Coronavirus infections in children: from SARS and MERS to COVID-19, a narrative review of epidemiological and clinical features

Coronavirus infections in children: from SARS and MERS to COVID-19, a narrative review of epidemiological and clinical features

Authors

  • Rosanna Iannarella Pediatric Clinic, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma
  • Claudia Lattanzi Pediatric Clinic, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma
  • Giulia Cannata Pediatric Clinic, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma
  • Alberto Argentiero Pediatric Clinic, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma
  • Cosimo Neglia Pediatric Clinic, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma
  • Valentina Fainardi Pediatric Clinic, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma
  • Giovanna Pisi Pediatric Clinic, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma
  • Susanna Esposito Pediatric Clinic, Pietro Barilla Children’s Hospital, Department of Medicine and Surgery, University of Parma

Keywords:

Coronavirus, Middle-East respiratory syndrome (MERS), Severe Acute respiratory syndrome (SARS), COVID-19, children, clinical manifestations.

Abstract

Emerging and re-emerging viruses represent an important challenge for global public health. In the 1960s, coronaviruses (CoVs) were recognized as disease agents in humans. In only two decades, three strains of CoVs have crossed species barriers rapidly emerging as human pathogens resulting in life-threatening disease with a pandemic potential: severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002, Middle-East respiratory syndrome coronavirus (MERS-CoV) in 2012 and the recently emerged SARS-CoV-2. This narrative review aims to provide a comprehensive overview of epidemiological, pathogenic and clinical features, along with diagnosis and treatment, of the ongoing epidemic of new coronavirus disease 2019 (COVID-19) in the pediatric population in comparison to the first two previous deadly coronavirus outbreaks, SARS and MERS. Literature analysis showed that SARS-CoV, MERS-CoV and SARS-CoV-2 infections seem to affect children less commonly and less severely as compared with adults. Since children are usually asymptomatic, they are often not tested, leading to an underestimate of the true numbers infected. Most of the documented infections belong to family clusters, so the importance of children in transmitting the virus remains uncertain. Like in SARS and MERS infection, there is the possibility that children are not an important reservoir for novel CoVs and this may have important implications for school attendance. While waiting for an effective against SARS-CoV-2, further prevalence studies in paediatric age are needed, in order to clarify the role of children in different age groups in the spread of the infection.

References

Lai MM. Coronavirus: organization, replication and expression of genome. Annu Rev Microbiol. 1990;44:303‐333. doi:10.1146/annurev.mi.44.100190.001511

Masters PS, Perlman S. Coronaviridae. In: Fields Virology, 6th ed, Knipe DM, Howley PM, Cohen JI, et al (Eds), Lippincott Williams & Wilkins, a Wolters Kluwer business, Philadelphia 2013. Vol 2, p.825

Woo PC, Huang Y, Lau SK, Yuen KY. Coronavirus genomics and bioinformatics analysis. Viruses. 2010;2(8):1804‐1820. doi:10.3390/v2081803

N. James Maclachlan Edward J Dubovi. In: Fenner's Veterinary Virology, 5th ed (2017), Chapter 24, p. 435

Su S, Wong G, Shi W, et al. Epidemiology, Genetic Recombination, and Pathogenesis of Coronaviruses. Trends Microbiol. 2016;24(6):490‐502. doi:10.1016/j.tim.2016.03.003

World Health Organization. Summary of probable SARS cases with onset of illness from 1 November 2002 to 31 July 2003. Available at http://www.who.int/csr/sars/country/table20030923/en/print.html; last accessed March 30 2020

World Health Organisation. Severe Acute Respiratory Syndrome Surveillance Team. Personal Communication

Chan WM, Kwan YW, Wan HS, Leung CW, Chiu MC. Epidemiologic linkage and public health implication of a cluster of severe acute respiratory syndrome in an extended family. Pediatr Infect Dis J. 2004;23(12):1156‐1159.

