Abstract
In January 2020, a new coronavirus was identified as responsible for a pandemic acute respiratory syndrome. The virus demonstrated a high infectious capability and not-neglectable mortality in humans. However, similarly to previous SARS and MERS, the new disease COVID-19 caused by SARS-CoV-2 seemed to relatively spare children and younger adults. Some hypotheses have been proposed to explain the phenomenon, including lower ACE2 expression in children, cross-immunization from measles/rubella/mumps and BCG-vaccination, as well as the integrity of respiratory mucosa. Herein, we hypothesize that an additional mechanism might contribute to children's relative protection from SARS-CoV-2, the cross-immunization conferred by previous exposures to other common respiratory coronaviruses. To support our hypothesis, we show a statistically significant similarity in genomic and protein sequences, including epitopes for B- and T-cell immunity, of SARS-CoV-2 and the other beta coronaviruses. Since these coronaviruses are highly diffused across pediatric populations, cross-reactive immunity might reasonably induce an at least partial protection from SARS-CoV-2 in children.
Highlights
Despite the significant improvements and the efforts made by governments and international organizations worldwide, the number of COVID-19 cases is still growing, and many issues are still unsolved, including definition of a standard care, development of effective immunization strategies, and proper epidemiological framework
Since SARS-CoV, SARSCoV-2, MERS CoV, HCoV-OC43, and HCoV-HKU1 are beta coronaviruses, we aimed to study the amino acid alignment of proteins such as S and N, which are structural proteins with high homology in all coronaviruses, with relevant immunogenic properties in SARS-CoV-2 [26]
We hypothesize that previous infections from other beta coronaviruses may confer partial protection from SARS-CoV-2 through some degrees of cross-immunity, especially in pediatric patients
Summary
Despite the significant improvements and the efforts made by governments and international organizations worldwide, the number of COVID-19 cases is still growing, and many issues are still unsolved, including definition of a standard care, development of effective immunization strategies, and proper epidemiological framework. The analysis of SARS-CoV-2 infection incidence and severity indicates, in particular, two intriguing clinical aspects: [1] high mean age of infected patients with higher mortality in patients >65 years old; [2] lowest SARS-CoV-2 incidence in children with rare cases of severe disease [3]. This was observed in SARS-CoV and MERS-CoV infection [4, 5]. During SARS-CoV epidemic, the overall mortality was about 15%; the stratified analysis by age, showed
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