March 29th, 2021

Looking at over 31,000 antibody samples from children and adults during the pandemic led to findings of a negative correlation between age and antibody response. Interestingly, individuals between the ages of 19 and 30 had the weakest antibody response of all groups. The reasons for this are unknown.

The very young had the most robust immune adaptive antibody response correlating with the least COVID19 disease risk.

The youngest children had roughly double the antibody response of adolescents and quadruple that of the 19 - 30 year olds.

"Although the seroprevalence in the pediatric and adult patient populations was similar, indicating children were as likely as adults to be infected with SARS-CoV-2, we found that SARS-CoV-2 IgG antibody production was distinctly different in children, adolescents, and different age groups of adults. Furthermore, the comprehensive assessment focusing on the SARS-CoV-2 antibody quantitative and qualitative profiles in pediatric patients and young adults revealed key differences in humoral antibody responses against SARS-CoV-2 based on age. Thus, our findings suggest that the differences in the clinical manifestations of COVID-19 in pediatric patients compared with adult patients could be partly due to age-related immune responses.""SARS-CoV-2 antibody avidity in this study showed the same pattern of negative correlation with age as IgG, total, and functional antibody levels. Our analysis demonstrated, for the first time that we know of, a significantly negative correlation between avidity and age in pediatric and young adult cohort." (Yang et. al. 2021)

We are over a year into the pandemic and we are finally getting a better picture of the age related outcome differences. Children at the youngest ages are at the lowest risk of disease based on rapid and effective antibody responses, limited ACE2 receptors for SARS2 attachment, reduced furin proteases for spike protein activity, reduced baseline inflammation, reduced autoantibodies against interferons and reduced coagulation risk.

With every advancing year in age, these principles are potentially flip flopped based on natural physiology coupled to poor lifestyle decisions. This appears to be the key piece of the puzzle for disease morbidity and mortality with advancing age.

Dr. M

Yang JAMANetwork