SARS-CoV-2 has transformed the lives of Americans and rapidly changed the delivery of healthcare. Initial reports suggested that children and adolescents were largely spared from developing COVID-19 despite being positive for SARS-CoV-2; however, recent reports from our center found that the disease has a different trajectory in children as many have developed multisystem inflammatory disorder (MIS- C). We still have much to learn about SARS-CoV-2. An initial first step is understanding seroconversion and the clinical, biological, and sociodemographic characteristics that may either promote or prevent seroconversion in a highly vulnerable pediatric group of patients. It has been established that the immunosuppression associated with cancer therapy limits both humoral and cellular immune responses; however, the specificity and function of antibodies vs. SARS-CoV-2 that may be generated in these children, and their correlation to recovery, are unknown. Our preliminary data suggests that immunocompromised children undergoing treatment for cancer may develop a detectable immune response to SARS-CoV-2, but the duration of the presence of antibodies and their associated neutralizing activities are unknown. To best manage children with cancer, it is essential to understand how seroconversion correlates with recovery from immunosuppression, how long protection lasts, and whether the antibody response is protective against SARS-CoV-2. We propose an observational cohort study recruiting 120 children and adolescents undergoing treatment for cancer at the Columbia University Irving Medical Center. At a routine clinical visit, participants will be recruited for a 6- week period in which we will perform a nasal swab to determine positivity to SARS-CoV-2, collect blood (antibody detection and neutralizing activity) and stool (metagenomics sequencing of the microbiome) specimens at 3- and 6-weeks post study entry. At the same time, we will interview participants? parents collecting information on sociodemographic factors associated with viral exposure. We will investigate the presence and activity of antibodies for SARS-CoV-2, controlling for the duration and severity of immunosuppression and explore if socio demographic characteristics that facilitate exposure to SARS-CoV-2 are associated with seroconversion. The long-term impact of our proposed research may result in new strategies in prevention techniques and screening modalities that may be implemented in subsequent waves of the virus.

Public Health Relevance

There is much to learn about SARS-CoV-2 and childhood cancer. An initial step is to understand seroconversion and the clinical, biological, and sociodemographic characteristics associated with the presence of antibodies, duration of antibodies, and their associated neutralizing activity in a group of highly immunosuppressed children with cancer. This will aid investigators in identifying risk factors that promote or hinder children's ability to seroconvert while undergoing treatment for cancer.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Center Core Grants (P30)
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Subcommittee I - Transistion to Independence (NCI)
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Belin, Precilla L
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Columbia University (N.Y.)
Internal Medicine/Medicine
Schools of Medicine
New York
United States
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