NIH Launches 1st Long-Term Study of Children with COVID-19

The three-year trial will track the effects of infection on those under 21.

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To better understand the long-term effects of COVID-19 infection in those under the age of 21, the U.S. government has launched a multi-year initiative to track the effects of SARS-CoV-2 infection on children and young adults.  

Researchers will evaluate how the disease has impacted the physical and mental health of children involved in the study in the three years after their diagnosis to “yield a detailed picture” of the effects on overall health of children, development, immune responses. The first enlisted participants were announced by the National Institutes of Health (NIH) on Nov. 15, 2021. Health officials across two institutions plan to track up to 1,000 children and young adults who previously tested positive for COVID-19, as well as their household contacts, for a total of up to 5,000 study participants over six years. 

Since the project was announced, some social media users have used the news to posit that administering a vaccine in a child without knowing the full effects of the disease are premature and ill-informed. 

It is true that scientific understanding of the impacts of COVID on children has changed throughout the course of the pandemic. For example, it was initially thought that children were less likely to transmit and exhibit severe cases the disease. But as of this writing, 6 million known child cases have occurred across the U.S., including many patients who have experienced acute and long-term impacts. 

Because children are only just now being able to receive their vaccine, they are a particularly vulnerable group to infection, notes NIH. To combat this, the agency launched the Researching COVID to Enhance Recovery (RECOVER) initiative to understand and treat past-acute sequelae SARS-CoV-2 (PASC), or long-term conditions that linger after COVID infection, in both children and adults.

“Although we know that children are vulnerable to COVID-19, we still do not have a clear picture of how COVID-19 affects them in the long term,” said Dr. Anthony Fauci, director of the National Institutes of Allergy and Infectious Disease at NIH, in a news release.

“In adult patients, the long-term sequelae of COVID, including post-acute COVID-19, can significantly affect quality of life. Our investigations into the pediatric population will deepen our understanding of the public health impact that the pandemic has had and will continue to have in the months and years to come.”

Health experts argue that children five and older should receive the vaccine, in large part due to the uncertainty of the long-term effects of COVID-19 infection. One such concern is a relatively unknown condition called multisystem inflammatory syndrome specifically in children (MIS-C), where various body parts become inflamed, including the vital organs, skin, and eyes. The condition first made headlines in early 2020 when children diagnosed with COVID-19 were presenting with severe inflammatory syndrome with symptoms similar to those seen in Kawasaki disease, a common cause of heart disease in children. Now named MIS-C, its cause is unknown, but the Centers for Disease Control and Prevention (CDC) notes that many children with MIS-C had SARS-CoV-2 or had been around someone who tested positive. 

With parental consent, children up to the age of 21 previously diagnosed with COVID-19 will be evaluated for their long-term immune response as well as any genetic or immunological factors that influence the mental or physical health outcomes three years following infection. The trial is listed at ClinicalTrials.gov under number NCT04830852 titled, “Pediatric SARS-CoV-2 and MIS-C Long-term Follow-up” and is estimated to be completed by July 1, 2027. 

As of this writing, the CDC recommends that everyone age five and older get a COVID-19 vaccination and authorized only the Comirnaty vaccine, which is manufactured by Pfizer-BioNTech, to those under 18. 

Sources:

Butters, Coen, et al. “Kawasaki Disease Fact Check: Myths, Misconceptions and Mysteries.” Journal of Paediatrics and Child Health, vol. 56, no. 9, Sept. 2020, pp. 1343–45. PubMed, https://doi.org/10.1111/jpc.15101.

CDC. “Multisystem Inflammatory Syndrome (MIS).” Centers for Disease Control and Prevention, 11 Feb. 2020, https://www.cdc.gov/mis/mis-c.html.

CDC and CDC. “COVID-19 Vaccines for Children & Teens.” Centers for Disease Control and Prevention, 4 Nov. 2021, https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/children-teens.html.

“COVID-19 Vaccine Campaign Expands to Elementary-Age Children.” Snopes.Com, https://www.snopes.com/ap/2021/11/03/covid-19-vaccine-campaign-expands-to-elementary-age-children/. Accessed 16 Nov. 2021.

DeBiasi, Roberta. Pediatric SARS-CoV-2 and MIS-C Long-Term Follow-Up. Clinical trial registration, NCT04830852, clinicaltrials.gov, 21 Sept. 2021. clinicaltrials.gov, https://clinicaltrials.gov/ct2/show/NCT04830852.

“Do Teens Spread COVID-19 As Fast As Adults?” Snopes.Com, https://www.snopes.com/fact-check/teens-spread-covid-adults/. Accessed 16 Nov. 2021.
HAN Archive – 00432 | Health Alert Network (HAN). 21 Sept. 2021, https://emergency.cdc.gov/han/2020/han00432.asp.

“Long-Term Study of Children with COVID-19 Begins.” National Institutes of Health (NIH), 15 Nov. 2021, https://www.nih.gov/news-events/news-releases/long-term-study-children-covid-19-begins.

National Institutes of Health (NIH), 15 Nov. 2021, https://www.nih.gov/news-events/news-releases/long-term-study-children-covid-19-begins.

“RECOVER: Researching COVID to Enhance Recovery.” RECOVER: Researching COVID to Enhance Recovery, https://recovercovid.org. Accessed 16 Nov. 2021.

RECOVER: Researching COVID to Enhance Recovery, https://recovercovid.org. Accessed 16 Nov. 2021.

https://twitter.com/KellyRiddell/status/1460328685991604230. Accessed 16 Nov. 2021.

“Virus Surge Breaks Hospital Records Amid Rising Toll on Kids.” Snopes.Com, https://www.snopes.com/ap/2021/08/26/covid-children/. Accessed 16 Nov. 2021.