COVID-19 Publications

Introduction In March 2020 the World Health Organisation (WHO) released a Global Research Roadmap in an effort to coordinate and accelerate the global research response to combat COVID-19 based on deliberations of 400 experts across the world. Three months on, the disease and our understanding have both evolved significantly. As we now tackle a pandemic in very different contexts and with increased knowledge, we sought to build on the work of the WHO to gain a more current and global perspective on these initial priorities.

Methods We undertook a mixed methods study seeking the views of the global research community to i) assess which of the early WHO roadmap priorities are still most pressing; ii) understand whether they are still valid in different settings, regions or countries; and iii) identify any new emerging priorities.

Results Thematic analysis of the significant body of combined data shows the WHO roadmap is globally relevant, however, new important priorities have emerged, in particular, pertinent to low and lower-middle income countries (less resourced countries), where health systems are under significant competing pressures. We also found a shift from prioritising vaccine and therapeutic development towards a focus on assessing the effectiveness, risks, benefits and trust in the variety of public health interventions and measures. Our findings also provide insight into temporal nature of these research priorities, highlighting the urgency of research that can only be undertaken within the period of virus transmission, as well as other important research questions but which can be answered outside the transmission period. Both types of studies are key to help combat this pandemic but also importantly to ensure we are better prepared for the future.

Conclusion We hope these findings will help guide decision making across the broad research system including the multi-lateral partners, research funders, public health practitioners, clinicians and civil society.

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What is already known about this topic?

Data from China suggest that pediatric coronavirus disease 2019 (COVID-19) cases might be less severe than cases in adults and that children (persons aged <18 years) might experience different symptoms than adults.

What is added by this report?

In this preliminary description of pediatric U.S. COVID-19 cases, relatively few children with COVID-19 are hospitalized, and fewer children than adults experience fever, cough, or shortness of breath. Severe outcomes have been reported in children, including three deaths.

What are the implications for public health practice?

Pediatric COVID-19 patients might not have fever or cough. Social distancing and everyday preventive behaviors remain important for all age groups because patients with less serious illness and those without symptoms likely play an important role in disease transmission.

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The Lancet, April 2020

Abstract Italy is the second exposed Country worldwide, after China, and Lombardia is the most affected Region in Italy, with more than half of the National cases, with 13% of whom being healthcare professionals. The Clinica Pediatrica Università degli Studi di Milano Bicocca is a General Pediatric and Hematology Oncology and Transplant Center embedded within the designated COVID-19 general Hospital San Gerardo in Monza, located in Lombardia, Italy.  Preventive and control measures specifically undertaken to cope with the emergency within Hemato-Oncology, Transplant, and Outpatient Unit in the Pediatric Department have been described. Preliminary COVID-19 experiences with the first Italian pediatric hemato-oncology patients are reported. The few available data regarding pediatrics and specifically hemato-oncological patients are discussed. The purpose of this report is to share pediatric hemato-oncology issues encountered in the first few weeks of the COVID-19 outbreak in Italy and to alert healthcare professionals worldwide to be prepared accordingly

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Following the outbreak in China, the Lombardy region of Italy has become one of the areas of highest incidence of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). As the outbreak grew to a pandemic, many centres worldwide raised the concern that immunocompromised patients may be at high risk of developing a severe respiratory disease called COVID-19. Unlike common viral agents (such as Adenovirus, Rhinovirus, Norovirus, Influenza, Respiratory Syncytial Virus), Coronaviruses have not shown to cause a more severe disease in immunosuppressed patients. For this family of viruses the host innate immune response appears the main driver of lung tissue damage during infection.

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What is already known about this topic?

Early data from China suggest that a majority of coronavirus disease 2019 (COVID-19) deaths have occurred among adults aged ≥60 years and among persons with serious underlying health conditions.

What is added by this report?

This first preliminary description of outcomes among patients with COVID-19 in the United States indicates that fatality was highest in persons aged ≥85, ranging from 10% to 27%, followed by 3% to 11% among persons aged 65–84 years, 1% to 3% among persons aged 55-64 years, <1% among persons aged 20–54 years, and no fatalities among persons aged ≤19 years.

What are the implications for public health practice?

COVID-19 can result in severe disease, including hospitalization, admission to an intensive care unit, and death, especially among older adults. Everyone can take actions, such as social distancing, to help slow the spread of COVID-19 and protect older adults from severe illness.

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