School Inner-City Asthma Intervention Study : Human Epidemiology and Response to SARS-COV-2 (HEROS) Supplement

COVID-19, the infectious disease caused by SARS-CoV-2, is rapidly affecting humans around the globe.While initial epidemiological data have focused on cases that resulted in severe respiratory disease seenpredominantly in adults, little information regarding the infection burden in children is available. This iscomplicated by the observation that many virologically-confirmed cases in children are asymptomatic. Homeenvironments are established sources of exposure that exacerbate symptoms of asthma and home-basedinterventions are proven effective. Prior to the inception of the School Inner-City Asthma Study (SICAS-1), noAmerican study had comprehensively evaluated the relationship between urban exposures in school,classroom, and home environments and asthma morbidity. Nearly all elementary school children spend 7 to12 hours a day in school, and most of that time is spent in one classroom. From SICAS-1, we learned thatstudent classroom-specific mouse allergen, mold, and particulate pollutant exposure is associated withworsening symptoms. We also demonstrated our ability to reduce these exposures in a busy, school setting.Our proposal builds upon our established, successful school-based infrastructure to determine whether aschool/classroom intervention will efficiently and effectively improve asthma morbidity by reducing theseexposures. Our goal is to determine the efficacy of school/classroom based environmental intervention inreducing asthma morbidity in urban schoolchildren. Our central hypothesis is that reducing classroom/schoolexposure to mouse allergen, mold, and particulate pollutants will decrease asthma morbidity in students withasthma. We plan to test this hypothesis in an intervention study of 250 elementary students with asthma frommultiple classrooms in 40 Boston inner-city elementary schools. Our clinical trial aims are to determine theeffectiveness of a school/classroom based environmental intervention (school integrated pest managementand classroom air purifying filter units within these schools) to reduce asthma morbidity. The supplement tothe parent grant is to leverage the cohort for the to participate in the multi-center survey entitled HumanEpidemiology and Response to SARS-CoV-2 (HEROS), study. This study can be rapidly implemented andrealistically conducted without necessitating any visits to a clinical research center. In addition to the need forsurveying children for asymptomatic SARS-CoV-2 infection, this study will allow a comparison betweenchildren with asthma and other atopic conditions and children without those conditions through remote surveysand collection of samples. This study is an unprecedented, high impact opportunity to leverage the parent trialwith in scope in understanding how SARS-C0V-2 differentially affects children with the condition of interest,compared to children without it.