COVID-19 in children

Welcome to our community of practitioners, researchers, and others, who have an interest in, and are contributing to, the body of science about COVID-19 in children. Although it seems at this point that COVID-19 has a less severe impact on the children, it is equally true that our understanding and treatment of the virus in children are in its infancy. One sick child is one too many, and we need to harness our understanding and treatment of the disease in children.

Purpose

This website therefore aims to promote the collaboration and sharing of resources and knowledge, specifically related to COVID-19 in children, amongst:   

  • South African clinicians working in child health and paediatrics;
  • Researchers working in maternal and child health; and
  • Virologists and epidemiologists interested in the epidemiology of COVID-19 in children.

We will be sharing information and contact details of the following:

  • Research projects
  • The latest research evidence
  • Reports from the World Health Organisation and relevant institutions
  • Funding opportunities
  • Diagnostic and treatment guidelines
 
Research projects

Multi-site studies

  • Paediatric genome project
    Determinants of MIS-C in Children in SA - presentation
    Aim: To identify host and viral genetic variants that may play a role in determining susceptibility and outcomes in SARS-CoV-2 positive children
    Method: To define cohorts of COVID-19 patients affected by the disease, and to collect detailed phenotypic data, DNA, RNA and serum on each patient; to undertake a detailed host and viral genotypic analysis in study participants; to undertake a genotype-phenotype association analysis to identify variants associated with susceptibility and outcome.
    Contact: michael.pepper@up.ac.za
     
  • Prevalence, clinical characteristics, immunologic responses and outcomes of children with suspected or confirmed COVID-19 disease
    COVID UP Study Data - presentation
    Aim: To describe the epidemiology, clinical progression, immunologic responses and outcome of pediatric Covid-19 disease amongst paediatric patients with respiratory disease admitted to Steve Biko Academic and Tshwane District hospital in South Africa
    Method: Two designs will be used: A retrospective review of all patients tested for COVID 19 at Steve Biko Academic Hospital and Tshwane District Hospital will be conducted between 16th March 2020 until Ethics approval; A prospective cohort study will be conducted once ethics approval has been obtained and systems are set up at hospitals to gather the data.
    Contact: jeane.cloete@up.ac.za
     
  • SARS-CoV-2 Infection in hospitalised South African Children: A multi-centre collaborative study to develop a COVID-19 Paediatric Registry
    COVID-19 Paediatric Registry - presentation
    Aim: To create a multi-centre registry to describe the epidemiology, clinical characteristics, and outcome of pediatric SARS-CoV-2 infection in children hospitalized at academic and non-academic hospitals in South Africa
    Setting: Academic and non-academic hospitals in Free state, Gauteng, Kwa Zulu Natal, Limpopo, Western Cape
    Method: Medical and laboratory record review
    Time frame: Ethics submissions in progress
    Contact: Ameena Goga (ameena.goga@mrc.ac.za)
  • WHO study
    Severe child COVID in LMIC hospital network -planning protocol - presentation
    Aim: To understand the clinical characteristics of SARS-CoV2 related disease in neonates, children and adolescents aged 0-19 years presenting to hospital in LMICs
    Setting: Network of 19 hospitals in four countries in Africa and Asia (Ethiopia, India, Pakistan, South Africa), with one coordinating centre per country, and network hospitals supported to improve diagnostics, therapies, data collection systems, and clinical guidelines for best practice management and therapy
    Method: (i) prospective surveillance; (ii) prospective case control study; (iii) retrospective data extraction, implemented over 6 months
    Time frame: Expect enrolment to begin in December 2020
    Contact: Karen Edmond (edmondk@who.int)

