The urgent need for research coordination to advance knowledge on COVID-19 in children

Affordable, portable and self-administrable electrical impedance tomography enables global and regional lung function assessment

Accessibility of diagnostic screening and treatment monitoring devices for respiratory diseases is critical in promoting healthcare and reducing sudden complications and mortality. Spirometry is the standard for diagnosing and monitoring several lung diseases. However, it lacks regional assessment capabilities necessary for detecting subtle regional changes in certain diseases. It also requires challenging breathing maneuvers difficult for elderlies, children, and diseased patients. Here, we actualized an affordable, portable, and self-administrable electrical impedance tomography (EIT) system for home-based lung function assessment and telemedicine. Through simultaneous EIT-spirometry trials on healthy subjects, we demonstrated that our device can predict spirometry indicators over a wide range and can provide regional mapping of these indicators. We further developed a close-to-effortless breathing paradigm and tested it by longitudinally monitoring a COVID-19 discharged subject and two healthy controls with results suggesting the paradigm can detect initial deterioration followed by recovery. Overall, the EIT system can be widely applicable for lung function screening and monitoring both at homes and clinics.

The role of the Big Two in socially responsible behavior during the COVID-19 pandemic: Agency and communion in adolescents’ personal norm and behavioral adherence to instituted measures

The outbreak of the COVID-19 virus urged all members of the society to adopt COVID-responsible behavioral patterns and practice them in everyday life. Given the variability in its adoption, it is critical to understand psychological factors associated with socially responsible behavior during the pandemic. This might be even more important among adolescents, who are less endangered by the virus but contribute to its spread. In this article, we focus on adolescent boys’ and girls’ agency and communion orientations to explain the level of importance they attribute to the instituted measures to contain the spread of the COVID-19 virus (personal norm), as well as their behavioral adherence to those measures. In total, 12,552 adolescents (67.6% girls, M_age = 15.06, SD_age = 2.44, age range 10–21) answered inventory assessing adolescents’ agentic and communal orientation (GRI-JUG) and items related to personal norm regarding the instituted measures and behavioral adherence to the measures. The results showed a small positive role of communion in both boys’ and girls’ personal norm and behavioral adherence, whereas agency played a very small negative role in boys’ and girls’ personal norm and boys’ behavioral adherence to measures. Nevertheless, these findings could indicate the importance of enhancing communal traits and behaviors in both genders in order to assure socially responsible behavior during the pandemic.

Immunology of SARS-CoV-2 infection in children

Children and adolescents exhibit a broad range of clinical outcomes from SARS-CoV-2 infection, with the majority having minimal to mild symptoms. Additionally, some succumb to a severe hyperinflammatory post-infectious complication called multisystem inflammatory syndrome in children (MIS-C), predominantly affecting previously healthy individuals. Studies characterizing the immunological differences associated with these clinical outcomes have identified pathways important for host immunity to SARS-CoV-2 and innate modulators of disease severity. In this Review, we delineate the immunological mechanisms underlying the spectrum of pediatric immune response to SARS-CoV-2 infection in comparison with that of adults.

A research and policy agenda for the post-pandemic world

The COVID-19 pandemic response has engaged the academic, public, private and health sectors in the real-time development of technologies and practices to enable predictive, preventive, personalised and participatory (P4) health. Myriad cases of collaborative innovation across these sectors have emerged throughout the pandemic response (despite certain observed technical, social and institutional barriers) that serve as examples to address post-pandemic health system challenges. In this paper, we propose a joint research and policy agenda to generate the knowledge and practices to identify and extend these acute gains toward chronic health system challenges in the post-pandemic era. We identify three key themes for post-pandemic research and policy: the dialectic between novel and traditional techniques, the tension between centralised and local decision-making, and cooperation across academic disciplines, sectors and borders. Going forward, attention to these three themes by researchers and policymakers will help align our health, policy, academic and technological systems to provide better health for all.

Paediatric research in the times of COVID-19

The COVID-19 pandemic poses many direct and indirect consequences for children's health and associated research. Direct consequences include participation of children in COVID-19 research trials, pausing other research in children and the potential implications of a global economic downturn on future research funding. Collaborative and networked research together with streamlined research processes and use of remote technology have been central to efforts by clinicians and scientists around the world and have proved essential for reducing COVID-19 morbidity and mortality. IMPACT: Maintain streamlined and efficient approaches to research governance and data sharing to facilitate high-quality collaborative research. Ensure early inclusion of children in trials of therapies for diseases that affect all age groups. Paediatric Research Societies should co-ordinate effective processes to define key research questions and develop multinational clinical trials for diagnostics, therapeutics and preventative strategies for infants, children and young people.