The disease course of coronavirus disease 2019 (COVID-19) is usually mild and self-limiting in previously healthy children, but they may also develop severe disease. Severe COVID-19 infection is especially observed in very young children or those with underlying comorbidities. Moreover, a multisystem inflammatory syndrome that mimics the Kawasaki disease shock syndrome can develop in children that are genetically predisposed to displaying an overactive immune response to SARS-CoV-2 infection. In this review, we describe the clinical phenotypes of mild and severe COVID-19 and multisystem inflammatory syndrome in children (MIS-C). We also discuss the possible immunobiological mechanisms that may be involved in the protection of children against COVID-19 and the development of multisystem inflammatory syndrome.

SARS-CoV-2, COVID-19, pediatric multisystem inflammatory disease, COVID-19 related, immunity, innate, T-lymphocytes, immunosenescence, immunity.,
Asian Pacific Journal of Allergy and Immunology
Department of Immunology

Suratannon, N, Dik, W.A, Chatchatee, P, & van Hagen, P.M. (2020). COVID-19 in children: Heterogeneity within the disease and hypothetical pathogenesis. Asian Pacific Journal of Allergy and Immunology, 38(3), 170–177. doi:10.12932/ap-170720-0920