COVID-19 and pediatrics—phylogeny, pathology, and pathogenesis of SARS-CoV-2

Severe acute respiratory syndrome–associated coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, with dramatic suddenness spread worldwide, causing the coronavirus disease 2019 (COVID-19). A broad-spectrum of clinical manifestations and complications of COVID-19 exist; in particular, outcomes of disease markedly differ between adults and children. COVID-19 infection in pediatric populations is usually asymptomatic and commonly mild with very low risk of death. While children infected with SARS-CoV-2 are less likely to develop severe illness, certain underlying medical conditions might increase the risk of severe disease. Therefore, it is critical to investigate host–pathogen interaction, including tissue tropism, viral replication and mechanism of dissemination in pediatrics, and how these factors interact in different age groups. This narrative review attempts to explain the pathogenesis and pathology associated with multisystemic inflammatory syndrome, chilblains, thromboses, cardiothoracic pathology, and maternofetal pathology in the placenta through clinical cases described in the literature.