Abstract
Since the COVID-19 outbreak was acknowledged by the WHO on 30 January 2020, much research has been conducted to unveil various features of the responsible SARS-CoV-2 virus. Different rates of contagion in adults, children, and pregnant women may guide us to understand the underlying infection conditions of COVID-19. In this study, we first provide a review of recent reports of COVID-19 clinical outcomes in children and pregnant women. We then suggest a mechanism that explains the curious case of COVID-19 in children/pregnant women. The unique stem cell molecular signature, as well as the very low expression of angiotensin-converting enzyme 2 and the lower ACE/ACE2 ratio in stem cells of children/pregnant women compared to adults might be the cause of milder symptoms of COVID-19 in them. This study provides the main molecular keys on how stem cells can function properly and exert their immunomodulatory and regenerative effects in COVID-19-infected children/pregnant women, while failing to replicate their role in adults. This can lay the groundwork for both predicting the pattern of spread and severity of the symptoms in a population and designing novel stem cell-based treatment and prevention strategies for COVID-19.
Highlights
mesenchymal stem cell (MSC) have unique properties that make them a promising candidate for cell therapy of COVID-19 [14]. These cells can secrete a wide range of immunomodulatory cytokines and growth factors, such as keratinocyte growth factor (KGF), angiopoietin-1 (Ang1), hepatic growth factor (HGF), nitric oxide (NO), transforming growth factor-β (TGF-β), prostaglandin E2 (PGE2), and indoleamine2,3-dioxygenase (IDO) [14,15,16,17]
We reviewed the reports of COVID-19 in children and pregnant women
Whereas severe cases of COVID-19 are rare in children, serious illness resulting in hospitalization still occurs
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. These cells can secrete a wide range of immunomodulatory cytokines and growth factors, such as keratinocyte growth factor (KGF), angiopoietin-1 (Ang1), hepatic growth factor (HGF), nitric oxide (NO), transforming growth factor-β (TGF-β), prostaglandin E2 (PGE2), and indoleamine2,3-dioxygenase (IDO) [14,15,16,17] In this way, MSCs can prevent ARDS-induced apoptosis of alveolar epithelial and endothelial cells, inhibit SARS-CoV-19-associated inflammation, and regenerate the damaged lung tissue [15,16,17,18,19,20]. Afarid et al discussed clinical trials evaluating MSCs application for the treatment of COVID-19 infection, demonstrating the unique features of stem cells in the immunomodulation of the COVID-19-induced cytokine storm, the regeneration of alveolar epithelial and endothelial cells, and the secretion of factors that could prevent lung fibrosis and severe COVID-19 manifestations [14]. We suggest a significant role for actively proliferating stem cells in making pregnant women and children more tolerant to COVID-19
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