Todd Bradley, PhD
Director of Immunogenomics, Genomic Medicine Center; Research Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine; Research Assistant Professor of Pediatrics, University of Kansas School of Medicine
Elin Grundberg, PhD
Roberta D. Harding & William F. Bradley Jr. Endowed Chair in Genomic Research; Research Faculty PhD; Research Associate Professor of Pathology, University of Kansas School of Medicine; Associate Professor of Pediatrics, University of Missouri-Kansas City School of Medicine
Mary E. Moffatt, MD
Program Director, Child Abuse Pediatrics Fellowship; Professor of Pediatrics, University of Missouri-Kansas City School of Medicine; Clinical Associate Professor of Pediatrics, University of Kansas School of Medicine
Rangaraj Selvarangan, PhD
Director of Clinical Microbiology and Virology Laboratories; Director of Research Affairs for Laboratory Medicine; Professor of Pathology, University of Missouri-Kansas City School of Medicine; Clinical Professor of Pathology, University of Kansas School of Medicine
Dithi Banerjee, MSc, PhD
Research Scientist PhD, Department of Pathology and Laboratory Medicine; Research Assistant Professor of Pathology, University of Missouri-Kansas City School of Medicine
While children are not classified as a major risk group for coronavirus disease (COVID-19), spikes in case numbers, coupled with evidence suggesting asymptomatic, contagious children carry higher levels of the virus than adults, has parents and caregivers seeking guidance.
The COVID-19 Diagnostics and Investigations Empowering the Family (CODIEFY) study at Children’s Mercy Kansas City is working to provide clarity, said Rangaraj Selvarangan, PhD, Pathology and Laboratory Medicine.
The multi-disciplinary CODIEFY team – led by Dr. Selvarangan and co-investigators Elin Grundberg, PhD; and Todd Bradley, PhD, Genomic Medicine Center – is using COVID-19 testing and single-cell genomic sequencing technology (which can show the differences and evolutionary relationships of various cells) and other tools to create evidence-based COVID-19 education that answers questions such as:
- How does COVID-19 spread among family members?
- How do contamination dynamics differ depending on whether an adult or child is the first one infected?
- Will a child really transfer COVID-19 to the adults or are adults more likely to transmit the virus?
“We really don’t know much about this virus and how it behaves in children, because adults are disproportionately affected,” Dr. Selvarangan said. “There is something that's protecting the child, which is really good to know, but it is important to understand the mechanism of what's behind that protection so we can preserve it (when developing vaccines, etc.). That knowledge will inform many of the policies moving forward.”
Dr. Selvarangan said CODIEFY team will use samples from consenting pediatric patients and adult health care workers and their house hold contact members to:
- track how the virus is transmitted by looking at the nose, throat and in stool samples.
- track what happens to the family after the virus has come and gone in one patient (e.g., why adults are positive, but children are selectively spared).
There is something that's protecting the child [from COVID-19], which is really good to know, but it is important to understand the mechanism of what's behind that protection so we can preserve it.
Dr. Grundberg, who received a grant from the University of Kansas Clinical and Translational Science Institute for COVID-19 research, said the CODIEFY team at the Genomic Medicine Center will also use the samples from consenting patients and health care workers to:
- apply single-cell technology to study how age affects the body's first cellular line of defense against the virus by comparing nasal swab samples of COVID-19-positive children and adults.
- apply the Genomic Answers for Kids toolbox to DNA samples from children with severe form of COVID-19 infections to determine if there are genetic predisposing aspects in play.
- better understand how the B-cell (antibody-making) response occurs during natural infection and identify both the beneficial and detrimental aspects of the immune response.
“We have this clear age association with (COVID-19) that’s so different from what we've seen from other respiratory viruses, so that’s on our side,” Dr. Grundberg said. “But there are other things we want to know: How are our first-responder, nasal epithelial and nasal immune cells, different in kids versus adults? How do the cells respond when they get the infection? That's where we think our platforms at the Genomic Medicine Center, can be a real benefit. Unfortunately, there are also the rare cases where kids present with symptoms that lead them to develop the severe form of COVID-19, which may be linked to genetic factors. These families will be invited to enroll into our “Genomics Answers for Kids program.”
Improving medical, clinical treatment
Dr. Bradley said the CODIEFY study will be important because the pediatric population is one that’s historically understudied when vaccines are being developed. That said, the knowledge the team gains regarding the B-cell responses in children will accelerate vaccine development for both adults and children as this factor is typically major correlate of immunity for vaccines.
“A basic understanding of how the host immune response is reacting, in terms of the B-cell or antibody response naturally, will inform vaccine design in the pediatric and adult population,” he said. “And in gaining that understanding, we will actually gain antibody tools that we can utilize for potential therapeutics and diagnostics as well.”