Children are not little adults

Coronavirus has caused a pandemic affecting both adults and children. Although mortality rates in adults are high, that in children has been low, with many children experiencing only mild disease. This article looks at the pathophysiologic mechanisms that may account for the differences observed in children, namely a strong immune response, a lower number of angiotensin-converting enzyme 2, and a lower inflammatory response. Though children in general have mild disease, there is a hyperinflammatory condition known as multisystem inflammatory syndrome, which is likely a postinfectious immunologic response, which is seen mainly in children and adolescents and not adults.