Hui DS, Sung JJ. Severe acute respiratory syndrome. Chest. 2003;124(1):12‐15. doi:10.1378/chest.124.1.12

Chan CW, Chiu WK, Chan CC, Chow EY, Cheung HM, Ip PL. Osteonecrosis in children with severe acute respiratory syndrome. Pediatr Infect Dis J. 2004;23(9):888‐890. doi:10.1097/01.inf.0000137570.37856.ea

Chiu WK, Cheung PC, Ng KL, et al. Severe acute respiratory syndrome in children: experience in a regional hospital in Hong Kong. Pediatr Crit Care Med. 2003;4(3):279‐283. doi:10.1097/01.PCC.0000077079.42302.81

Leung CW, Kwan YW, Ko PW, et al. Severe acute respiratory syndrome among children. Pediatrics. 2004;113(6):e535‐e543. doi:10.1542/peds.113.6.e535

Ng PC, Lam CW, Li AM, et al. Inflammatory cytokine profile in children with severe acute respiratory syndrome. Pediatrics. 2004;113(1 Pt 1):e7‐e14. doi:10.1542/peds.113.1.e7

Leung CW, Chiu WK. Clinical picture, diagnosis, treatment and outcome of severe acute respiratory syndrome (SARS) in children. Paediatr Respir Rev. 2004;5(4):275‐288. doi:10.1016/j.prrv.2004.07.010

Bitnun A, Allen U, Heurter H, et al. Children hospitalized with severe acute respiratory syndrome-related illness in Toronto. Pediatrics. 2003;112(4):e261. doi:10.1542/peds.112.4.e261

Li G, Chen X, Xu A. Profile of specific antibodies to the SARS-associated coronavirus. N Engl J Med. 2003;349(5):508‐509. doi:10.1056/NEJM200307313490520

Tsou IY, Loh LE, Kaw GJ, Chan I, Chee TS. Severe acute respiratory syndrome (SARS) in a paediatric cluster in Singapore. Pediatr Radiol. 2004;34(1):43‐46. doi:10.1007/s00247-003-1042-2

Leung CW, Li CK. PMH/PWH interim guideline on the management of children with SARS. HK J Paediatr 2003;8:168-9

Zaki AM, van Boheemen S, Bestebroer TM, Osterhaus AD, Fouchier RA. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia [published correction appears in N Engl J Med. 2013 Jul 25;369(4):394]. N Engl J Med. 2012;367(19):1814‐1820. doi:10.1056/NEJMoa1211721

World Health Organisation. Middle East respiratory syndrome coronavirus (MERS-CoV) – The Kingdom of Saudi Arabia. Available at: https://www.who.int/csr/don/24-february-2020-mers-saudi-arabia/en/; last accessed March 4 2020

Zumla A, Hui DS, Perlman S. Middle East respiratory syndrome. Lancet. 2015;386(9997):995‐1007. doi:10.1016/S0140-6736(15)60454-8

Bartenfeld M, Griese S, Uyeki T, Gerber SI, Peacock G. Middle East Respiratory Syndrome Coronavirus and Children. Clin Pediatr (Phila). 2017;56(2):187‐189. doi:10.1177/0009922816678820

Memish ZA, Al-Tawfiq JA, Makhdoom HQ, et al. Screening for Middle East respiratory syndrome coronavirus infection in hospital patients and their healthcare worker and family contacts: a prospective descriptive study. Clin Microbiol Infect. 2014;20(5):469‐474. doi:10.1111/1469-0691.12562

Khuri-Bulos N, Payne DC, Lu X, et al. Middle East respiratory syndrome coronavirus not detected in children hospitalized with acute respiratory illness in Amman, Jordan, March 2010 to September 2012. Clin Microbiol Infect. 2014;20(7):678‐682. doi:10.1111/1469-0691.12438

Memish ZA, Al-Tawfiq JA, Assiri A, et al. Middle East respiratory syndrome coronavirus disease in children. Pediatr Infect Dis J. 2014;33(9):904‐906. doi:10.1097/INF.0000000000000325

Thabet F, Chehab M, Bafaqih H, Al Mohaimeed S. Middle East respiratory syndrome coronavirus in children. Saudi Med J. 2015;36(4):484‐486. doi:10.15537/smj.2015.4.10243

Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, et al. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. Lancet Infect Dis. 2013;13(9):752‐761. doi:10.1016/S1473-3099(13)70204-4

World Health Organisation. Middle East respiratory syndrome coronavirus: case definition for reporting to WHO. Available at: https://www.who.int/csr/disease/coronavirus_infections/case_definition/en/; last accessed March 4 2020

World Health Organisation. WHO Statement Regarding Cluster of Pneumonia Cases in wuhan, China. Available at: https://www.who.int/china/news/detail/09-01-2020-who-statement; last accessed March 4 2020

Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020;382(8):727‐733. doi:10.1056/NEJMoa2001017

World Health Organization. Coronavirus disease (COVID-19) outbreak. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019; last accessed March 4 2020

World Health Organisation. WHO Virtual press conference on COVID-19. March 11, 2020. Available at: https://www.who.int/docs/defaultsource/coronaviruse/transcripts/who-audio-emergencies-coronavirus-press-conference-full-and-final11mar2020.pdf?sfvrsn=cb432bb3_2; last accessed March 16 2020

Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270‐273. doi:10.1038/s41586-020-2012-7

Lu R, Zhao X, Li J, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395(10224):565‐574. doi:10.1016/S0140-6736(20)30251-8

Ren LL, Wang YM, Wu ZQ, et al. Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study. Chin Med J (Engl). 2020;133(9):1015‐1024. doi:10.1097/CM9.0000000000000722

Guo Q, Li M, Wang C, Wang P, Fang Z, Tan J, Wu S, Xiao Y, Zhu H. Host and infectivity prediction of Wuhan 2019 novel coronavirus using deep learning algorithm. bioRxiv 2020

Ji W, Wang W, Zhao X, Zai J, Li X. Homologous recombination within the spike glycoprotein of the newly identified coronavirus may boost cross-species transmission from snake to human. J Med Virol 2020;92, 433–440

Xiao KP, Zhai JP Feng YY, et al. Isolation and Characterization of 2019 -nCoV-like Coronavirus from Malayan Pangolins. bioRxiv 2020.02.17.951335

Lam T, Shum M, Zhu HZ, et al. Identification of 2019-nCoV related coronaviruses in Malayan pangolins in southern China. bioRxiv 2020.02.13.945485

Lu R, Zhao X, Li J, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395(10224):565‐574. doi:10.1016/S0140-6736(20)30251-8

Lu G, Wang Q, Gao GF. Bat-to-human: spike features determining 'host jump' of coronaviruses SARS-CoV, MERS-CoV, and beyond. Trends Microbiol. 2015;23(8):468‐478. doi:10.1016/j.tim.2015.06.003

Du L, He Y, Zhou Y, Liu S, Zheng BJ, Jiang S. The spike protein of SARS-CoV--a target for vaccine and therapeutic development. Nat Rev Microbiol. 2009;7(3):226‐236. doi:10.1038/nrmicro2090

Du L, Yang Y, Zhou Y, Lu L, Li F, Jiang S. MERS-CoV spike protein: a key target for antivirals. Expert Opin Ther Targets. 2017;21(2):131‐143. doi:10.1080/14728222.2017.1271415

Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell. 2020;181(2):271‐280.e8. doi:10.1016/j.cell.2020.02.052

Wang Q, Zhang Y, Wu L, et al. Structural and Functional Basis of SARS-CoV-2 Entry by Using Human ACE2. Cell. 2020;181(4):894‐904.e9. doi:10.1016/j.cell.2020.03.045

Xia S, Zhu Y, Liu M, et al. Fusion mechanism of 2019-nCoV and fusion inhibitors targeting HR1 domain in spike protein [published online ahead of print, 2020 Feb 11]. Cell Mol Immunol. 2020;1‐3. doi:10.1038/s41423-020-0374-2

Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395(10223):514‐523. doi:10.1016/S0140-6736(20)30154-9

Dietz K. The estimation of the basic reproduction number for infectious diseases. Stat Methods Med Res. 1993;2(1):23‐41. doi:10.1177/096228029300200103

Ridenhour B, Kowalik JM, Shay DK. Unraveling R0: considerations for public health applications. Am J Public Health. 2014;104(2):e32‐e41. doi:10.2105/AJPH.2013.301704

World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report-46, 7th March 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200306-sitrep-46-covid-19.pdf?sfvrsn=96b04adf_4; last accessed March 16 2020

Lai A, Bergna A, Acciarri C, Galli M, Zehender G. Early phylogenetic estimate of the effective reproduction number of SARS-CoV-2 [published online ahead of print, 2020 Feb 25]. J Med Virol. 2020;10.1002/jmv.25723. doi:10.1002/jmv.25723

Liu Y, Gayle AA, Wilder-Smith A, Rocklöv J. The reproductive number of COVID-19 is higher compared to SARS coronavirus. J Travel Med. 2020;27(2):taaa021. doi:10.1093/jtm/taaa021

Hamming I, Timens W, Bulthuis ML, Lely AT, Navis G, van Goor H. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004;203(2):631‐637. doi:10.1002/path.1570

Zou X, Chen K, Zou J, Han P, Hao J, Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Front Med. 2020;14(2):185‐192. doi:10.1007/s11684-020-0754-0

Zhang H, Kang Z, Gong H, Xu D, Wang J, Li Z, et al. The digestive system is a potential route of 2019-nCov infection: a bioinformatics analysis based on single-cell transcriptomes. Preprint at https://www.biorxiv.org/content/10.1101/2020.01.30.927806v1 (2020)

