Understanding the increased REsilience of Children compared to Adults in SARS-CoV-2 infecTion (RECAST)

In RECAST we will investigate whether the resilience of children compared to adults in SARS-CoV-2 infection is due to an age-specific immune response pattern. Our analyses involve multi-omics approaches using single cell RNA sequencing, mass cytometry on whole blood, high-throughput serum proteomics, serum- and saliva-based serology to reveal age-, respective disease-course specific classifiers of cellular composition and activation as well as mRNA and protein expression. We successfully applied these technologies in a collaborative approach within the PA-COVID-19 clinical trial and identified distinct response patterns between COVID-19 patients showing a mild versus critical disease course. Within RECAST this approach will be uniquely complemented with an ex-vivo analysis of nasopharyngeal epithelial cell responses playing a major role in mucosal barrier function. In addition to the infrastructure for data- and sample acquisition from hospitalized adults as part of the PA-COVID-19 study platform, RECAST benefits from vast network of participating pediatric outpatient practices and nursery schools providing access to a large number of children. RECAST will provide in depth understanding of protective immune responses in children and mildly symptomatic adults with COVID-19. We aim to identify new diagnostic biomarkers and therapeutic targets of COVID-19. In addition, the RECAST study will generate data on age-specific resilience factors, which may aide evidence-based decision making on social distancing and lockdown measures for childcare facilities and schools.