COVID-19: A Systematic Review and Meta-Analysis.Journal of the Pediatric Infectious Diseases Society · 2024Pooled it
- Guidance for prevention and management of COVID-19 in children and adolescents: A consensus statement from the Pediatric Infectious Diseases Society Pediatric COVID-19 Therapies Taskforce.Journal of the Pediatric Infectious Diseases Society · 2024Pooled it
- Do we need to vaccinate every child against COVID-19: What evidence suggests-A systematic review of opinions.Frontiers in public health · 2022Pooled it
- Immunogenicity, safety and consistency of seven lots of an inactivated COVID-19 vaccine in healthy children and adolescents: a randomized, double-blind, controlled, phase IV clinical trial.Frontiers in immunology · 2023Trial
- Antibiotic overuse in children with viral infections: lessons from the SARS-CoV-2 pandemic.BMJ paediatrics open · 2026Article
- Viral variant but not host factors associate with SARS-CoV-2 viral kinetics.Communications medicine · 2026Article
- Expression of angiotensin-converting enzyme 2, transmembrane serine protease 2, and sirtuin 1 proteins in lungs of different age groups.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2026Article
- The Common Cold Is Associated With Protection From SARS-CoV-2 Infections.The Journal of infectious diseases · 2025Observational
- Pediatric Liver and Kidney Transplant Recipients Demonstrate Greater Serological Response to SARS-CoV-2 Vaccination Than Adults.Transplantation direct · 2025Article
- Assessment of the prevalence of respiratory pathogens and the level of immunity to respiratory viruses in soldiers and civilian military employees in Poland.Respiratory research · 2025Article
- Comparative analysis of C-Reactive protein levels among Non-comorbid, Comorbid, and Multimorbid Hospitalized COVID-19 patients.BMC infectious diseases · 2025Observational
- The underlying mechanism behind the different outcomes of COVID-19 in children and adults.Frontiers in immunology · 2025Review
- Serological analyses against endemic human coronaviruses and SARS-CoV-2 in children and adults using samples collected before the COVID-19 pandemic.IJID regions · 2024Article
- The lung ultrasound in children with SARS-COV-2 infection: a national multicenter prospective study.European journal of pediatrics · 2024Article
- The Interleukin-6 gene variants may protect against SARS-CoV-2 infection and the severity of COVID-19: a case-control study in a Moroccan population.BMC medical genomics · 2024Article
- Long COVID in Children, Adults, and Vulnerable Populations: A Comprehensive Overview for an Integrated Approach.Diseases (Basel, Switzerland) · 2024Review
- COVID-19 vaccination induces distinct T-cell responses in pediatric solid organ transplant recipients and immunocompetent children.NPJ vaccines · 2024Article
- Article
- Use of Remdesivir in children with COVID-19: report of an Italian multicenter study.Italian journal of pediatrics · 2024Article
- Genetic determinants of SARS-CoV-2 and the clinical outcome of COVID-19 in Southern Bangladesh.Immunity, inflammation and disease · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although there are many hypotheses for the age-related difference in the severity of COVID-19, differences in innate, adaptive and heterologous immunity, together with differences in endothelial and clotting function, are the most likely mechanisms underlying the marked age gradient. Children have a faster and stronger innate immune response to SARS-CoV-2, especially in the nasal mucosa, which rapidly controls the virus. In contrast, adults can have an overactive, dysregulated and less effective innate response that leads to uncontrolled pro-inflammatory cytokine production and tissue injury. More recent exposure to other viruses and routine vaccines in children might be associated with protective cross-reactive antibodies and T cells against SARS-CoV-2. There is less evidence to support other mechanisms that have been proposed to explain the age-related difference in outcome following SARS-CoV-2 infection, including pre-existing immunity from exposure to common circulating coronaviruses, differences in the distribution and expression of the entry receptors ACE2 and TMPRSS2, and difference in viral load.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.