Chai X, Hu L, Zhang Y, Han W, Lu Z, Ke A, et al. Specific ACE2 expression in cholangiocytes may cause liver damage after 2019-nCoV infection. Preprint at https://www.biorxiv.org/content/10.1101/2020.02.03.931766v1 (2020)

Lee PI, Hsueh PR. Emerging threats from zoonotic coronaviruses-from SARS and MERS to 2019-nCoV [published online ahead of print, 2020 Feb 4]. J Microbiol Immunol Infect. 2020;. doi:10.1016/j.jmii.2020.02.001

Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;382(13):1199‐1207. doi:10.1056/NEJMoa2001316

van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med. 2020;382(16):1564‐1567. doi:10.1056/NEJMc2004973

Lu CW, Liu XF, Jia ZF. 2019-nCoV transmission through the ocular surface must not be ignored. Lancet. 2020;395(10224):e39. doi:10.1016/S0140-6736(20)30313-5

Sun CB, Wang YY, Liu GH, Liu Z. Role of the Eye in Transmitting Human Coronavirus: What We Know and What We Do Not Know. Front Public Health. 2020;8:155. Published 2020 Apr 24. doi:10.3389/fpubh.2020.00155

Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect. 2020;104(3):246‐251. doi:10.1016/j.jhin.2020.01.022

Guo ZD, Wang ZY, Zhang SF, et al. Aerosol and Surface Distribution of Severe Acute Respiratory Syndrome Coronavirus 2 in Hospital Wards, Wuhan, China, 2020 [published online ahead of print, 2020 Apr 10]. Emerg Infect Dis. 2020;26(7):10.3201/eid2607.200885. doi:10.3201/eid2607.200885

Yeo C, Kaushal S, Yeo D. Enteric involvement of coronaviruses: is faecal-oral transmission of SARS-CoV-2 possible?. Lancet Gastroenterol Hepatol. 2020;5(4):335‐337. doi:10.1016/S2468-1253(20)30048-0

Chen Y, Chen L, Deng Q, et al. The presence of SARS-CoV-2 RNA in the feces of COVID-19 patients [published online ahead of print, 2020 Apr 3]. J Med Virol. 2020;10.1002/jmv.25825. doi:10.1002/jmv.25825

Holshue ML, DeBolt C, Lindquist S, et al. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med. 2020;382(10):929‐936. doi:10.1056/NEJMoa2001191

Cai J, Xu J, Lin D, et al. A Case Series of children with 2019 novel coronavirus infection: clinical and epidemiological features [published online ahead of print, 2020 Feb 28]. Clin Infect Dis. 2020;ciaa198. doi:10.1093/cid/ciaa198

Ong SWX, Tan YK, Chia PY, et al. Air, Surface Environmental, and Personal Protective Equipment Contamination by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) From a Symptomatic Patient [published online ahead of print, 2020 Mar 4]. JAMA. 2020;323(16):1610‐1612. doi:10.1001/jama.2020.3227

Istituto Superiore di Sanità. Epidemia COVID-19. Aggiornamento nazionale. 20 maggio 2020 – ore 16.00. Available at: https://www.epicentro.iss.it/coronavirus/bollettino/bollettino-sorveglianza-integrata-covid-19_20-maggio-2020; last accessed May 24 2020

Yang P, Liu P, Li D, Zhao D. Corona Virus Disease 2019, a growing threat to children?. J Infect. 2020;80(6):671‐693. doi:10.1016/j.jinf.2020.02.024

Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;382(13):1199‐1207. doi:10.1056/NEJMoa2001316

Dong Y, Mo XI, Hu Y, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics. 2020;16:16. doi:10.1542/peds.2020-0702

Lu X, Zhang L, Du H, et al. SARS-CoV-2 Infection in Children. N Engl J Med. 2020;382(17):1663‐1665. doi:10.1056/NEJMc2005073

Liu W, Zhang Q, Chen J, et al. Detection of Covid-19 in Children in Early January 2020 in Wuhan, China. N Engl J Med. 2020;382(14):1370‐1371. doi:10.1056/NEJMc2003717

Zheng F, Liao C, Fan QH, et al. Clinical Characteristics of Children with Coronavirus Disease 2019 in Hubei, China. Curr Med Sci. 2020;40(2):275‐280. doi:10.1007/s11596-020-2172-6

Cai J, Xu J, Lin D, et al. A Case Series of children with 2019 novel coronavirus infection: clinical and epidemiological features [published online ahead of print, 2020 Feb 28]. Clin Infect Dis. 2020;ciaa198. doi:10.1093/cid/ciaa198

