COVID-19 infection in children
Infections with coronavirus SARS-CoV-2 that appeared in December 2019 (COVID-19) in China have become a global public health threat worldwide (Rothan & Byrareddy, 2020). COVID-19 targets the lower respiratory airway causing severe acute syndrome resulting in increasing death cases among people. The epidemiological reports shown that the death cases of COVID-19 infection are higher in healthy or older adults compared to children. A study showed that among 44,672 COVID-19 confirmed cases, 549 (1.2%) were between 10–19 years, and 416 (0.9%) were between 0–10 years (Novel Coronavirus Pneumonia Emergency Response Epidemiology, 2020). About 4% of children were asymptomatic, 51% had a mild illness, and 39% had a moderate illness. Another study showed that the percentage of severe COVID-19 infection among children was 6% compared to 18.5% of adults(Dong et al., 2020). Generally, infected children show milder to asymptomatic COVID-19 infection. Adults with severe COVID-19 suffer from deadly pneumonia and insufficient supply of oxygen throughout the body, probably due to disruption of hemoglobin by SARS-CoV-2 as reported by several frontline clinicians from New York City; on the other hand, clinical reports showed the children are insusceptible to pneumonia caused by COVID-19 infection (2020; Huang et al., 2020; Li et al., 2020; Lippi & Mattiuzzi, 2020; Wang et al., 2020a). With the help of in-silico molecular modeling and docking analysis, it is predicted that Orf1ab, ORF10, and ORF3a proteins of SARS-CoV-2 binds with the heme of the beta chain of hemoglobin resulting in dissociation of iron from the porphyrin ring such studies still need further in vitro and in vivo investigations. The considerable variation in COVID-19 infection between children and adults raises a question that could help to understand the mechanism of COVID- 19 pathogenesis.