Why Young Kids Don’t Get as Sick from COVID-19 as Adults Do?

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The world has been caught up in coronavirus concerns for a couple of months now. Reading about severe illness and death due to COVID-19 has become a way of life for most of us. Yet among the many puzzling aspects that we might read about regarding this illness, there’s some news that has somewhat of a positive spin on it: for the most part, our kids are not getting sick from it.

Why do children seem to do so much better in the face of this virus which is life threatening for so many? One difficulty that we run into in answering this question is that everything is happening so fast that it’s tough to gather meaningful data that doesn’t somehow change the picture from one week to the next—sometimes faster than it can be published. Thus, we have to sometimes base our impressions on what might seem like ancient history, despite happening just a few weeks ago.

Some Early Numbers

We all know that the early cases of COVID-19 were reported in China, so a lot of the published data has come from there. That early research shows that children who contracted the virus were not generally ill enough to be hospitalized. Among the tens of thousands of these early cases, there was only one death in the pediatric age group (a 14-year-old). In the United States, it was several weeks before any child deaths were reported, and they are still few and far between; most have been in young infants. Hospitalizations have also been low; as of April 2nd, only 1.7% have been children under 18.

But…Why?

The researchers in China early on tried to come up with some answers to this very question. Some put forward the theory that kids are getting infected less, because they are not “out and about” as much as adults. Yet all parents have to do is look at what often goes around in their children’s own school to know that they can pass things back and forth pretty quickly. Similarly, some have said that are youngest haven’t been getting tested as often, because they have so many respiratory illnesses that many maladies thought to be colds were actually COVID-19. But that just explains less infections being diagnosed—not less very sick kids, whom we would hope by now are being tested more frequently.

Another theory has to do with what we’ve been exposed to. Adults, particularly older ones, have had a lifetime of exposure to smoke, pollutants, and other insults on our lungs. Perhaps there’s just enough damage from these agents to make the lungs less resistant to COVID-19, even if they seem relatively unscathed from other infections. However, there’s another possibility—the body is defending the virus too much rather than too little. Read on:

Our Immune System

We all know that different infections can hit us differently, depending on how old we are. Infants and young children are much more susceptible to certain bacteria than are adults. On the other hand, certain diseases such as mononucleosis, chicken pox and Fifth disease make adults sicker than they do kids.

A lot of this has to do with our infection-fighting immune system. We all need an immune system to ward off germs. However, sometimes our natural infection fighters can turn on us and contribute to illness. This happens not only with certain infections, but also with diseases such as lupus and rheumatoid arthritis, which affect adults more than children.

Could the experienced immune system of adults be to blame? To get some perspective on this, I contacted Dr. Alfredo Tagarro, a pediatrician and research physician in Madrid, Spain. In the journal JAMA Pediatrics, Dr. Tagarro and his colleagues published findings in regarding the COVID19 cases in Madrid as of mid-March. At that time, the researchers noted that 0.8% of the affected individuals were children younger than 18 years. Per Dr. Tagarro: “It’s only conjecture, but I am pretty confident that it has a lot to do with the immune system in children which is, at the same time, more tolerant than in adults.”

This definitely gives us food for thought in this time of uncertainty. Certainly, more research is needed. And it doesn’t explain why among young people who become very ill from COVID-19, the majority are young infants with weaker immune systems. It seems as if where coronavirus is concerned, our bodies can take both the praise and the blame for illness: perhaps some part of our immune system helps, and another part can cause harm.

As we all get through this, hopefully we’ll know a little more going forward. We can, however, take some comfort in knowing that the great majority of our youngest citizens seem to get through infection OK.

Stan Sack
Dr. Stan Sack has 29 years’ experience as a primary care pediatrician in Massachusetts and Florida. A medical writer since 2015, he enjoys blogging on topics that are on parents’ minds but are covered less often in books and on websites. He lives in the Florida Keys with his family and enjoys healthy cooking, fitness activities and singing in his spare time.

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