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Malcangi G, Inchingolo AD, Inchingolo AM, Piras F, Settanni V, Garofoli G, Palmieri G, Ceci S, Patano A, Mancini A, Vimercati L, Nemore D, Scardapane A, Rapone B, Semjonova A, D’Oria MT, Macchia L, Bordea IR, Migliore G, Scarano A, Lorusso F, Tartaglia GM, Giovanniello D, Nucci L, Maggialetti N, Parisi A, Domenico MD, Brienza N, Tafuri S, Stefanizzi P, Curatoli L, Corriero A, Contaldo M, Inchingolo F, Dipalma G. COVID-19 Infection in Children and Infants: Current Status on Therapies and Vaccines. CHILDREN (BASEL, SWITZERLAND) 2022; 9:249. [PMID: 35204969 PMCID: PMC8870718 DOI: 10.3390/children9020249] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/21/2022] [Accepted: 02/10/2022] [Indexed: 02/06/2023]
Abstract
Since the beginning in December 2019, the SARS-CoV-2 outbreak appeared to affect mostly the adult population, sparing the vast majority of children who only showed mild symptoms. The purpose of this investigation is to assess the status on the mechanisms that give children and infants this variation in epidemiology compared to the adult population and its impact on therapies and vaccines that are aimed towards them. A literature review, including in vitro studies, reviews, published guidelines and clinical trials was performed. Clinical trials concerned topics that allowed a descriptive synthesis to be produced. Four underlying mechanisms were found that may play a key role in providing COVID-19 protection in babies. No guidelines are available yet for therapy due to insufficient data; support therapy remains the most used. Only two vaccines are approved by the World Health Organization to be used in children from 12 years of age, and there are currently no efficacy or safety data for children below the age of 12 years. The COVID-19 clinical frame infection is milder in children and adolescents. This section of the population can act as vectors and reservoirs and play a key role in the transmission of the infection; therefore, vaccines are paramount. More evidence is required to guide safely the vaccination campaign.
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Affiliation(s)
- Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Vito Settanni
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Grazia Garofoli
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Giulia Palmieri
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Sabino Ceci
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Luigi Vimercati
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Damiano Nemore
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Arnaldo Scardapane
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Alexandra Semjonova
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Maria Teresa D’Oria
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
- Department of Medical and Biological Sciences, University of Udine, Via delle Scienze, 206, 33100 Udine, Italy
| | - Luigi Macchia
- Department of Emergency and Organ Transplantation (D.E.T.O.), School and Chair of Allergology and Clinical Immunology, University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | | | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy;
| | - Delia Giovanniello
- Department of Toracic Surgery, Hospital “San Camillo Forlanini”, 00152 Rome, Italy;
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (L.N.); (M.C.)
| | - Nicola Maggialetti
- Department of Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, 70124 Bari, Italy;
| | - Antonio Parisi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, 71121 Foggia, Italy;
| | - Marina Di Domenico
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Nicola Brienza
- Unit of Anesthesia and Resuscitation, Department of Emergencies and Organ Transplantations, Aldo Moro University, 70124 Bari, Italy; (N.B.); (A.C.)
| | - Silvio Tafuri
- Department of Biomedical Science and Human Oncology, University of Bari, 70124 Bari, Italy; (S.T.); (P.S.)
| | - Pasquale Stefanizzi
- Department of Biomedical Science and Human Oncology, University of Bari, 70124 Bari, Italy; (S.T.); (P.S.)
| | - Luigi Curatoli
- Department Neurosciences & Sensory Organs & Musculoskeletal System, University of Bari Aldo Moro, 70124 Bari, Italy;
| | - Alberto Corriero
- Unit of Anesthesia and Resuscitation, Department of Emergencies and Organ Transplantations, Aldo Moro University, 70124 Bari, Italy; (N.B.); (A.C.)
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (L.N.); (M.C.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy; (G.M.); (A.D.I.); (A.M.I.); (F.P.); (V.S.); (G.G.); (G.P.); (S.C.); (A.P.); (A.M.); (L.V.); (D.N.); (A.S.); (B.R.); (A.S.); (M.T.D.); (G.D.)
