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UNDER DEVELOPMENT UNICEF Innocenti's curated library of COVID-19 + Children research

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Commentaries and Think Pieces

COVID-19 herd immunity by immunisation: are children in the herd?

AUTHOR(S)
Stephen Obaro

Published: April 2021 Journal: The Lancet Infectious Diseases

The scourge of COVID-19 has been global, but the most affected subgroups in the population have largely been older people and individuals with comorbid conditions that predispose them to increasingly severe disease and poor outcomes. Overall, the disease burden in children has been reasonably mild, even in those with comorbidities, such as oncological conditions. Protection from severe disease in children might be related to a lower expression of host factors required for viral replication, and to differences in the magnitude and timing of innate or adaptive immune responses. Data for recorded COVID-19 cases show that only 7% of children younger than 18 years with severe disease required intensive care, whereas 53% of adults who had severe disease required intensive care.

Journal article

Comparison of severe acute respiratory syndrome Coronavirus 2-specific antibodies' binding capacity between human milk and serum from Coronavirus disease 2019-recovered women

AUTHOR(S)
Veronique Demers-Mathieu; Ciera DaPra; Elena Medo

Published: April 2021 Journal: Breastfeeding Medicine

Human milk from coronavirus disease 2019 (COVID-19)-recovered women may be useful as oral antibody therapy to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and provide long-term immunity to neonates and young children. As convalescent plasma is already used as antibody therapy, this study aimed to compare the binding capacity of antibodies specific to the receptorbinding domain (RBD) of SARS-CoV-2 between human milk.

Journal article

Education, healthy ageing and vaccine literacy

AUTHOR(S)
J.-P. Michel; J. Goldberg

Published: April 2021 Journal: The journal of nutrition, health & aging

The Covid pandemic is a timely opportunity to try to broaden our understanding of the links between education and health literacy and explore the vaccine-decision process with a view to identifying interventions that will positively influence vaccine uptake.

Journal article

Monitoring progress of maternal and neonatal immunization in Latin America and the Caribbean

AUTHOR(S)
Martha Velandia-González; Alba Vilajeliu; Marcela Contreras (et al.)

Published: March 2021 Journal: Vaccine

The Americas committed to strengthening maternal and neonatal immunization (MNI) through the Pan American Health Organization (PAHO) Regional Immunization Action Plan (RIAP)2016–20. This paper describes the progress toward RIAP MNI-related targets and those related to improvement of data quality and information systems; analyze national MNI policies and vaccination coverages; and identify enablers and challenges of monitoring and reporting MNI vaccination coverage in Latin America and the Caribbean (LAC).

Journal article

Differences in immune responses between children and adults with COVID-19

AUTHOR(S)
Yin Yuan; Qiu-peng Wang; Dan Sun (et al.)

Published: February 2021 Journal: Current Medical Science

Over 85 590 000 individuals have been infected with severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Although there have been an increasing number of reports on coronavirus disease 2019 (COVID-19), it is unclear why infected children show milder symptoms than adults. A retrospective case study was performed at two designated hospitals for COVID-19. Patients (56 children and 63 adults) with confirmed SARS-CoV-2 infection and mild pneumonia were randomly enrolled in this study. The median age of the children was 7.0 years, and 51.79% of them were boys. The median age of the adults was 57 years, and 47.62% were men. The most common symptoms were fever, cough, sputum and diarrhoea. There were no significant differences in symptoms between children and adult patients.

Journal article

Innate cell profiles during the acute and convalescent phase of SARS-CoV-2 infection in children

AUTHOR(S)
Melanie R. Neeland; Samantha Bannister; Vanessa Clifford (et al.)

Published: February 2021 Journal: Nature Communications volume

Children have mild severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) confirmed disease (COVID-19) compared to adults and the immunological mechanisms underlying this difference remain unclear. Here, it is reported acute and convalescent innate immune responses in 48 children and 70 adults infected with, or exposed to, SARS-CoV-2. It has been found clinically that mild SARS-CoV-2 infection in children is characterised by reduced circulating subsets of monocytes (classical, intermediate, non-classical), dendritic cells and natural killer cells during the acute phase. In contrast, SARS-CoV-2-infected adults show reduced proportions of non-classical monocytes only. It has also been observed increased proportions of CD63+ activated neutrophils during the acute phase to SARS-CoV-2 in infected children. Children and adults exposed to SARS-CoV-2 but negative on PCR testing display increased proportions of low-density neutrophils that have been observed up to 7 weeks post exposure. This study characterises the innate immune response during SARS-CoV-2 infection and household exposure in children.

