Title: The immune basis of acute and chronic morbidity following COVID-19 infection in children.
Funder: Action Medical Research

Abstract: Background_x000D_ Children and adults respond differently to COVID-19 infection. Thankfully, most children do not experience serious symptoms, but for those who are admitted to hospital with severe COVID-19 infection, the pattern of illness is much more variable. Whereas adults typically present with breathing difficulties and lung failure, severely-affected children display a range of symptoms suggesting more widespread inflammation, for example, vomiting, diarrhoea, tummy pain, skin rash, tiredness and headache. The majority of children with severe disease show signs of this widespread inflammation, known as Paediatric Multisystem Inflammatory Syndrome (PIMS), which usually occurs several weeks after infection. The aims of this project are to gain a better understanding of how COVID-19 affects children, including why severe disease is relatively uncommon and why children experience different symptoms compared to adults._x000D_ _x000D_ The research project_x000D_ These researchers will analyse blood, faecal and lung cell samples taken from children aged between five and 11 years with severe or moderate COVID-19 infection. They will study the immune responses of affected children during and after hospital admission and characterise the risk factors associated with severe and/or prolonged disease. Understanding why some children become critically ill and identifying those most likely to be severely affected could allow early, personalised treatment to give children the best chance of making a full and rapid recovery. They will also look at age-related immune responses to gain a better understanding of why most children are only mildly affected by COVID-19 and why those who are severely affected typically present with the more generalised symptoms of paediatric multisystem inflammatory syndrome (PIMS) rather than the acute lung failure seen in adults. This will involve comparing the breadth of the inflammatory response in children with PIMS to that seen in children with milder symptoms. _x000D_ This study will form part of a nationally coordinated approach and be closely aligned with other national and international studies. The clinical and biological information generated by these studies will provide an important data resource for researchers working on both the current and future pandemics. _x000D_

Lay abstract: Background_x000D_ Children and adults respond differently to COVID-19 infection. Thankfully, most children do not experience serious symptoms, but for those who are admitted to hospital with severe COVID-19 infection, the pattern of illness is much more variable. Whereas adults typically present with breathing difficulties and lung failure, severely-affected children display a range of symptoms suggesting more widespread inflammation, for example, vomiting, diarrhoea, tummy pain, skin rash, tiredness and headache. The majority of children with severe disease show signs of this widespread inflammation, known as Paediatric Multisystem Inflammatory Syndrome (PIMS), which usually occurs several weeks after infection. The aims of this project are to gain a better understanding of how COVID-19 affects children, including why severe disease is relatively uncommon and why children experience different symptoms compared to adults._x000D_ _x000D_ The research project_x000D_ These researchers will analyse blood, faecal and lung cell samples taken from children aged between five and 11 years with severe or moderate COVID-19 infection. They will study the immune responses of affected children during and after hospital admission and characterise the risk factors associated with severe and/or prolonged disease. Understanding why some children become critically ill and identifying those most likely to be severely affected could allow early, personalised treatment to give children the best chance of making a full and rapid recovery. They will also look at age-related immune responses to gain a better understanding of why most children are only mildly affected by COVID-19 and why those who are severely affected typically present with the more generalised symptoms of paediatric multisystem inflammatory syndrome (PIMS) rather than the acute lung failure seen in adults. This will involve comparing the breadth of the inflammatory response in children with PIMS to that seen in children with milder symptoms. _x000D_ This study will form part of a nationally coordinated approach and be closely aligned with other national and international studies. The clinical and biological information generated by these studies will provide an important data resource for researchers working on both the current and future pandemics. _x000D_

Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS
Health categories: INFECTION;INFLAMMATORY AND IMMUNE SYSTEM