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Malcangi G, Inchingolo AD, Inchingolo AM, Santacroce L, Marinelli G, Mancini A, Vimercati L, Maggiore ME, D’Oria MT, Hazballa D, Bordea IR, Xhajanka E, Scarano A, Farronato M, Tartaglia GM, Giovanniello D, Nucci L, Serpico R, Sammartino G, Capozzi L, Parisi A, Di Domenico M, Lorusso F, Contaldo M, Inchingolo F, Dipalma G. COVID-19 Infection in Children, Infants and Pregnant Subjects: An Overview of Recent Insights and Therapies. Microorganisms 2021; 9:1964. [PMID: 34576859 PMCID: PMC8469368 DOI: 10.3390/microorganisms9091964] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The SARS-CoV-2 pandemic has involved a severe increase of cases worldwide in a wide range of populations. The aim of the present investigation was to evaluate recent insights about COVID-19 infection in children, infants and pregnant subjects. METHODS a literature overview was performed including clinical trials, in vitro studies, reviews and published guidelines regarding the present paper topic. A descriptive synthesis was performed to evaluate recent insights and the effectiveness of therapies for SARS-CoV-2 infection in children, infants and pregnant subjects. RESULTS Insufficient data are available regarding the relationship between COVID-19 and the clinical risk of spontaneous abortion and premature foetus death. A decrease in the incidence of COVID-19 could be correlated to a minor expression of ACE2 in childrens' lungs. At present, a modulation of the dose-effect posology for children and infants is necessary. CONCLUSIONS Pregnant vertical transmission has been hypothesised for SARS-CoV-2 infection. Vaccines are necessary to achieve mass immunity for children and also pregnant subjects.
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Affiliation(s)
- Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Luigi Santacroce
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Luigi Vimercati
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Maria Elena Maggiore
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Maria Teresa D’Oria
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
- Department of Medical and Biological Sciences, University of Udine, Via delle Scienze, 206, 33100 Udine, Italy
| | - Denisa Hazballa
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
- Kongresi Elbasanit, Rruga: Aqif Pasha, 3001 Elbasan, Albania
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Edit Xhajanka
- Department of Dental Prosthesis, Medical University of Tirana, Rruga e Dibrës, U.M.T., 1001 Tirana, Albania;
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Marco Farronato
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy; (M.F.); (G.M.T.)
| | | | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (L.N.); (R.S.); (M.C.)
| | - Rosario Serpico
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (L.N.); (R.S.); (M.C.)
| | - Gilberto Sammartino
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy;
| | - Loredana Capozzi
- Istituto Zooprofilattico Sperimentale Della Puglia e Della Basilicata, 71121 Foggia, Italy; (L.C.); (A.P.)
| | - Antonio Parisi
- Istituto Zooprofilattico Sperimentale Della Puglia e Della Basilicata, 71121 Foggia, Italy; (L.C.); (A.P.)
| | - Marina Di Domenico
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy; (L.N.); (R.S.); (M.C.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.S.); (G.M.); (A.M.); (L.V.); (M.E.M.); (M.T.D.); (D.H.); (F.I.); (G.D.)
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Cakir U, Demirel MA, Kanik Yuksek S, Tugcu AU, Tufan N, Tayman C. Case Report of Severe COVID-19 Pneumonia in a Term Newborn. J Trop Pediatr 2021; 67:6362433. [PMID: 34471924 PMCID: PMC8499898 DOI: 10.1093/tropej/fmab023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Coronavirus disease (COVID-19) has been shown to affect all age groups. The data in the literature usually admit a milder form of disease in infants and newborns than adults. COVID-19 is rarely seen in newborns and an urgent diagnosis should be made in any suspicious situation. A 6-day-old female newborn was admitted to our hospital with fever and dyspnea without cough. A rapid reverse-transcription polymerase chain reaction COVID-19 showed a positive result. Chest computed tomography revealed bilateral and widespread pulmonary involvement. After support therapy, the newborn was successfully discharged. We should carefully consider the new type of coronavirus as an agent for pneumonia in newborns with fever and dyspnea together with non-symptomatic family history. Our case was one of the interesting reported cases of severe pneumonia presenting in the perinatal period.