Research Report

Digital technologies for real-time monitoring of immunization activities: good practices and lessons learned

Institution: *UNICEF, GAVI
Published: January 2021

This report compiles the good practices and lessons learned from countries implementing real-time monitoring (RTM) - activities that employ digital technologies to accelerate the sharing, analysis and use of data to improve campaign quality - for immunization campaigns. Data and information were collected using a mix of interviews (United Nations Children's Fund, World Health Organization, and regional and country office staff); consultations with key partners; a field mission to Pakistan; and documents and journal articles. Four countries with robust experience implementing RTM technologies for immunization campaigns - Indonesia, Pakistan, Uganda and Zambia - were included as case studies.

Journal article

COVID-19 in children: could pertussis vaccine play the protective role?

AUTHOR(S)
Mohamad Bachar Ismail; Sarah Al Omari; Rayane Rafei (et al.)

Published: December 2020 Journal: Medical Hypotheses

While COVID-19 continues to spread across the globe, diligent efforts are made to understand its attributes and dynamics to help develop treatment and prevention measures. The paradox pertaining to children being the least affected by severe illness poses exciting opportunities to investigate potential protective factors. The Hypothesis of this paper is that childhood vaccination against pertussis (whooping cough) might play a non-specific protective role against COVID-19 through heterologous adaptive responses in this young population. Pertussis is a vaccine-preventable infectious disease of the respiratory tract and it shares many similarities with COVID-19 including transmission and clinical features. Although pertussis is caused by a bacterium (Bordetella pertussis) while COVID-19 is a viral infection (SARS-CoV-2), previous data showed that cross-reactivity and heterologous adaptive responses can be seen with unrelated agents of highly divergent groups, such as between bacteria and viruses.

Journal article

Immune responses to SARS-CoV-2 in three children of parents with symptomatic COVID-19

AUTHOR(S)
Shidan Tosif; Melanie R. Neeland; Nigel W. Crawford (et al.)

Published: November 2020 Journal: Nature Communications

Compared to adults, children with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have predominantly mild or asymptomatic infections, but the underlying immunological differences remain unclear. This study describes clinical features, virology, longitudinal cellular, and cytokine immune profile, SARS-CoV-2-specific serology and salivary antibody responses in a family of two parents with PCR-confirmed symptomatic SARS-CoV-2 infection and their three children, who tested repeatedly SARS-CoV-2 PCR negative. Cellular immune profiles and cytokine responses of all children are similar to their parents at all timepoints. All family members have salivary anti-SARS-CoV-2 antibodies detected, predominantly IgA, that coincide with symptom resolution in 3 of 4 symptomatic members. Plasma from both parents and one child have IgG antibody against the S1 protein and virus-neutralizing activity detected. Using a systems serology approach, this study shows higher levels of SARS-CoV-2-specific antibody features of these family members compared to healthy controls. These data indicate that children can mount an immune response to SARS-CoV-2 without virological confirmation of infection, raising the possibility that immunity in children can prevent the establishment of SARS-CoV-2 infection.

Journal article

A comprehensive review of neurologic manifestations of COVID-19 and management of pre-existing neurologic disorders in children

AUTHOR(S)
Yunsung Kim; Sarah A. Walser; Sheila J. Asghar (et al.)

Published: October 2020 Journal: Journal of Child Neurology

Since the first reports of SARS-CoV-2 infection from China, multiple studies have been published regarding the epidemiologic aspects of COVID-19 including clinical manifestations and outcomes. The majority of these studies have focused on respiratory complications. However, recent findings have highlighted the systemic effects of the virus, including its potential impact on the nervous system. Similar to SARS-CoV-1, cellular entry of SARS-CoV-2 depends on the expression of ACE2, a receptor that is abundantly expressed in the nervous system. Neurologic manifestations in adults include cerebrovascular insults, encephalitis or encephalopathy, and neuromuscular disorders. However, the presence of these neurologic findings in the pediatric population is unclear. In this review, the potential neurotropism of SARS-CoV-2, known neurologic manifestations of COVID-19 in children, and management of preexisting pediatric neurologic conditions during the COVID-19 pandemic are discussed.

Evidence Synthesis and other Reviews

Childhood immunization and COVID-19: an early narrative review

AUTHOR(S)
Bojana Beric-Stojsic; Julie Kalabalik-Hoganson; Denise Rizzolo (et al.)

