Characterization of COVID-19 in the pediatric population: study of sero-surveillance and of immunological and biochemical biomarkers of disease severity

Principal Investigators

Objectives

The main objective of this project is to characterize the SARS-CoV-2 infection in children by

  1. Studying clinical, serological, biochemical and immunological variables, to identify protective or susceptibility factors determining the clinical spectrum of COVID-19 in this population, and
  2. Establishing a hospital-based surveillance system to monitor the evolution of the pandemic in the pediatric population.

The project has five specific objectives:

  1. Describing the clinical and demographic characteristics of pediatric patients with COVID-19.
  2. Estimating seroprevalences and incidences of SARS-CoV-2 infection in the general and at-risk pediatric populations.
  3. Determining whether there are differences in innate and adaptive immune responses to SARS-CoV-2 depending on patients' age and/or the disease severity. This specific sub-study of immune responses will compare children with young adults and pregnant women.
  4. Describing the trend of oxidative stress markers and pro-adrenomedullin levels during COVID-19 in pediatric patients, and their changes related to patients' age and/or the disease severity.
  5. Integrating all immune and biochemical biomarkers, and compare them in terms of their prognostic capacity for poor evolution.

Project design

Prospective population-based study of children (≤ 18 years) who attend Hospital Sant Joan de Déu during the pandemic for COVID-19 suspicion. Pregnant women are also recruited for the inflammatory response study.

Cohorts

Patients with suspected COVID-19 infection (estimate n = 3000):

  • CASES: children (≤18 years old) with PCR-confirmed COVID-19 disease.
  • CONTROLS: children (≤18 years old) with a PCR that is negative for COVID-19.

Results obtained from pediatric patients will be compared to a cohort of young adults and pregnant women with PCR-confirmed COVID-19 disease.

Samples

  • Nasopharyngeal-bronchoalveolar aspirate (day 1, day 14, day 40): PCR.
  • Saliva and feces samples (day 1): PCR twice a week.
  • Capillary blood sample (day 1): Rapid serological test.
  • Blood serum and plasma bank (day 1, day 14, day 40): Cytokine quantification and ELISA-based serologic tests.
  • Peripheral blood mononuclear cells (PBMCs) (day 1, day 14, day 40-60): Immunophenotyping and antigen specific T-cell activation studies.
  • RNA samples: IFN-related transcriptomic analysis (day 1, day 14).

Publications

Velasco-Arnaiz et al. Pediatric antimicrobial stewardship in the COVID-19 outbreak. Infection Control & Hospital Epidemiology. June 24, 2020. doi: 10.1017/ice.2020.312.

Pino et al. Correspondence on: 'Paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 mimicking Kawasaki disease (Kawa-COVID-19): a multicentre cohort' by Pouletty et al. Annals of the Rheumatic Diseases. August 05, 2020. doi: 10.1136/annrheumdis-2020-218538.

Congresses

Immunopathogenesis of COVID-19 related pediatric inflammatory multisystem syndrome. Cytokine profile and SARS-CoV-2 specific immune complexes. 26th European Pediatric Rheumatology Congress, September 23-25, 2020, Geneve, Switzerland. Oral Communication.

Group members

External Collaborators

  • Immunology Service, Biomedic Diagnostic Center, Hospital Clínic de Barcelona, (within the Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic Barcelona, Barcelona, Spain).
  • Cytometry and Genomics Unit. Scientific and Technological Centers of the University of Barcelona (CCiTUB).