To the Editor,The CORAL Birth cohort is a unique birth cohort project examining allergic and autoimmune dysregulation in infants born between March and May 2020, during the first SARS-CoV-2 lockdown in Ireland. We hypothesised that the dramatic social and environmental changes imposed by the pandemic-mandated lockdown would have implications on the incidence of allergic conditions, possibly mediated by changes in microbiome diversity. We report here interim data of health outcomes, including allergic conditions, at 12 months in this cohort.We have previously published health outcome data at 6 months. 1 A total of 365 infants were enrolled, and 344 were retained to 12 months.Allergic outcomes in the CORAL cohort were compared with a national pre-pandemic birth cohort from the BASELINE study. 2 The 12-month appointment involved skin prick testing (SPT), assessment of any atopic dermatitis (AD), lateral flow SARS-CoV-2 antibody testing and stool and blood sample for analysis. Patient demographic characteristics for the cohort at 12 months are outlined in Table 1.We hypothesised that social restrictions imposed by the SARS-CoV-2 lockdown would result in altered infant microbiome and atopic outcomes through reduced encounters with 'old friend' microbes brought to the infant through family members, creche and sibling school attendance. However, changes in other related health factors, including reduced antibiotic use and increased breastfeeding, which may positively affect gut microbiome diversity were also noted in this cohort.
IntroductionThe CORAL (Impact of Corona Virus Pandemic on Allergic and Autoimmune Dysregulation in Infants Born During Lockdown) study reported a reduction in social communication milestones in 12-month-old infants born into the COVID-19 pandemic.AimsTo look at 24-month developmental and behavioural outcomes in the CORAL cohort.DesignThe CORAL study is a longitudinal prospective observational study of Irish infants born in the first 3 months of the pandemic. At 24 months of age, the Ages and Stages Developmental Questionnaire (ASQ24) and the Child Behaviour Checklist (CBCL) were completed and compared with prepandemic BASELINE (Babies After SCOPE: Evaluating the Longitudinal Impact Using Neurological and Nutritional Impact) cohort.Results917 babies (312 CORAL infants and 605 BASELINE infants) were included. At 24 months of age, infants in the CORAL and BASELINE cohorts had similar developmental ASQ24 scores in fine motor, problem solving and personal and social domains but ASQ24 communication scores were significantly lower in the CORAL group compared with the BASELINE cohort (mean (SD) 49.5 (15.1) vs 53.7 (11.6), p<0.01). Infants from the CORAL cohort were more likely to score below standardised cut-offs for developmental concern in the communication domain (11.9% CORAL compared with 5.4% BASELINE, p<0.01). Unadjusted ASQ24 gross motor scores were lower for the pandemic cohort. Fewer CORAL infants fell under 2 SD cut-off in personal-social subdomain. For CBCL, there was no evidence of difference in scores between the cohorts on multivariable analysis.Conclusion24-month-old pandemic-born infants had largely similar developmental and behavioural scores compared with their prepandemic counterparts. Concerns have been raised in the communication developmental domain.
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