Why is COVID-19 less severe in children?

You hear more now about kids getting sick with COVID-19, but a Maryland pediatrician believes it’s only because the Delta variant is so contagious.

All evidence thus far suggests the more contagious Delta variant of the coronavirus impacts children and adults the same way as SARS-CoV-2, the original virus that causes COVID-19.

A pediatric infectious disease specialist at the University of Maryland School of Medicine believes higher amount of illness, hospitalizations and fatalities being reported in children now is a reflection of how quickly the virus is being spread.

“So far for the Delta variant, we think the proportion is the same,” Associate Professor of Pediatrics Dr. Andrea A. Berry said. “Children have a lower amount of symptomatic illness, a lower amount of hospitalizations, and a lower amount of mortalities than, for example, elderly adults.”

Why is COVID-19 less severe in children?

“The question of why the response is different in adults versus children is really not well-understood,” Berry said. “There are a couple of hypotheses.”

Among them is that adults are more likely to have co-morbid conditions, and children have better immune systems for fighting infections than elderly adults. There also are some viral infections that cause more dramatic responses with repeat exposures.

“A good example of that is Dengue virus infection,” Berry said. “There are four major types of Dengue viruses, and when somebody gets one of the subtypes that tend to be a milder illness and then at the second, third or fourth infection, it manifests as dengue hemorrhagic fever.”

There are several common human coronaviruses that cause illnesses such as the common cold.

“Most people get infected with one or more of these viruses at some point in their lives,” according to the Centers for Disease Control and Prevention.

Seasonal coronavirus exposure is also given as a potential reason that kids are protected.

“Maybe some of the seasonal coronavirus exposures that adults have had predispose them to have a more severe disease,” Berry said. “I would say this is pretty soundly in the hypothesis phase; it’s not well established. But the idea is that previous exposures to seasonal coronaviruses might cause an immune response, that when the SARS-CoV-2 virus, which is the virus responsible for COVID-19, infects an adult, maybe that reaction is more severe.”

In a discussion about children having less severe disease than adults, Berry said she wants emphasize that youngsters do get sick, hospitalized and die from COVID-19, and that they need to be protected.

“A huge way that is important for helping children stay safe is for the people who are eligible around those children — the adults and children 12 and older — to be vaccinated,” Berry said. “When the time comes that vaccination is available to children under 12, I would advocate for them to get vaccinated as well.”

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Kristi King

Kristi King is a veteran reporter who has been working in the WTOP newsroom since 1990. She covers everything from breaking news to consumer concerns and the latest medical developments.

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