Published: October 2020 Journal: Frontiers in Public Health

The COVID-19 pandemic has evolved into arguably the largest global public health crisis in recent history—especially in the absence of a safe and effective vaccine or an effective anti-viral treatment. As reported, the virus seems to less commonly infect children and causing less severe symptoms among infected children. This narrative review provides an inclusive view of scientific hypotheses, logical derivation, and early analyses that substantiate or refute such conjectures. At the completion of a relatively less restrictive search of this evolving topic, 13 articles—all published in 2020, were included in this early narrative review.

Journal article

What chances do children have against COVID-19? Is the answer hidden within the thymus?

AUTHOR(S)
Hatice Güneş; Serpil Dinçer; Can Acıpayam (et al.)

Published: October 2020 Journal: European Journal of Pediatrics

As with other types of coronaviruses, SARS-CoV-2 affects children less frequently, and it has been observed that the disease is mild. In the pathogenesis of a standard viral infection, the pathogen’s contact with the mucosa is initially followed by an innate immunity response. T cells are the primary decisive element in adaptive immunity capability. For this reason, the adaptive immune response mediated by the thymus is a process that regulates the immune response responsible for preventing invasive damage from a virus. Regulatory T cells (T-reg) are active during the early periods of life and have precise roles in immunomodulation. The thymus is highly active in the intrauterine and neonatal period; it begins to shrink after birth and continues its activity until adolescence. The loss of T-reg function by age results in difficulty with the control of the immune response, increased inflammation as shown in coronavirus disease (COVID-19) as an inflammatory storm. Also, the thymus is typically able to replace the T cells destroyed by apoptosis caused by the virus. Thymus and T cells are the key factors of pathogenesis of SARS-CoV-2 in children. Since thymus activity and T lymphocyte function in children protect them against the virus effects, stimulating and preventing the inhibition of the thymus can be possible treatment components against COVID-19.

Journal article

Acro-ischemic injuries in children-adolescents during CoViD-19 pandemic: from lifestyle changes due to lockdown to interferone

AUTHOR(S)
Federico Marchetti; Claudia Guiducci; Barbara Bigucci

Published: September 2020 Journal: Recenti Progressi in Medicina

This paper reports the descriptive experience of 14 cases of acro-ischemia in children and adolescents observed in the territorial area of Ravenna and Rimini. The cases were subjected to the nasopharyngeal swab and to the search for antibodies with ELISA method for CoViD-19 both with negative results.

Datasets

Children, HIV and AIDS, how will progress be impacted by COVID-19?

Institution: UNICEF Data & Analytics
Published: July 2020 UNICEF Publication

Coronavirus-related service disruptions threaten to reverse the decade-long progress made for children and pregnant women in the fight against HIV.

Cite this research | Language: English | Topics: Health | Tags: HIV and AIDS, immunization, multi-country, vaccination policies

Journal article

Reflection on lower rates of COVID-19 in children: Does childhood immunizations offer unexpected protection?

AUTHOR(S)
Lyu Jinglu; Tianyu Miao; Ranran Cao (et al.)

Published: July 2020 Journal: Medical Hypotheses

The incidence of COVID-19 in children and teenagers is only about 2% in China. Children had mild symptoms and hardly infected other children or adults. It is worth considering that children are the most vulnerable to respiratory pathogens, but fatal SARS-like virus had not caused severe cases among them. According to the pathological studies of COVID-19 and SARS, a sharp decrease in T lymphocytes leads to the breakdown of the immune system. The cellular immune system of children differs from that of adults may be the keystone of atypical clinical manifestations or even covert infection. The frequent childhood vaccinations and repeated pathogens infections might be resulting in trained immunity of innate immune cells, immune fitness of adaptive immune cells or cross-protection of antibodies in the children. Therefore, due to lack of specific vaccine, some vaccines for tuberculosis, influenza and pneumonia may have certain application potential for the front-line health workers in the prevention and control of COVID-19. However, for high-risk susceptible populations, such as the elderly with basic diseases such as hypertension and diabetes, it is necessary to explore the remedial effect of the planned immune process on their immunity to achieve the trained immunity or immune fitness, so as to improve their own antiviral ability.

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UNICEF Innocenti's Children and COVID-19 Library is a database collecting research from around the world on COVID-19 and its impacts on children and adolescents.

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