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Tweetable abstract The reopening of schools in the fall entails risks given the controversies in pediatric COVID-19 pathogenesis and the ambiguous role of children in transmission.The severity of coronavirus disease 2019 (COVID-19) is linked to an increasing number of risk factors, including exogenous (environmental) stimuli such as air pollution, nicotine, and cigarette smoke. These three factors increase the expression of angiotensin I converting enzyme 2 (ACE2), a key receptor involved in the entry of severe acute respiratory syndro