Implementation research

Other

  • COVID-KIDS: A prospective hospital-based (Tygerberg Hospital) study investigating the clinical phenotype, immunology, respiratory morbidity, psychological impact and transmission dynamics of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
    Contact persons: Andrew Redfern (redfern@sun.ac.za) and Mariek van der Zalm (mariekevdzalm@sun.ac.za)  
  • COVID-HG: A research study to determine the underlying human genetic causes of severe COVID-19 disease or resistance in South Africans
    Contact persons: Marlo Moller (marlom@sun.ac.za) and Desiree Petersen (desiree.petersen@cpgr.org.za)
Diagnostic and treatment guidelines
  • COVID-19 Maternal & newborn care guidelines V2 (updated 8 July 2020)
    This living document contains the latest algorithms and guidelines for managing pregnant women and newborns in the context of COVID-19 in South Africa. The document also contain a guideline for the provision of maternity and reproductive health services in South Africa during the COVID-19 pandemic – for provinces, districts, facilities and clinical managers.
Information repositories
  • A COVID-19 knowledge hub of knowledge hubs for decisionmakers / researchers
    The African Centre for Evidence and the McMaster Health Forum, reputable leaders in knowledge synthesis, have created a living hub of COVID-19 knowledge hubs. The hub was developed through a systematic process of identification, screening and coding of hubs that met pre-defined eligibility criteria. Of the 440 hubs that were originally identified, 304 hubs met our eligibility criteria. 
    The living hub of COVID-19 knowledge hubs can help people like these:
    • a social-services policymaker in Ghana may use the living hub of hubs to rapidly identify organizations in Ghana (or in English-speaking west African countries more generally) that may have already prepared locally relevant resources that can help to guide her country’s COVID-19 response;
    • a stakeholder in Argentina may use it to look for comparative analyses of COVID-19 data from Latin American countries that are explained in Spanish and can be used in a briefing he is giving to peer organizations; and
    • a research group may use it to avoid duplication when setting up a new COVID-19 knowledge hub and to improve coordination among existing hubs.
       
  • Clinicaltrials.gov website: COVID-19 and children studies

  • COVID-19 response MNH FRAMEWORK - V3.5 (updated 16 February 2021)
    South African Framework and Guidelines for Maternal and Neonatal Care during a Crisis: COVID-19 response
    This living document is coordinated by the SAMRC Research Unit for Maternal and Infant Health Care Strategies. Contributions and updates come from various interest groups, committees and government departments. Documents are updated regularly.
    The aim is to facilitate communication and provide information for all levels of care in a crisis involving maternal and neonatal care.There are three main chapters and numerous appendices: 1. Structure behind the framework; 2. Important interfaces in making decisions regarding the crisis; 3. Tasks and actions at different health-system levels and for managers, clinicians and other health care and support personnel. (Appendices: messages for pregnant and postnatal women; algorithms and guidelines for managing pregnant women and newborns; health services; community and community health workers; monitoring and evaluation; miscellaneous example documents.)
  • Harvard Medical School
     
  • Johns Hopkins repository of MCH-related papers
    All publications provide emerging evidence related to COVID-19 and
    • Child health (from neonates to adolescents)
    • Maternal health (pregnant women, women of reproductive age)
    • Breastfeeding and Infant feeding
    • Nutrition (related to MCH)

30 new publications focus specifically on COVID-19 and pregnancy.
A new report details the trends of weekly incidence of SARS-CoV-2 infection among children, adolescents, and young adults in the US, stratified by age to coincide with age groupings in educational settings.
Another study specifically compared viral loads in symptomatic and asymptomatic children with SARS-CoV-2.
Others focus more on the broader impact of the pandemic on child health, such as trends in pediatric hospitalization and health service utilization.
New publications discuss the observed differences in D-dimer levels between pediatric patients with MIS-C and those with COVID-19 alone; others point to acute gastro-intestinal pain and persistent fever as potential warning signs of PIMS-TS/MIS-C.
We also have a specific repository only on COVID-19, Breastfeeding, Infant Feeding, and Breast Milk.

Statements by professional bodies
Seminal publications

CDC

NICD

WHO

Peer-reviewed articles

Non-peer reviewed articles / reports / presentations 

Media Coverage
Apps and Products
  • Paediatric Protective Pillars App: WITS Paediatrics fund and Wits Department of Paediatrics
    The WITS Paediatrics fund and the Wits Department of Paediatrics are excited to launch the Paediatric Protective Pillars. (Download instructions)
    Our aim is to share useful, carefully curated content widely and easily to support colleagues across our circuit (and beyond) as they navigate the current COVID-19 crisis. The App is centred on four Pillars:
    • Guidelines Pillar – Access to Guidelines
    • Training Pillar – Access to teaching material
    • Support Pillar ­– Access to care and psychological support for Health care workers
    • SOS Pillar -  Guidance for clinicians in our department who may have COVID”
Funding opportunities
 
Institutional partners

Community members

Invitation
If you have any information that you want to post on this website, or enquiries on content hosted here, please contact Arrie Odendaal: willem.odendaal@mrc.ac.za

 

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