A long-term study is about to begin to discover the impact of Covid-19 on children, from a physical and mental point of view. Indeed, the first participant has already been ‘enrolled’ at the National Institutes of Health Clinical Center in Bethesda, Maryland.
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The research, supported by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), will track up to 1,000 children and young adults who previously tested positive for Covid-19 and will assess the impact the disease has had on their physical and mental health over the course of three years. The project is part of the initiative Researching Covid to Enhance Recovery of the NIH, the leading federal medical research agency in the United States, which includes 27 institutes and is part of the United States Department of Health and Human Services.
Covid-19 and children
The findings should lead to a detailed picture of the effects of coronavirus disease on physical growth and development, immune responses to infection, and overall quality of life in the years following the infection.
In the early days of the pandemic, data suggested that children were less likely to contract the virus and still be severely affected. However, among the 6 million pediatric cases of Covid-19 reported in the United States, many have experienced acute effects of the disease over a long period. Not to mention that children can suffer from a number of inflammatory symptoms, collectively called pediatric inflammatory multisystem syndrome (Multisystem Inflammatory Syndrome in Children O MIS-C), which affect multiple organs and also cause serious illness. In recent months there have been numerous publications on the subject: the pediatric clinic of the Materno-Infantile Irccs “Burlo Garofolo” has carried out with the pediatric clinic of Brescia, a multicentre work that has collected all the cases of Kawasaki disease and all the cases of Systemic Multi-Inflammatory Disease registered in Italy during the first epidemic wave. The results were published on Pediatric Rheumatology. The syndrome is also carefully studied in the universities of Verona and Padua, in particular at the Regional Center of Pediatric Rheumatology of Padua directed by Francesco Zulian which followed 46 among young people and children hospitalized after 4-6 weeks of exposure to the virus, with symptoms such as fever, gastrointestinal problems, skin rashes and inflammation of internal organs.
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Participants in the study
Returning to the long-term study, each step will obviously take place with the consent of parents or guardians. The NIH Clinical Center will recruit children and teens ages 3 to 21, and Children’s National Hospital in Washington, DC, children ranging from birth to 21. The intent is also to identify any risk factors for possible, various complications and screen for genetic factors that can influence the immune response and determine if immunological factors can influence outcomes over time.
How the study will take place
Those involved, who must have tested positive for Covid-19, even if asymptomatic, will undergo a complete medical history. Doctors will collect a variety of baseline samples, including blood, nasal swabs, stools, and urine, and have the young people undergo further heart and other organ tests. The procedures of the study include computed tomography of the chest, cardiac magnetic resonances, echocardiogram, pulmonary function tests. A genetic analysis is also planned to identify potential risk factors. Family members who are not infected can enroll as a control cohort and will be involved to compare exam data.
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The study will be divided into two sections: participants enrolled within 12 weeks of acute infection or positive test will be part of the “recovery group” and will take part in the study visits at the beginning and then every 3 months for the first 6 months , and then every 6 months for a total of 3 years. Participants enrolled more than 12 weeks after acute infection or positive test will be in the “convalescence group” and will participate in study visits at departure and every 6 months thereafter for a total of 3 years.
The researchers estimate that, in total, the study will last about six years.
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