Spectrum, determinants and long term outcome of SARS-CoV2 infection and disease in African children.

Children in LMICs experience a very high burden of pneumonia, which continues to be the major single killer of children under five years of age. Risk factors such as malnutrition, pollution, crowded living conditions and the high burden of infectious diseases all contribute to the vulnerability of children to developing severe pneumonia in these settings. However, surprisingly children in LMICs and globally are only mildly affected by COVID-19, with very few severe cases or deaths occurring in young children. This project will investigate what factors protect children against developing infection or severe disease from COVID-19 across LMICs and whether prior infection with other organisms, including seasonal coronaviruses, protects children against severe disease through development of immunity. This project will provide new information on COVID-19 in childhood, protective factors, immune responses and the long term impact on child health. "This funding provides a wonderful opportunity to better understand COVID-19 in African children in a low and middle income country context. Children are usually very vulnerable to developing severe pneumonia, however this hasn't occurred with COVID-19. Understanding why children are only mildly affected may be key to develop new strategies to prevent or ameliorate illness." Professor Heather Zar, University of Cape Town, South Africa