Rutgers Leads National Collaboration to Study Long-Term Effects of COVID-19 in Children

Rutgers Robert Wood Johnson Medical School will serve as a national hub for pediatric sites as part of the NIH's $470 Million RECOVER research initiative.

Rutgers Robert Wood Johnson Medical School (RWJMS) is projected to receive approximately $30 million, establishing a critical partnership with the larger National Institutes of Health-funded RECOVER initiative to study long-term and delayed impacts of COVID-19 in children and lead a national collaboration with the potential to recruit from any state to investigate these outcomes.

Impacts of infection with the virus SARS-CoV-2 that present or persist more than 30 days are collectively referred to as post-acute sequelae of COVID-19 (PASC).

Among the first PASC recognized is Multisystem Inflammatory Syndrome in Children (MIS-C), a severe acute inflammatory illness, which typically begins unexpectedly about a month after the initial infection. Children with MIS-C have fever and other symptoms that may include inflammation of the gastrointestinal tract, circulatory system and skin that sometimes mimic another rare illness, Kawasaki’s Disease. Beyond MIS-C, children are also susceptible to what is commonly referred to as “long COVID.” A team of researchers at Rutgers have studied COVID-19 and MIS-C from shortly after it was first described in the United States.

“Children and adolescents are susceptible to long-term symptoms. Some have brain fog. Others lose their stamina and with it their ability to participate in athletic activities. We are still learning what long COVID may look like in children, as well as in adults. Pain, headaches, fatigue, anxiety, depression, fever, cough and sleep problems have all been reported,” said Lawrence Kleinman, a professor and vice chair of the Department of Pediatrics at RWJMS and a professor of global public health at the Rutgers School of Public Health and lead investigator for the Collaborative Long-term study of Outcomes of COVID-19 in Kids (CLOCK) consortium at Rutgers. The CLOCK team will recruit children, adolescents and young adults from across the United States into the NIH’s RECOVER cohort study.

“CLOCK will make essential contributions to the RECOVER Cohort’s ability to identify the nature of PASC, what makes children susceptible to PASC and ultimately what we can do to prevent and treat this frightening and potentially debilitating condition in children, as well as in adults,” Kleinman said.

CLOCK was developed collaboratively with a variety of prominent organizations, most of which are expected to participate in the four-year research study. CLOCK partners include the American Academy of Pediatrics and its PROS Research Network, the American Academy of Family Physicians and its National Research Network, along with its partner the DARTNet Institute, Family Voices — a national grassroots organization that advances partnerships with parents, and distinguished pediatric institutions such as Baylor College of Medicine/Texas Children’s Hospital, Bristol Myers Squibb Children’s Hospital, Central Michigan University, Children’s Hospital of Philadelphia, Children’s Mercy Hospital of Kansas City, Connecticut Children’s, Johns Hopkins University School of Medicine, Hackensack Meridian Children’s Health, MetroHealth System (Cleveland), New York Medical College/Maria Fareri Children’s Hospital, RWJ Barnabas Health, University of California, San Francisco and the Yale University School of Medicine.

Several of the CLOCK partners also join Rutgers as colleagues in the Eunice Kennedy Shriver National Institute of Child Health and Human Development’s Predicting Viral-Associated Inflammatory Disease Severity in Children with Laboratory Diagnostics and Artificial Intelligence (PreVAIL kIds) initiative. PreVAIL kIds is part of the Rapid Acceleration of Diagnostics (RADx) Radical (RADx-rad) program and seeks to develop and validate translational tools to predict which children with SARS-CoV-2, the virus that causes COVID-19, are most likely to experience severe illness such as pneumonia or MIS-C.

“This scientifically rigorous and collaborative approach allows us to research a diverse group of children and their parents or caregivers as participants, which is critical to informing the treatment and prevention of the long-term effects of COVID-19,” Kleinman said.

Data from the RECOVER Cohort will include clinical information, laboratory tests and analyses of participants in various stages of recovery following SARS-CoV-2 infection. The full RECOVER Cohort will include adults, pregnant individuals and children; enroll patients during the acute, as well as post-acute, phases of the SARS-CoV-2 infection; evaluate tissue pathology; analyze data from millions of electronic health records; and use mobile health technologies, such as smartphone apps and wearable devices, which will gather real-world data in real time. In addition to hubs like Rutgers/CLOCK, the RECOVER study is supported by cores such as those for clinical sciences (NYU Grossman School of Medicine), data resources (Massachusetts General Hospital) and a biorepository (Mayo Clinic Alix School of Medicine).

Those interested in the work of the CLOCK consortium can email clockrecover1@rwjms.rutgers.edu. 

For more information about the NIH RECOVER Initiative go to https://recovercovid.org/.