A better understanding of severe COVID-19 in children

Most children who catch COVID-19 experience only mild symptoms of infection. But a small percentage with the virus may still have to go to hospital.  So far, 13 Australians under the age of 19 have died from COVID.

A group of Australian and French researchers has identified two key pathways to severe COVID-19 in children. They’re hoping that the findings will allow for the earlier identification and better treatment of severe paediatric COVID-19.

The research centres around two outcomes of COVID-19 infection in children: COVID-19 associated acute respiratory distress syndrome (COVID-19 ARDS), and the rarer multisystem inflammatory syndrome in children, or MIS-C.

The presentation of severe COVID-19 in children can differ from adults. COVID-19 ARDS, essentially a very severe lung breakdown, is common in adults as well, but MIS-C, which includes symptoms like rash, stomach pain, and vomiting, is specific to children.

“It’s two different ways that COVID manifests in children and we’ve investigated those underlying pathways that lead to either one of those,” explains Conor McCafferty, a PhD student at the Murdoch Children’s Research Institute at the University of Melbourne, and lead author on a paper describing the research, which has been published in Nature Communications.

McCafferty and colleagues investigated blood samples from 20 healthy children, and 33 children who’d developed either COVID-19 ARDS or MIS-C after catching COVID.

They used a technique called proteomics, which allowed them to investigate multiple proteins at once.

They found 52 proteins specific to ARDS in the blood samples, and 85 specific to MIS-C.

McCafferty says that these proteins are the first step in early diagnosis and finding a treatment for severe paediatric COVID-19 sooner.

“Once we figure out exactly what these pathways are, which we’ve done here, then the next research is a bit more targeted,” McCafferty says. “When we’re looking for treatments or diagnostic tools, we’re not going in blind. We know particularly which parts of the blood and which systems to look for.

“It’s narrowing down exactly where to look for a diagnosis and looking (…) exactly where to treat.”

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