Page 27 - RU RWJ Medicine Magazine • Winter 2021
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Reynold A. Panettieri Jr., MD
“This is a pretty novel approach to reaching into communities that other- wise would not have agreed to or favored testing and could be a para- digm moving forward to reach vulnerable patient populations.”
Children Are Not Immune
Although the vast majority of those infected at the start of the pan- demic appeared to be adults, clinicians began seeing signs of the virus in children and adolescents. Some children presented with severe compli- cations as first described in early May by Lawrence C. Kleinman, MD, MPH, FAAP, professor and vice chair for academic development and chief of the Division of Population Health, Quality, and Implementation Sciences (PopQuIS) in the Department of Pediatrics in a study released in JAMA Pediatrics. This study captured the experience of American and Canadian pediatric intensive care units (PICUs) in the early days of the pandemic. Among the key findings was that while four of five children managed in PICUs had underlying conditions ranging from obesity to medical com- plexity, nearly one in five had no comorbid or underlying conditions identified.
Even before the JAMA Pediatrics article, evidence was emerging of a new clinical condition associated with COVID-19. Dr. Kleinman’s research helped to provide the baseline of COVID-19 characteristics, while subse- quent work outlined symptoms that appear weeks after infection, now known as multiple inflammatory syndrome in children (MIS-C). Along with Steven Horwitz, MD, FAAP, assistant professor of pediatrics, Dr. Kleinman helped to stimulate a focus on this condition and its treatment that resulted in a landmark publication in the New England Journal of Medicine, which described the national experience with MIS-C and articulated the clinical characteristics and outcomes characterized by inflammation of two or more organ systems within the body in the context of a SARS-CoV2 exposure or infection.
“This new illness highlights how our understanding of COVID in
children keeps changing,” said Dr. Klein- man. “We have moved from thinking that COVID-19 spares children to understand- ing that children are impacted and play an important role in this pandemic. They can get very sick.”
Dr. Kleinman also is leading national collaborations, including as director of the Maternal Child Health Measurement Re- search Network (MCH MRN), funded by the Maternal Child Health Bureau of the Health Services Research Administration. One of the key priorities of the MCH MRN relates to COVID-19 in mothers and child- ren. Another national collaboration led by Dr. Kleinman with other Rutgers scientists, the COVID-19 Network of Networks Ex- panding Clinical and Translational approaches to Predict Severe Illness in children (CON- NECT to Predict SIck Children), was funded by the NIH in December to seek to identify risk factors for serious illness in children.
Moving Forward
Still entrenched in the pandemic nearly a year later and managing the second wave of infections, medical school investi-
gators continue their pursuit of learning about the virus’ susceptibility and long- term effects in order to improve health outcomes of sufferers and save the lives of those most vulnerable.
“Real benefits occurred from these studies because of scientific forethought, platforms for research that could be mobilized and the expertise to translate the science into real therapeutic approaches and remediation of disease,” said Dr. Panettieri.
“As a result of our ability to organize quickly and pivot research when the crisis emerged, we are much better prepared to take care of our patients during subsequent surges of infection,” said Dr. Carson. “We all are committed to discovering which treatments and vaccines work and to do our part to make the world safer.” M
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