Xia W, Shao J, Guo Y, Peng X, Li Z, Hu D. Clinical and CT features in pediatric patients with COVID-19 infection: Different points from adults. Pediatr Pulmonol. 2020;55(5):1169‐1174. doi:10.1002/ppul.24718

Riphagen S, Gomez X, Gonzalez-Martinez C, Wilkinson N, Theocharis P. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet. 2020;395(10237):1607‐1608. doi:10.1016/S0140-6736(20)31094-1

Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 2020;109(6):1088‐1095. doi:10.1111/apa.15270

Centers for Disease Control and Prevention. Coronavirus Disease 2019 in Children — United States, February 12–April 2, 2020. Available at: https://www.cdc.gov/mmwr/volumes/69/wr/mm6914e4.htm#F2_down; last accessed May 24 2020

Dong Y, Mo X, Hu Y, et al. Epidemiology of COVID-19 Among Children in China [published online ahead of print, 2020 Mar 16]. Pediatrics. 2020;e20200702. doi:10.1542/peds.2020-0702

Henry BM, Lippi G, Plebani M. Laboratory abnormalities in children with novel coronavirus disease 2019 [published online ahead of print, 2020 Mar 16]. Clin Chem Lab Med. 2020;/j/cclm.ahead-of-print/cclm-2020-0272/cclm-2020-0272.xml. doi:10.1515/cclm-2020-0272

Fang Y, Zhang H, Xie J, et al. Sensitivity of Chest CT for COVID-19: Comparison to RT-PCR [published online ahead of print, 2020 Feb 19]. Radiology. 2020;200432. doi:10.1148/radiol.2020200432

Li W, Cui H, Li K, Fang Y, Li S. Chest computed tomography in children with COVID-19 respiratory infection. Pediatr Radiol. 2020;50(6):796‐799. doi:10.1007/s00247-020-04656-7

Duan YN, Zhu YQ, Tang LL, Qin J. CT features of novel coronavirus pneumonia (COVID-19) in children [published online ahead of print, 2020 Apr 14]. Eur Radiol. 2020;1‐7. doi:10.1007/s00330-020-06860-3

Zimmermann P, Curtis N. Coronavirus Infections in Children Including COVID-19: An Overview of the Epidemiology, Clinical Features, Diagnosis, Treatment and Prevention Options in Children. Pediatr Infect Dis J. 2020;39(5):355‐368. doi:10.1097/INF.0000000000002660

Hon KL, Leung CW, Cheng WT, et al. Clinical presentations and outcome of severe acute respiratory syndrome in children. Lancet. 2003;361(9370):1701‐1703. doi:10.1016/s0140-6736(03)13364-8

Chen ZM, Fu JF, Shu Q, et al. Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus [published online ahead of print, 2020 Feb 5]. World J Pediatr. 2020;1‐7. doi:10.1007/s12519-020-00345-5

Tsou IY, Loh LE, Kaw GJ, Chan I, Chee TS. Severe acute respiratory syndrome (SARS) in a paediatric cluster in Singapore. Pediatr Radiol. 2004;34(1):43‐46. doi:10.1007/s00247-003-1042-2

Chen ZM, Fu JF, Shu Q, et al. Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel coronavirus [published online ahead of print, 2020 Feb 5]. World J Pediatr. 2020;1‐7. doi:10.1007/s12519-020-00345-5

Jones VG, Mills M, Suarez D, et al. COVID-19 and Kawasaki Disease: Novel Virus and Novel Case [published online ahead of print, 2020 Apr 7]. Hosp Pediatr. 2020;hpeds.2020-0123. doi:10.1542/hpeds.2020-0123

Giamarellos-Bourboulis EJ, Netea MG, Rovina N, et al. Complex Immune Dysregulation in COVID-19 Patients with Severe Respiratory Failure [published online ahead of print, 2020 Apr 17]. Cell Host Microbe. 2020;S1931-3128(20)30236-5. doi:10.1016/j.chom.2020.04.009

Zhou Y, Fu B, Zheng X, et al. Pathogenic T cells and inflammatory monocytes incite inflammatory storm in severe Covid-19 patients. Natl Sci Rev 2020 Mar 13. doi: 10.1093/nsr/nwaa041

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07-09-2020

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Coronavirus infections in children: from SARS and MERS to COVID-19, a narrative review of epidemiological and clinical features. Acta Biomed [Internet]. 2020 Sep. 7 [cited 2024 Jun. 20];91(3):e2020032. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/10294

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