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Affiliation(s)
- Ufuk Cakir
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Ankara City Hospital, Ankara, Turkey,Correspondence: Ufuk Cakir, Division of Neonatology, Department of Pediatrics, Health Sciences University, Ankara Bilkent City Hospital, 9. Cankaya, Ankara, 06800, Turkey. Tel: +90 505 8581781. Fax: +90 312 306 52 71. E-mail: <>
| | - Merve Akin Demirel
- Department of Pediatrics, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Saliha Kanik Yuksek
- Department of Pediatric Infectious Diseases, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Ali Ulas Tugcu
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Nihan Tufan
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Cuneyt Tayman
- Division of Neonatology, Department of Pediatrics, Health Sciences University, Ankara City Hospital, Ankara, Turkey
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Pollard AJ, Bijker EM. A guide to vaccinology: from basic principles to new developments. Nat Rev Immunol 2020; 21:83-100. [PMID: 33353987 PMCID: PMC7754704 DOI: 10.1038/s41577-020-00479-7] [Citation(s) in RCA: 796] [Impact Index Per Article: 159.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 12/17/2022]
Abstract
Immunization is a cornerstone of public health policy and is demonstrably highly cost-effective when used to protect child health. Although it could be argued that immunology has not thus far contributed much to vaccine development, in that most of the vaccines we use today were developed and tested empirically, it is clear that there are major challenges ahead to develop new vaccines for difficult-to-target pathogens, for which we urgently need a better understanding of protective immunity. Moreover, recognition of the huge potential and challenges for vaccines to control disease outbreaks and protect the older population, together with the availability of an array of new technologies, make it the perfect time for immunologists to be involved in designing the next generation of powerful immunogens. This Review provides an introductory overview of vaccines, immunization and related issues and thereby aims to inform a broad scientific audience about the underlying immunological concepts. This Review, aimed at a broad scientific audience, provides an introductory guide to the history, development and immunological basis of vaccines, immunization and related issues to provide insight into the challenges facing immunologists who are designing the next generation of vaccines.
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Affiliation(s)
- Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK. .,NIHR Oxford Biomedical Research Centre, Oxford University Hospitals Trust, Oxford, UK.
| | - Else M Bijker
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford University Hospitals Trust, Oxford, UK
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Lenoci G, Galante D, Ceci E, Manzulli V, Moramarco AM, Chiaromonte A, Labarile G, Lattarulo S, Resta A, Pace L, Rondinone V, Parisi A, Cipolletta D, Marino L, Padalino I, Serrecchia L, Aceti A, Iatarola M, Tolve F, Fasanella A. Sars-CoV-2 isolation from a 10-day-old newborn in Italy: A case report. IDCases 2020; 22:e00960. [PMID: 32963961 PMCID: PMC7497735 DOI: 10.1016/j.idcr.2020.e00960] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 12/12/2022] Open
Abstract
This is the first described case of isolation of Sars-CoV-2 in Vero E6 cell-culture from a 10-day-old newborn in Italy. The infection was detected in the mother after the child was born and therefore a vertical transmission can be excluded. Despite the presence of the virus, the newborn showed mild symptoms of the disease.
This report describes the evolution of COVID-19 in a 10 day-old-baby. The mother developed the disease immediately after childbirth and therefore a vertical transmission can be excluded. The isolation of the virus in cell culture with a cytopathic effect already visible after 48 h, indicates that the viral load of the newborn was quite high, but not serious course of the disease was observed. This paper wants to highlight the possible role of newborns and children in the spread of the disease.
