Research Highlights: Pediatrics & COVID-19

The impact of COVID-19 has been widespread — with more than 6 million confirmed cases worldwide since the virus was identified in January 2020. Preliminary research has been focused on how the condition manifests in adults. Recently, clinicians have seen a rise in multisystem inflammatory syndrome in children (MIS-C), a new syndrome associated with the coronavirus that causes COVID-19. Physicians and researchers at Columbia University College of Physicians and Surgeons and Weill Cornell Medicine, are studying the effects of COVID-19 on children, particularly those with co-occurring health conditions.

Epigenetic Priming of Inflammatory Genes in COVID-19: Potential Insights into Pathogenesis and Prognosis

Virginia Pascual, MD
Weill Cornell Medicine

This study will examine the role of “Trained Immunity” in predisposition to severe COVID-19 outcome. The proposal is based on preliminary data obtained as a collaboration between the Josefovicz and Pascual labs addressing how the epigenetic reprogramming of innate immune precursors might predispose children with autoinflammatory diseases to exaggerated responses to subsequent inflammatory triggers. The hypothesis is that COVID-19 patients suffering from “cytokine storms” are epigenetically predisposed to innate immunity-related morbidity.

Epidemiology of healthcare utilization in pediatric emergency departments during COVID-19

Deborah Levine, MD/Shari L. Platt, MD/Fraymovich, DO
Weill Cornell Medicine

This is a retrospective observational study of epidemiology of the patients presenting to the pediatric emergency department during COVID-19 (3/1/20-6/1/20) compared to one year prior (3/1-19-6/19) using the INSIGHT database. We hope to compare acuity between both groups.

Infectious diseases diagnoses of children admitted with COVID-19-like symptoms during an outbreak in New York City

Jin-Young Han, MD, PhD
Weill Cornell Medicine

The purpose of this study is to retrospectively review previously collected medical records on all children who were admitted to NewYork-Presbyterian Komansky Children’s Hospital with COVID-19-like symptoms during the early weeks of the New York City outbreak to determine if these children had SARS-CoV-2 or some other infection. This study is an important first step in identifying the best way to clinically diagnose which children have COVID-19, and which do not.

Delivery Room Preparedness and early Neonatal Outcomes during COVID-19 Pandemic in New York City

Jeffery Perlman, MD
Weill Cornell Medicine

This study describes the preparations and precautions put in place for deliveries of COVID positive mothers in the delivery room, and the experience of 326 deliveries, of which 31 (9.7%) were COVID positive. Full study »

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Genetic Analysis of MIS-C

Josh Milner, MD and Emily Mace, PhD (Pediatric Allergy, Immunology & Rheumatology)/Wendy Chung, MD, PhD (Pediatric Clinical Genetics)
Columbia University Irving Medical Center

Through genetic sequencing of samples collected from MIS-C patients treated at Columbia, researchers are looking for potential causes of these patients’ severe responses after COVID-19 infection, to help identify children at risk of MIS-C before COVID-19 infection occurs. The team will also perform immunologic analysis on samples collected during hospitalization and at a follow-up visit to compare patients’ immune systems while inflamed and at baseline, to understand the fundamental issues driving this unique and severe disorder.

The Impact of Coronavirus disease 2019 (COVID-19) on Patients with Congenital Heart Disease across the Lifespan: The experience of a Congenital Heart Disease Center in New York City

Matthew Lewis, MD (Adult Congenital Heart Disease) and Brett Anderson, MD, MBA (Pediatric Cardiology)/Wendy Chung, MD, PhD
Columbia University Irving Medical Center

COVID-19 impacts those with heart disease more severely than the general population, studies show, but COVID-19’s effect on the congenital heart disease (CHD) population, who are younger and have fewer comorbidities than those with acquired heart disease, is unclear. Clinicians and researchers across the medical center are working together to ascertain the impact of COVID-19 infection on the unique physiologies of CHD (early findings submitted), as well as to identify clinical and genetic risk factors in this potentially vulnerable population.

Longitudinal Follow-Up of Babies Born to Mothers Infected With SARS-Cov-2

Anna Penn, MD, PhD (Neonatology), Ronald Wapner, MD (OBGYN)/Dani Dumitriu, MD, PhD (Neonatology), Catherine Monk, PhD (OBGYN)/others throughout CUIMC
Columbia University Irving Medical Center

Babies born to mothers with COVID-19 have little evidence of infection or severe disease, but the longterm consequences are completely unknown. Clinicians and researchers from across Columbia campuses and schools are teaming up to develop the world's largest longitudinal neurodevelopmental follow-up of these babies. Two of the many topics include 1) outcomes and potential mechanisms such as placental insufficiency, inflammatory markers, and genetic vulnerability, and 2) the precise neurodevelopmental domains and trajectories affected by the pandemic and/or in utero exposure. Together, this comprehensive dataset will be invaluable to developing preventative management for this vulnerable population.

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