Post by Nadica (She/Her) on Dec 3, 2024 1:59:14 GMT
Expanding Knowledge of Pediatric Long COVID and MIS-C - Published Dec 2, 2024
Respiratory viral illnesses like COVID-19 tend to surge in the colder months, as people spend more time indoors, travel for the holidays, and gather with family and friends. While no longer considered a federal Public Health Emergency, COVID-19 continues to be a public health concern.
Not only can SARS-CoV-2 cause acute respiratory illness, but millions of people who had COVID-19 continue to experience a wide range of symptoms months or years after their initial infection. Although more common after severe COVID-19, long COVID also can develop after asymptomatic or mild illness.
Persistent symptoms ranging from brain fog to gastrointestinal problems can hamper children’s participation in school, sports, and social activities. For some kids, long COVID is debilitating. A report issued this summer by the National Academies of Sciences, Engineering, and Medicine external link concludes that more research is needed to understand long COVID in children, as information from adult studies may not be directly applicable to younger populations.
NICHD is committed to filling these evidence gaps, in part through our support of NIH’s RECOVER initiative external link, which leads efforts to better characterize long COVID. A large study involving more than 60 sites across the nation found that long COVID affects adolescents differently than school-age children, suggesting that a one-size-fits-all approach is unlikely to be effective for identifying children with long COVID. Rather, screening tools, as well as potential treatments, may need to be tailored for specific groups.
Institute research also addresses a rare postinfection complication called MIS-C—a severe, sometimes fatal, condition marked by inflammation of one or more organs. NIH established the PreVAIL kIds initiative to rapidly diagnose and characterize MIS-C associated with SARS-CoV-2, as well as to understand the spectrum of pediatric SARS-CoV-2 illness and predict the chances of long-term complications.
Work supported through PreVAIL kIds revealed changes in MIS-C symptoms as SARS-CoV-2 evolved during the pandemic. While serious complications from MIS-C appeared to decrease from 2020 to 2022, they remained pronounced.
Although MIS-C can be life-threatening, most children with the condition recover with medical care, highlighting the need for strategies to accurately and quickly detect MIS-C. Work by the PreVAIL kIds investigators and their global scientific collaborators has made major strides toward the development of such diagnostics—evidenced by a growing number of scientific publications, patent filings, and commercial partnerships. For example, PreVAIL kIds scientists were part of a large international team that identified a five-gene signature that distinguishes MIS-C from bacterial infections, viral infections, and Kawasaki disease—a rare condition that also includes swelling of internal organs. Other work revealed potential protein biomarkers for MIS-C that can be detected in saliva or blood serum.
NICHD-supported research also is providing insights into the causes of MIS-C, with recent results suggesting the condition may result from an immune system attack on one of the body’s own proteins. A section of human SNX8 greatly resembles a region of the SARS-CoV-2 nucleocapsid, which is hidden deep inside the virus. By recognizing this usually hidden viral protein fragment, the immune system also learns to target SNX8, potentially leading to the inflammation characteristic of MIS-C.
Like many infectious diseases, COVID-19 can affect children differently than adults. Compared to adults, children tend to experience less severe symptoms after acute SARS-CoV-2 infection, and we continue to learn more about how the long-term effects of infection may also differ. To optimize treatment of pediatric COVID-19 and its complications, we must first understand the unique needs of children.
Respiratory viral illnesses like COVID-19 tend to surge in the colder months, as people spend more time indoors, travel for the holidays, and gather with family and friends. While no longer considered a federal Public Health Emergency, COVID-19 continues to be a public health concern.
Not only can SARS-CoV-2 cause acute respiratory illness, but millions of people who had COVID-19 continue to experience a wide range of symptoms months or years after their initial infection. Although more common after severe COVID-19, long COVID also can develop after asymptomatic or mild illness.
Persistent symptoms ranging from brain fog to gastrointestinal problems can hamper children’s participation in school, sports, and social activities. For some kids, long COVID is debilitating. A report issued this summer by the National Academies of Sciences, Engineering, and Medicine external link concludes that more research is needed to understand long COVID in children, as information from adult studies may not be directly applicable to younger populations.
NICHD is committed to filling these evidence gaps, in part through our support of NIH’s RECOVER initiative external link, which leads efforts to better characterize long COVID. A large study involving more than 60 sites across the nation found that long COVID affects adolescents differently than school-age children, suggesting that a one-size-fits-all approach is unlikely to be effective for identifying children with long COVID. Rather, screening tools, as well as potential treatments, may need to be tailored for specific groups.
Institute research also addresses a rare postinfection complication called MIS-C—a severe, sometimes fatal, condition marked by inflammation of one or more organs. NIH established the PreVAIL kIds initiative to rapidly diagnose and characterize MIS-C associated with SARS-CoV-2, as well as to understand the spectrum of pediatric SARS-CoV-2 illness and predict the chances of long-term complications.
Work supported through PreVAIL kIds revealed changes in MIS-C symptoms as SARS-CoV-2 evolved during the pandemic. While serious complications from MIS-C appeared to decrease from 2020 to 2022, they remained pronounced.
Although MIS-C can be life-threatening, most children with the condition recover with medical care, highlighting the need for strategies to accurately and quickly detect MIS-C. Work by the PreVAIL kIds investigators and their global scientific collaborators has made major strides toward the development of such diagnostics—evidenced by a growing number of scientific publications, patent filings, and commercial partnerships. For example, PreVAIL kIds scientists were part of a large international team that identified a five-gene signature that distinguishes MIS-C from bacterial infections, viral infections, and Kawasaki disease—a rare condition that also includes swelling of internal organs. Other work revealed potential protein biomarkers for MIS-C that can be detected in saliva or blood serum.
NICHD-supported research also is providing insights into the causes of MIS-C, with recent results suggesting the condition may result from an immune system attack on one of the body’s own proteins. A section of human SNX8 greatly resembles a region of the SARS-CoV-2 nucleocapsid, which is hidden deep inside the virus. By recognizing this usually hidden viral protein fragment, the immune system also learns to target SNX8, potentially leading to the inflammation characteristic of MIS-C.
Like many infectious diseases, COVID-19 can affect children differently than adults. Compared to adults, children tend to experience less severe symptoms after acute SARS-CoV-2 infection, and we continue to learn more about how the long-term effects of infection may also differ. To optimize treatment of pediatric COVID-19 and its complications, we must first understand the unique needs of children.