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We hypothesized that a more robust early innate immune response to SARS-CoV-2 may protect against severe disease and compared clinical outcomes, viral copies and cellular gene and protein expression in nasopharyngeal swabs from 12 children and 27 adults upon presentation to the Emergency Department. SARS-CoV-2 copies were similar, but compared to adults, children displayed higher expression of genes associated with interferon signaling, NLRP3 inflammasome, and other innate pathways. Higher levels of IFN-\u03b12, IFN-\u03b3, IP-10, IL-8, and IL-1\u03b2 protein were detected in nasal fluid in children versus adults. Anti-SARS-CoV-2 IgA and IgG were detected in nasal fluid from both groups and correlated negatively with mucosal IL-18. These findings suggest that a vigorous mucosal immune response in children compared to adults contributes to favorable clinical outcomes.<\/jats:p>","DOI":"10.1101\/2021.02.12.21251310","type":"posted-content","created":{"date-parts":[[2021,2,13]],"date-time":"2021-02-13T23:50:12Z","timestamp":1613260212000},"source":"Crossref","is-referenced-by-count":5,"title":["Natural Mucosal Barriers and COVID-19 in Children"],"prefix":"10.64898","author":[{"given":"Carl A.","family":"Pierce","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharlene","family":"Sy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Galen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doctor Y","family":"Goldstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Orner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marla J.","family":"Keller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevan C.","family":"Herold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betsy C.","family":"Herold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2021021511500502000_2021.02.12.21251310v1.1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6915e3"},{"issue":"1","key":"2021021511500502000_2021.02.12.21251310v1.2","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1097\/MOP.0000000000000721","article-title":"Pediatric influenza and illness severity: what is known and what questions remain?","volume":"31","year":"2019","journal-title":"Curr Opin Pediatr"},{"issue":"12","key":"2021021511500502000_2021.02.12.21251310v1.3","doi-asserted-by":"crossref","first-page":"6194","DOI":"10.1172\/JCI145301","article-title":"Inflammatory syndromes associated with SARS-CoV-2 infection: dysregulation of the immune response across the age spectrum","volume":"130","year":"2020","journal-title":"J Clin Invest"},{"key":"2021021511500502000_2021.02.12.21251310v1.4","first-page":"242702429","article-title":"Nasal Gene Expression of Angiotensin-Converting Enzyme 2 in Children and Adults","volume":"323","year":"2020","journal-title":"JAMA"},{"key":"2021021511500502000_2021.02.12.21251310v1.5","doi-asserted-by":"crossref","unstructured":"Zhang Z , Guo L , Huang L , Zhang C , Luo R , Zeng L , et al. 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