SARS-CoV-2 Infection and Racial Disparities in Children: Protective Mechanisms and Severe Complications Related to MIS-C

• Type of Material: Article
• Authors: Sanjana Kurup, Howard University; Regan Burgess, Howard University; Fatou Tine, Howard University; Ann Chahroudi, Emory University; Dexter L Lee, Howard University
• Language: English
• Date: 2021-07-13
• Publisher: SPRINGER INT PUBL AG
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2021
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1007/s40615-021-01092-7
• Title of Journal or Parent Work: JOURNAL OF RACIAL AND ETHNIC HEALTH DISPARITIES
• Volume: 9
• Issue: 4
• Start Page: 1536
• End Page: 1542
• Grant/Funding Information: Howard University Aging Grant. Howard University College of Medicine Pilot Award-Dean’s Office. Howard University RCMI; National Institutes of Health: 5K01HL092593-05, Georgetown-Howard University Center for Clinical and Translational Science Collaborative Pilot Program.
• Keywords: Kawasaki Disease; Public, Environmental & Occupational Health; MIS-C; MULTISYSTEM INFLAMMATORY SYNDROME; Science & Technology; SARS-CoV-2; Health disparities; Pediatrics; Life Sciences & Biomedicine; DISEASE
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

A novel coronavirus has resulted in a pandemic with over 176 million confirmed cases and over 3.8 million recorded deaths. In the USA, SARS-CoV-2 infection has a significant burden on minority communities, especially Hispanic and Black communities, which are overrepresented in cases compared to their percentage in the population. SARS-CoV-2 infection can manifest differently in children and adults, with children tending to have less severe disease. A review of current literature was performed to identify the hypothesized protective immune mechanisms in children, and to describe the rare complication of multisystem inflammatory syndrome in children (MIS-C) that has been documented in children post-SARS-CoV-2 infection. Epidemiologic data and case studies have indicated that children are less susceptible to more severe clinical features of SARS-CoV-2 infection, a finding that may be due to differences in the cytokine response generated by the innate immune system, high amounts of ACE-2 which maintain homeostatic functions by preventing inflammation, and trained immunity acquired from regular vaccinations. Despite these protective mechanisms, children are still susceptible to severe complications, such as MIS-C. The racial disparities seen in MIS-C are extremely apparent, and certain populations are more affected. Most specifically, 33% of MIS-C patients are Hispanic/Latino, and 30% Black. Current studies published on MIS-C do not detail whether certain symptoms are more present in certain racial/ethnic groups. Knowledge of these disparities could assist health care professionals with devising appropriate strategies for post-acute SARS-CoV-2 infection follow-up in children as well as vaccine distribution in specific communities to help slow the spread of SARS-CoV-2 infection, and ultimately reduce the potential for complications such as MIS-C.