The interplay between environmental exposures and COVID-19 risks in the health of children
Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Environmental Health
Abstract
Background: An unusual feature of SARS-Cov-2 infection and the COVID-19 pandemic is that children are less
severely affected than adults. This is especially paradoxical given the epidemiological links between poor air quality
and increased COVID-19 severity in adults and that children are generally more vulnerable than adults to the
adverse consequences of air pollution.
Objectives: To identify gaps in knowledge about the factors that protect children from severe SARS-Cov-2 infection
even in the face of air pollution, and to develop a transdisciplinary research strategy to address these gaps.
Methods: An international group of researchers interested in children’s environmental health was invited to
identify knowledge gaps and to develop research questions to close these gaps.
Discussion: Key research questions identified include: what are the effects of SAR-Cov-2 infection during pregnancy
on the developing fetus and child; what is the impact of age at infection and genetic susceptibility on disease
severity; why do some children with COVID-19 infection develop toxic shock and Kawasaki-like symptoms; what are
the impacts of toxic environmental exposures including poor air quality, chemical and metal exposures on innate
immunity, especially in the respiratory epithelium; what is the possible role of a “dirty” environment in conveying
protection – an example of the “hygiene hypothesis”; and what are the long term health effects of SARS-Cov-2
infection in early life.
Conclusion: A concerted research effort by a multidisciplinary team of scientists is needed to understand the links
between environmental exposures, especially air pollution and COVID-19. We call for specific research funding to
encourage basic and clinical research to understand if/why exposure to environmental factors is associated with
more severe disease, why children appear to be protected, and how innate immune responses may be involved.
Lessons learned about SARS-Cov-2 infection in our children will help us to understand and reduce disease severity
in adults, the opposite of the usual scenario.
Description
Research Article
Keywords
Children’s environmental health, COVID-19, Combined exposures, SARS-Cov-2