Clinical Epidemiology of Pediatric COVID-19 and MIS-C

PROJECT SUMMARY / ABSTRACT Although the novel Coronavirus (SARS-CoV-2) has accounted for significant health and economic costs throughout the world, relatively little is known about its effect on children. The first pediatric case of SARS- CoV-2 in the United States was reported on March 2, 2020, and within just three months, over 64,000 cases were confirmed. Even though children, as a group, have been relatively spared from the effects of the virus, there has been an increasing body of evidence to suggest that some may become critically ill. Since a number of children with SARS-CoV-2 infections manifest with severe systemic inflammation and multi-organ dysfunction, more research on determinants of disease and long-term outcomes of those affected is critical. Dr. Oliveira is a pediatric infectious disease clinician whose long-term goal is to become an independently funded physician-scientist, who integrates the disciplines of clinical epidemiology, data science, and biomedical informatics to detect and respond to emerging infectious diseases. The work described in this proposal builds on the scientific themes he developed throughout his prior training and aims to mechanistically understand the effects of SARS-CoV-2 in children by integrating three different scientific tools: natural language processing, machine learning, and clinical epidemiology. The first consideration for this K23 award period will be to use novel computational tools to build automated surveillance and data-extraction system that can facilitate the identification and tracking of incident cases of SARS-CoV-2 in children (Aim 1). Using this surveillance system, Dr. Oliveira will create a comprehensive registry and conduct a rigorous, model-based investigation to derive a state-of-the-art prediction model of clinical deterioration in children with SARS-CoV-2 (Aim 2). Last, he will recruit a longitudinal cohort of SARS-Cov-2 and determine the frequency of complications and long-term outcomes after recovery (Aim 3). This mentored research experience will furnish Dr. Oliveira with skills and expertise in various aspects of clinical epidemiology, including the establishment of surveillance systems, conducting longitudinal studies, computer programing, and executing sophisticated analyses of the longitudinal data. Workshops, semester- long courses will complement this practical experience, and one-on-one mentorship by a multidisciplinary team of established, independently funded, internationally respected investigators and pioneers in the fields of epidemiology, infectious diseases, biomedical informatics, and mathematical modeling. After this work, Dr. Oliveira will have produced important science that could improve the care of all the children affected by this pandemic. Furthermore, he will have gained a unique set of skills and built the necessary infrastructure that will allow him to establish a research program integrating the disciplines of clinical epidemiology, data science, and informatics to detect, prevent, and respond to future pandemics.