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Affiliation(s)
- Giuseppe Lenoci
- Ente Ecclesiastico Ospedale Generale Regionale "F. Miulli", Strada Prov. 127 Acquaviva - Santeramo Km. 4, 70021, Acquaviva delle Fonti, Italy
| | - Domenico Galante
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121, Foggia, Italy
| | - Edmondo Ceci
- Ente Ecclesiastico Ospedale Generale Regionale "F. Miulli", Strada Prov. 127 Acquaviva - Santeramo Km. 4, 70021, Acquaviva delle Fonti, Italy
| | - Viviana Manzulli
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121, Foggia, Italy
| | - Angela Maria Moramarco
- Ente Ecclesiastico Ospedale Generale Regionale "F. Miulli", Strada Prov. 127 Acquaviva - Santeramo Km. 4, 70021, Acquaviva delle Fonti, Italy
| | - Anna Chiaromonte
- Ente Ecclesiastico Ospedale Generale Regionale "F. Miulli", Strada Prov. 127 Acquaviva - Santeramo Km. 4, 70021, Acquaviva delle Fonti, Italy
| | - Giuseppina Labarile
- Ente Ecclesiastico Ospedale Generale Regionale "F. Miulli", Strada Prov. 127 Acquaviva - Santeramo Km. 4, 70021, Acquaviva delle Fonti, Italy
| | - Simone Lattarulo
- Ente Ecclesiastico Ospedale Generale Regionale "F. Miulli", Strada Prov. 127 Acquaviva - Santeramo Km. 4, 70021, Acquaviva delle Fonti, Italy
| | - Annalisa Resta
- Ente Ecclesiastico Ospedale Generale Regionale "F. Miulli", Strada Prov. 127 Acquaviva - Santeramo Km. 4, 70021, Acquaviva delle Fonti, Italy
| | - Lorenzo Pace
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121, Foggia, Italy
| | - Valeria Rondinone
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121, Foggia, Italy
| | - Antonio Parisi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121, Foggia, Italy
| | - Dora Cipolletta
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121, Foggia, Italy
| | - Leonardo Marino
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121, Foggia, Italy
| | - Iolanda Padalino
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121, Foggia, Italy
| | - Luigina Serrecchia
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121, Foggia, Italy
| | - Angela Aceti
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121, Foggia, Italy
| | - Michela Iatarola
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121, Foggia, Italy
| | - Francesco Tolve
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121, Foggia, Italy
| | - Antonio Fasanella
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata, Via Manfredonia 20, 71121, Foggia, Italy
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De Rose DU, Piersigilli F, Ronchetti MP, Santisi A, Bersani I, Dotta A, Danhaive O, Auriti C. Novel Coronavirus disease (COVID-19) in newborns and infants: what we know so far. Ital J Pediatr 2020; 46:56. [PMID: 32349772 PMCID: PMC7190200 DOI: 10.1186/s13052-020-0820-x] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 04/17/2020] [Indexed: 12/15/2022] Open
Abstract
Recently, an outbreak of viral pneumonitis in Wuhan, Hubei, China successively spread as a global pandemia, led to the identification of a novel betacoronavirus species, the 2019 novel coronavirus, successively designated 2019-nCoV then SARS-CoV-2). The SARS-CoV-2 causes a clinical syndrome designated coronavirus disease 2019 (COVID19) with a spectrum of manifestations ranging from mild upper respiratory tract infection to severe pneumonitis, acute respiratory distress syndrome (ARDS) and death. Few cases have been observed in children and adolescents who seem to have a more favorable clinical course than other age groups, and even fewer in newborn babies. This review provides an overview of the knowledge on SARS-CoV-2 epidemiology, transmission, the associated clinical presentation and outcomes in newborns and infants up to 6 months of life.
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Affiliation(s)
- Domenico Umberto De Rose
- Neonatal Intensive Care Unit, Department of Neonatology, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy
| | - Fiammetta Piersigilli
- Neonatal Intensive Care Unit, Department of Neonatology, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy
- Division of Neonatology, St-Luc University Hospital, Catholic University of Louvain, 1200, Brussels, Belgium
| | - Maria Paola Ronchetti
- Neonatal Intensive Care Unit, Department of Neonatology, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy
| | - Alessandra Santisi
- Neonatal Intensive Care Unit, Department of Neonatology, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy
| | - Iliana Bersani
- Neonatal Intensive Care Unit, Department of Neonatology, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy
| | - Andrea Dotta
- Neonatal Intensive Care Unit, Department of Neonatology, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy
| | - Olivier Danhaive
- Division of Neonatology, St-Luc University Hospital, Catholic University of Louvain, 1200, Brussels, Belgium
| | - Cinzia Auriti
- Neonatal Intensive Care Unit, Department of Neonatology, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165, Rome, Italy.
