Nature https://doi.org/10.1038/04345-x (2022)
One of the characteristic features of COVID-19 is the much milder disease course seen in children; however, the mechanisms that underlie this are incompletely understood. To address this question, Mayer and colleagues use multi-omics approaches to compare immune responses in matched samples from the respiratory tracts and blood of adults and children. Both children and adults show similar expression of SARS-CoV-2 entry receptors in the respiratory tract but the interferon (IFN) response signature is clearly distinct. In healthy children, the epithelium shows an increased IFN signature with poor induction during COVID-19. By contrast, adults have an initially weak IFN signature that is strongly induced in COVID-19. Systemically, children show a generally naive immune compartment during COVID-19 whereas adults show a strong cytotoxic and inflammatory signature. Collectively, this suggests that the higher steady-state expression of IFN in children restricts SARS-CoV-2 in the upper respiratory tract and prevents more severe systemic inflammation.
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Fehervari, Z. Young versus old. Nat Immunol 23, 150 (2022). https://doi.org/10.1038/s41590-022-01135-z
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DOI: https://doi.org/10.1038/s41590-022-01135-z