Establishment of a Pediatric COVID-19 Biorepository: Unique Considerations and Opportunities for Studying the Impact of the COVID-19 Pandemic on Children

Abstract

Background: COVID-19, the disease caused by the highly infectious and transmissible coronavirus SARS-CoV-2, has quickly become a morbid global pandemic. Although the impact of SARS-CoV-2 infection in children is less clinically apparent, collecting high-quality biospecimens from infants, children and adolescents in a standardized manner during the COVID-19 pandemic is essential to establish a biologic understanding of the disease in the pediatric population. This biorepository enables pediatric centers world-wide to collect samples in a standardized manner to drive forward our understanding of COVID-19 by addressing specific pediatric and neonatal COVID-19-related questions. Methods: A broad study was implemented with strategic enrollment guidelines to include patients seen in urgent care clinics and hospital settings, neonates born to SARS-CoV-2 infected mothers, and asymptomatic children. The methodology described here, details the importance of establishing collaborations between the clinical and research teams to harmonize protocols for patient recruitment and sample collection, processing and storage. Results: Considerations and challenges facing enrollment of neonatal and pediatric cohorts are described. A roadmap is laid out for successful collection, processing, storage and database management of multiple pediatric samples such as blood, nasopharyngeal and oropharyngeal swabs, sputum, saliva, tracheal aspirates, stool, and urine. Using this methodology, we enrolled 327 participants, who provided a total of 972 biospecimens.Conclusions: Pediatric biospecimens will be key in answering questions relating to viral transmission by children, differences between pediatric and adult viral susceptibility, and, immune responses, the impact of maternal SARS-CoV-2 infection on fetal development, and factors driving the Multisystem Inflammatory Syndrome in Children. The specimens in this biorepository will allow necessary comparative studies between children and adults, help determine the accuracy of current pediatric viral testing techniques, in addition to, understanding neonatal exposure to SARS-CoV-2 infection and disease abnormalities. The successful establishment of a pediatric biorepository is critical to provide insight into disease pathogenesis, and subsequently, develop future treatment and vaccination strategies.

Neutrophil Profiles of Pediatric COVID-19 and Multisystem Inflammatory Syndrome in Children

“…Blood samples were processed as previously described ( 43 ). Briefly, blood samples were collected in vacutainer tubes containing Ethylenediaminetetraacetic Acid (EDTA) anticoagulant.…”

“…Blood samples were processed as previously described ( 43 ). Briefly, blood samples were collected in EDTA vacutainer tubes.…”

“…Blood was processed from healthy pediatric patients and MIS-C patients as previously described ( 43 ). From the isolated neutrophils, an aliquot of 1×10 4 cells in 50 μl RPMI (no FBS) were collected.…”

Zonulin Antagonist, Larazotide (AT1001), As an Adjuvant Treatment for Multisystem Inflammatory Syndrome in Children: A Case Series

“…All patients met criteria for MIS-C as defined by the Centers for Disease Control and Prevention (4). All MIS-C patients provided consent, and assent when indicated, to the Massachusetts General Hospital Pediatric COVID-19 Biorepository (14) (IRB 2020P000955) to allow sample and metadata analysis. Clinical laboratories (C-reactive protein [CRP], d-dimer), symptomatology, and body temperatures were obtained from medical records.…”

Durability and cross-reactivity of SARS-CoV-2 mRNA vaccine in adolescent children

“…Adolescent children and their parents assented and consented, respectively, to participate in the MGH Pediatric COVID-19 Biorepository (MGB IRB #2020P000955) (5). Demographic information was extracted from medical records.…”