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7
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Relationship between vaccination and nutritional status in children: Analysis of recent Demographic and Health Surveys. DEMOGRAPHIC RESEARCH 2020. [DOI: 10.4054/demres.2020.42.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Nicoli F, Appay V. Immunological considerations regarding parental concerns on pediatric immunizations. Vaccine 2017; 35:3012-3019. [PMID: 28465096 DOI: 10.1016/j.vaccine.2017.04.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 03/31/2017] [Accepted: 04/12/2017] [Indexed: 01/10/2023]
Abstract
Despite the fundamental role of vaccines in the decline of infant mortality, parents may decide to decline vaccination for their own children. Many factors may influence this decision, such as the belief that the infant immune system is weakened by vaccines, and concerns have been raised about the number of vaccines and the early age at which they are administered. Studies focused on the infant immune system and its reaction to immunizations, summarized in this review, show that vaccines can overcome those suboptimal features of infant immune system that render them more at risk of infections and of their severe manifestations. In addition, many vaccines have been shown to improve heterologous innate and adaptive immunity resulting in lower mortality rates for fully vaccinated children. Thus, multiple vaccinations are necessary and not dangerous, as infants can respond to several antigens as well as when responding to single stimuli. Current immunization schedules have been developed and tested to avoid vaccine interference, improve benefits and reduce side effects compared to single administrations. The infant immune system is therefore capable, early after birth, of managing several antigenic challenges and exploits them to prompt its development.
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Affiliation(s)
- Francesco Nicoli
- Sorbonne Universités, UPMC Univ Paris 06, DHU FAST, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), F-75013 Paris, France; INSERM, U1135, CIMI-Paris, F-75013 Paris, France.
| | - Victor Appay
- Sorbonne Universités, UPMC Univ Paris 06, DHU FAST, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), F-75013 Paris, France; INSERM, U1135, CIMI-Paris, F-75013 Paris, France; International Research Center of Medical Sciences (IRCMS), Kumamoto University, Kumamoto 860-0811, Japan
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10
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11
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No evidence of an increase of bacterial and viral infections following Measles, Mumps and Rubella vaccine. Vaccine 2009; 27:1422-5. [PMID: 19146903 DOI: 10.1016/j.vaccine.2008.12.038] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2008] [Revised: 12/01/2008] [Accepted: 12/20/2008] [Indexed: 11/20/2022]
Abstract
The suggestion that multi-antigen vaccines might overload the immune system has led to calls for single antigen vaccines. In 2003 we showed that rather than an increase there appeared to be a reduced risk of severe bacterial infection in the three months following Measles, Mumps and Rubella vaccine (MMR). The present analysis of illnesses in a general population is based on an additional 10 years of data for bacterial infections and also includes admissions with viral infections. Analyses were carried out using the self-controlled case-series method and separately for bacterial and viral infection cases, using risk periods of 0-30 days, 31-60 days and 61-90 days post MMR vaccine. An analysis was also carried out for those cases which were given MMR and Meningococcal serogroup C (MCC) vaccines concomitantly. A reduced risk was seen in the 0-30-day period for both bacterial infection (relative incidence=0.68, 95% CI 0.54-0.86) and viral infections (relative incidence=0.68, 95% CI 0.49-0.93). There was no increased risk in any period when looking at combined viral or bacterial infections or for individual infections with the single exception of an increased risk in the 31-60 days post vaccination period for herpes infections (relative incidence=1.69, 95% CI 1.06-2.70). For the children given Meningococcal group C vaccines concomitantly no significantly increased risk was seen in either the bacterial (relative incidence=0.54, 95% CI 0.26-1.13) or viral cases (relative incidence=0.46, 95% CI 0.11-1.93). Our study confirms that the MMR vaccine does not increase the risk of invasive bacterial or viral infection in the 90 days after the vaccination and does not support the hypothesis that there is an induced immune deficiency due to overload from multi-antigen vaccines.
