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A new study is aiming to look at the rate of coronavirus infections in U.S. children and the number of those who go on to develop symptoms to better determine how the virus impacts the nation’s youth. The study, led by the National Institutes of Health (NIH), is seeking to enroll 6,000 people from families already involved in NIH-led pediatric studies, and will also examine the impact the virus has on children with asthma and other allergy conditions compared to those who do not.
Initially, experts believed that children were largely spared by COVID-19, and while the majority of patients who require hospitalization are adults there have been fatalities and confirmed cases involving youth.
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According to the Centers for Disease Control and Prevention (CDC), approximately 2 percent of confirmed COVID-19 cases involve persons under age 18. In China, 2.2 percent of cases involved persons younger than 19, and in Italy, 1.2 percent of confirmed cases were among children under 18.
The incubation period for pediatric patients is believed to be similar to adult patients, and patients may exhibit fever, cough, nasal congestion, sore throat, shortness of breath, diarrhea, nausea, vomiting, fatigue, headache, myalgia and poor feeding or appetite. According to the CDC, other studies have determined that up to 13 percent of pediatric SARS-CoV-2 infections were asymptomatic, although the duration of infection involving this population is not well understood.
The study, dubbed Human Epidemiology and Response to SARS-CoV-2 (HEROS), will follow the children and their families for six months to determine who is infected and whether the virus is transmitted to other family members.
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“One interesting feature of this novel coronavirus pandemic is that very few children have become sick with COVID-19 compared to adults,” Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), which is part of the NIH, said in a news release. “Is this because children are resistant to infection with SARS-CoV-2, or because they are infected but do not develop symptoms? The HEROS study will help us begin to answer these and other key questions.”
The study, which will be conducted remotely, will require a caregiver to collect nasal swabs from the child who is enrolled in the study, as well as other family members who are participating. The samples will then be mailed to a lab for analysis, and the caregiver will answer an online questionnaire pertaining to symptoms, social distancing, activities outside the home and recent exposure, according to a news release. Additional blood samples will need to be collected at two weeks, 18 weeks and 24 weeks into the study period, which will eventually be analyzed for the presence of antibodies.
Should another member of the family become ill, a separate questionnaire pertaining to whether the infection is COVID-19 will be filled out, and additional nasal swabs plus a stool sample from the symptomatic person will need to be sent to the lab.
The researchers will also analyze whether reduced expression of a certain gene, ACE2, in airway cells of children with allergic diseases correlates with a lower infection rate.
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“So far, data on the extent of SARS-CoV-2 infection in the U.S. population have been limited to people who physically interact with the health care system: those who are tested – especially those who test positive – and those with severe disease,” Dr. Tina Hartert, lead study author, said in the news release. “These data provide real-time guidance in a setting of limited test availability, but they don’t enable us to understand the full extent of SARS-CoV-2 infection in the entire population. The HEROS study will help fill this knowledge gap and inform public health interventions.”