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

• Published in: Journal of racial and ethnic health disparities Vol. 9; no. 4; pp. 1536 - 1542
• Main Authors: Kurup, Sanjana, Burgess, Regan, Tine, Fatou, Chahroudi, Ann, Lee, Dexter L.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.08.2022; Springer Nature B.V
• Subjects: Child; Children; Community; Complications; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 vaccines; Cultural differences; Cytokine storm; Enzymes; Epidemiology; Ethnic groups; Health disparities; Homeostasis; Humans; Immune system; Immunity (Disease); Infections; Inflammation; Innate immunity; Kawasaki disease; Literature reviews; Marginalized groups; Medical personnel; Medicine; Medicine & Public Health; Minority & ethnic groups; Multisystem inflammatory syndrome in children; Pandemics; Pathogens; Pediatrics; Pneumonia; Protective factors; Quality of Life Research; Race factors; Racial inequality; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Severity; Signs and symptoms; Social Inequality; Social Structure; Systemic Inflammatory Response Syndrome - epidemiology; Thrombosis; Viral diseases; Viral infections; United States > US; Europe; Pediatrics; SARS-CoV-2; MIS-C; Kawasaki Disease; Health disparities
• ISSN: 2197-3792; 2196-8837; 2196-8837
• DOI: 10.1007/s40615-021-01092-7

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.