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13
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Vennemann MMT, Höffgen M, Bajanowski T, Hense HW, Mitchell EA. Do immunisations reduce the risk for SIDS? A meta-analysis. Vaccine 2007; 25:4875-9. [PMID: 17400342 DOI: 10.1016/j.vaccine.2007.02.077] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2006] [Revised: 01/29/2007] [Accepted: 02/27/2007] [Indexed: 11/26/2022]
Abstract
BACKGROUND There are claims that immunisations cause sudden infant death syndrome (SIDS), but some studies have found either no association or that they are associated with a reduced risk of SIDS. AIMS To conduct a meta-analysis examining the relationship between immunisation and SIDS. METHODS Nine case-controls studies were identified examining this association, of which four adjusted for potential confounders. RESULTS The summary odds ratio (OR) in the univariate analysis suggested that immunisations were protective, but the presence of heterogeneity makes it difficult to combine these studies. The summary OR for the studies reporting multivariate ORs was 0.54 (95% CI=0.39-0.76) with no evidence of heterogeneity. CONCLUSIONS Immunisations are associated with a halving of the risk of SIDS. There are biological reasons why this association may be causal, but other factors, such as the healthy vaccinee effect, may be important. Immunisations should be part of the SIDS prevention campaigns.
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Affiliation(s)
- M M T Vennemann
- Institute of Legal Medicine, University of Münster, Roentgenstrasse 23, 48129 Münster, Germany.
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Gregson AL, Edelman R. Does antigenic overload exist? The role of multiple immunizations in infants. Immunol Allergy Clin North Am 2003; 23:649-64. [PMID: 14753385 DOI: 10.1016/s0889-8561(03)00097-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
There is no evidence that currently recommended vaccines overload or weaken the infant immune system. Infants have an enormous capacity to respond safely and effectively to multiple vaccines. The schedule for the administration of childhood vaccines is tailored to the unique developmental pattern of the infant immune system. Childhood vaccines provide immediate protection from common childhood illness and establish the foundation for lifelong immunity that develops with subsequent vaccination or infection. Widespread vaccination of infants and children represents a public health triumph of the 20th century. This fact must be reinforced continually by health care workers and parent education to help maintain progress in the 21st century.
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Affiliation(s)
- Aric L Gregson
- Malaria Section, Center for Vaccine Development, University of Maryland School of Medicine, 685 West Baltimore Street, HSF Room 480, Baltimore, MD 21201, USA
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Offit PA, Quarles J, Gerber MA, Hackett CJ, Marcuse EK, Kollman TR, Gellin BG, Landry S. Addressing parents' concerns: do multiple vaccines overwhelm or weaken the infant's immune system? Pediatrics 2002; 109:124-9. [PMID: 11773551 DOI: 10.1542/peds.109.1.124] [Citation(s) in RCA: 169] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Recent surveys found that an increasing number of parents are concerned that infants receive too many vaccines. Implicit in this concern is that the infant's immune system is inadequately developed to handle vaccines safely or that multiple vaccines may overwhelm the immune system. In this review, we will examine the following: 1) the ontogeny of the active immune response and the ability of neonates and young infants to respond to vaccines; 2) the theoretic capacity of an infant's immune system; 3) data that demonstrate that mild or moderate illness does not interfere with an infant's ability to generate protective immune responses to vaccines; 4) how infants respond to vaccines given in combination compared with the same vaccines given separately; 5) data showing that vaccinated children are not more likely to develop infections with other pathogens than unvaccinated children; and 6) the fact that infants actually encounter fewer antigens in vaccines today than they did 40 or 100 years ago.
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Affiliation(s)
- Paul A Offit
- Section of Infectious Diseases, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, and Wistar Institute of Anatomy and Biology, Philadelphia, Pennsylvania, USA.
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