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코로나바이러스감염증-19: 소아청소년의 임상 경과가 성인에 비하여 양호한 이유

Coronavirus Disease 2019: Reasons for Better Clinical Course for Children Compared to Adults

김동현|곽병옥
대한소아감염학회 (The Korean Society of Pediatric Infectious Diseases)|2021.04|Pediatric Infection and Vaccine|제28권 제1호|pp. 1-6|DOI 10.14776/piv.2021.28.e3

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COVID-19ChildRespiratory infectionsSevere acute respiratory syndrome coronavirus 2

초록

소아청소년 코로나바이러스감염증-19 환자들의 유병률과 사망률이 성인에 비하여 낮지만, 임상적인 중증도가 낮은 이유는 아직 잘 알려져 있지 않다. 소아청소년 환자들이 비교적 가벼운 임상 경과를 보이는 이유에 관하여 지금까지 알려진 내용들을 살펴보면, 코로나바이러스감염증-19의 임상 경과에 영향을 줄 수 있는 면역 체계의 특성과 면역 상호작용, 안지오텐신전환효소 2 수용체의 역할, 호흡기계의 특징, 동반 질환과 위험 요인 보유, 방역 조치의 영향 등에서 소아청소년은 성인과 구별되는 차이점이 있었다. 그러나 상대적으로 양호한 임상 경과를 보이는 소아청소년 환자들이라 하더라도 필요한 의료 자원이 적시에 제공되어야 한다.

Abstract

There have been several reports on why the clinical course of coronavirus disease 2019 (COVID-19) in pediatric patients is milder than in adults. There are distinctive points in the immune system between children and adults, as well as in the angiotensin-converting enzyme 2 gene expression, the characteristics of the respiratory system, the effects of comorbidities and risk factors, and the effect of infection control. Even though children tend to have mild forms of COVID-19, this does not mean that we should not regard it as a matter of importance.

참고문헌 (30)

  1. Coronavirus Disease 2019 (COVID-19), "World Health Organization", World Health Organization, ~, pp.Situation Report-204 (2020)
  2. Wu Z, "Characteristics of and important lessons from the coronavirus disease 2019(COVID-19)outbreak in China : summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention", JAMA, 323, pp.1239~1242 (2020)
  3. Cruz AT, "COVID-19 in children : initial characterization of the pediatric disease", Pediatrics, 145, pp.e20200834~ (2020)
  4. Jiehao C, "A case series of children with 2019 novel coronavirus infection : clinical and epidemiological features", Clin Infect Dis, 71, pp.1547~1551 (2020)
  5. Dong Y, "Epidemiology of COVID-19 among children in China", Pediatrics, 145, pp.e20200702~ (2020)
  6. Simon AK, "Evolution of the immune system in humans from infancy to old age", Proc Biol Sci, 282, pp.20143085~ (2015)
  7. Benn CS, "A small jab-a big effect : nonspecific immunomodulation by vaccines", Trends Immunol, 34, pp.431~439 (2013)
  8. Olin A, "Stereotypic immune system development in newborn children", Cell, 174, pp.1277~1292.e14 (2018)
  9. "Correlation between Universal BCG Vaccination Policy and Reduced Mortality for COVID-19" (2020)[URL]
  10. Kleinnijenhuis J, "Long-lasting effects of BCG vaccination on both heterologous Th1", Th17 responses and innate trained immunity, 2014, pp.6, 152~158
  11. Arts RJW, "BCG vaccination protects against experimental viral infection in humans through the induction of cytokines associated with trained immunity", Cell Host Microbe, 23, pp.89~100.e5 (2018)
  12. Nickbakhsh S, "Virus-virus interactions impact the population dynamics of influenza and the common cold", Proc Natl Acad Sci U S A, 116, pp.27142~27150 (2019)
  13. Jia HP, "ACE2 receptor expression and severe acute respiratory syndrome coronavirus infection depend on differentiation of human airway epithelia", J Virol, 79, pp.14614~14621 (2005)
  14. Xu H, "High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa", Int J Oral Sci, 12, pp.8~ (2020)
  15. Hamming I, "Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis", J Pathol, 203, pp.631~637 (2004)
  16. Bunyavanich S, "Nasal gene expression of angiotensin-converting enzyme 2 in children and adults", JAMA, 323, pp.2427~2429 (2020)
  17. Imai Y, "Angiotensin-converting enzyme 2 protects from severe acute lung failure", Nature, 436, pp.112~116 (2005)
  18. Schouten LR, "Age-dependent differences in pulmonary host responses in ARDS : a prospective observational cohort study", Ann Intensive Care, 9, pp.55~ (2019)
  19. Ortiz ME, "Heterogeneous expression of the SARS-coronavirus-2 receptor ACE2 in the human respiratory tract", EBioMedicine, 60, pp.102976~ (2020)
  20. Phalen RF, "Postnatal enlargement of human tracheobronchial airways and implications for particle deposition", Anat Rec, 212, pp.368~380 (1985)
  21. Chilvers MA, "Functional analysis of cilia and ciliated epithelial ultrastructure in healthy children and young adults", Thorax, 58, pp.333~338 (2003)
  22. Navarro S, "Regeneration of the aging lung : a mini-review", Gerontology, 63, pp.270~280 (2017)
  23. Du RH, "Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2 : a prospective cohort study", Eur Respir J, 55, pp.2000524~ (2020)
  24. Brake SJ, "Smoking upregulates angiotensin-converting enzyme-2 receptor : a potential adhesion site for novel coronavirus SARS-CoV-2(COVID-19)", J Clin Med, 9, pp.841~ (2020)
  25. Shekerdemian LS, "Characteristics and outcomes of children with coronavirus disease 2019(COVID-19)infection admitted to US and Canadian pediatric intensive care units", JAMA Pediatr, 174, pp.868~873 (2020)
  26. Oualha M, "Severe and fatal forms of COVID-19 in children", Arch Pediatr, 27, pp.235~238 (2020)
  27. Lee J, "Do we really need to isolate all children with COVID-19 in healthcare facilities", J Korean Med Sci, 35, pp.e277~ (2020)
  28. Kim J, "Role of children in household transmission of COVID-19", Arch Dis Child (2020)
  29. Yoonsun Yoon, "Stepwise School Opening and an Impact on the Epidemiology of COVID-19 in the Children", Journal of Korean Medical Science, 35(46), pp.1~13 (2020), 대한의학회[DOI]
  30. Eun Young Kim, "Children with COVID-19 after Reopening of Schools, South Korea", Pediatric Infection and Vaccine, 27(3), pp.180~183 (2020), 대한소아감염학회[DOI]

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