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SARS-CoV-2 infection in children is less severe than it is in adults. We perform a longitudinal analysis of the early innate responses in children and adults with mild infection within household clusters. Children display fewer symptoms than adults do, despite similar initial viral load, and mount a robust anti-viral immune signature typical of the SARS-CoV-2 infection and characterized by early interferon gene responses; increases in cytokines, such as CXCL10 and GM-CSF; and changes in blood cell numbers. When compared with adults, the antiviral response resolves faster (within a week of symptoms), monocytes and dendritic cells are more transiently activated, and genes associated with B cell activation appear earlier in children. Nonetheless, these differences do not have major effects on the quality of SARS-CoV-2-specific antibody responses. Our findings reveal that better early control of inflammation as observed in children may be key for rapidly controlling infection and limiting the disease course.
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•Innate response against SARS-CoV-2 is robust in children despite limited symptoms•Resolution of inflammation and onset of B cell response occur faster in children•Antibody response is not compromised by the shorter antiviral inflammatory response
SARS-CoV-2 infection in children is less severe than it is in adults. Vono et al. find that children mount a potent, but more transient, antiviral innate response with a more rapid onset of B cell response. A more efficient early control of inflammation may be key to limiting disease severity.