Long before the pandemic struck, Children’s Hospital of Philadelphia (CHOP) saw its role as not only a pediatric hospital that would provide superior care to children, but also as a home for visionary research that would translate into groundbreaking treatments. Whether it’s a policy-oriented think tank within the hospital, or Frontier Programs meant to break new ground in pediatric research and therapies, CHOP has always been a place where innovation and creativity drive the overall mission. These principles have not only differentiated CHOP as a world-class hospital but have also fostered a research community that was able to pivot in the face of crisis and ultimately answer many questions about the novel virus that struck the United States in March 2020.
Since then, CHOP experts have played a critical role in revealing the science and broader societal effects of the virus, publishing their research in top tier journals and often driving the national conversation. From modeling the trajectory of the virus, to understanding the biology of the mysterious MIS-C, to providing expert guidance on COVID-19 vaccines, researchers at CHOP have published more than 300 studies related to COVID-19. Below are just a few of the meaningful scientific contributions that continue to help policymakers and clinicians manage the COVID-19 pandemic now and into the future.
Mapping COVID-19 transmission across the United States
Researchers in CHOP’s PolicyLab built a model called COVID-Lab to observe how social distancing, population density and daily temperatures affect the number and spread of COVID-19 infections over time across the county. To build and maintain the COVID-19 mapping model, the interdisciplinary team — representing collective expertise in public health, infectious diseases, public policy, communication, epidemiology, statistics and data visualization — met multiple times a week, dedicated to creating a model that would remain reliable throughout the pandemic.
The model forecasts four-week projections of case transmission weekly for 819 counties with active outbreaks, representing 82% of the U.S. population and 83% of all identified coronavirus cases. Over the course of the pandemic, COVID-Lab has been used by county commissioners, state governors and the White House Coronavirus Task Force to implement policies to help contain the pandemic.
Leading the country in vaccine education and advocacy
Throughout the pandemic and the subsequent rollout of the COVID-19 vaccine, CHOP’s Vaccine Education Center (VEC) has provided consistent guidance on COVID-19 vaccine research and safety. Proactively addressing public concern about the COVID-19 vaccine through regularly updated FAQs and video interviews with experts, VEC has been a consistent source of truth during a time of widespread skepticism. VEC’s COVID-19-related video content on YouTube has so far been viewed over 650,000 times. Director Paul Offit, MD, is a member of the Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee and co-inventor of RotaTeq®, an oral rotavirus vaccine. Through media interviews on multiple national outlets as well as virtual town halls for CHOP patients and families, Dr. Offit has advised the nation on the safety and effectiveness of the COVID-19 vaccines in an effort to promote mass vaccination to end the pandemic.
Studying the science of resilience
Psychiatrist Ran Barzilay, MD, PhD, and others at the Lifespan Brain Institute (LiBI) are studying the effects of resilience on mental well-being during the coronavirus pandemic. A child psychiatrist at CHOP, Dr. Barzilay believes the COVID-19 pandemic is a time for people to exercise resilience — the ability to overcome adversity — and for scientists to study this ability in large populations facing the same stressor. To collect data related to risk factors and resilience factors, the LiBI research team created an online survey, which includes questions about resilience, emotions and stress during the COVID-19 pandemic and provides immediate personalized feedback regarding a participant’s resilience profile and mental health. By establishing a registry of participants willing to be contacted in the future, Dr. Barzilay plans to investigate how COVID-19-related stress affects groups of people over time, as well as the genetic basis of resilience.
Creating more effective care models in diverse communities
Wanjiku Njoroge, MD, another psychiatrist at CHOP, is studying the challenges faced by Black women living in Philadelphia amidst two pandemics – COVID-19 and structural racism – and the ways in which interventions could be helpful.
Dr. Njoroge and colleagues at the University of Pennsylvania surveyed more than 1,000 peripartum women about mental health during the COVID-19 pandemic. These women will be resurveyed after delivery with additional questions about mental health, provider trust and support, mother/infant bonding, race/ethnicity, stressful life events, perceived discrimination and area deprivation index. The goal of this study is to better understand the diversity of women’s experiences and create care models that are culturally appropriate and effective in supporting mothers and infants.
Developing an innovative diagnostic tool for MIS-C
Audrey Odom John, MD, PhD, Chief of Infectious Diseases at CHOP, and Hamid Bassiri, MD, PhD, infectious disease attending physician, are leading an NIH-funded study to help better diagnose MIS-C in children with fever. The NIH’s Rapid Acceleration of Diagnostics Radical (RADx-rad) initiative was created to support innovative research to develop nontraditional approaches to identify the wide range of SARS CoV-2 associated illness, including MIS-C. CHOP is one of only eight sites in the country participating in this study. By leveraging Dr. Odom John’s knowledge and expertise in pediatric biomarker discovery, CHOP researchers will examine whether MIS-C causes changes in metabolites found in the breath, urine or saliva of children. They hope to use the results of these discovery studies to develop a much-needed MIS-C diagnostic, which could have a major impact on the care of children with fever in the post-COVID era.
Improving treatment for MIS-C and COVID-19
Edward Behrens, MD, David Teachey, MD, Hamid Bassiri, MD, PhD and others in CHOP’s Immune Dysregulation Program have looked into the biology and immunology of COVID-19 and MIS-C and published numerous papers on the disturbances of the immune system and biological changes due to the SARS-CoV-2 virus. One such study used deep immune profiling to show children with MIS-C have highly activated immune systems that, in many ways, are similar to those of adults with severe COVID-19. Better understanding of immune activation in patients with MIS-C could not only help better treat those patients but also improve treatment for adults with severe COVID-19.
In a related study, CHOP researchers found elevated levels of a biomarker related to blood vessel damage in children with SARS-CoV-2 infection, even if the children had minimal or no symptoms of COVID-19. This study shows SARS-CoV-2 may have additional consequences that are currently unknown. The team plans to continue testing and monitoring children with SARS-CoV-2 in order to better understand the short- and long-term effects of the virus.
Studying COVID-19 Vaccines in Children
With COVID-19 vaccines approved for Emergency Use Authorization for those 12 years of age and older, scientists are now investigating vaccines for children under 12. In the spring of 2021, Moderna chose more than 80 sites across the United States and Canada to validate safety and effectiveness of a COVID-19 vaccine in children 6 months to 11 years. Jeffrey Gerber, MD, PhD, is leading Moderna’s COVID-19 vaccine trial at CHOP. CHOP has also partnered with Vanderbilt University, St. Louis Children's Hospital and UPMC Children's Hospital of Pittsburgh to develop a Vaccine and Treatment Evaluation Unit (VTEU) in an effort to test new and improved vaccines and therapies against infectious diseases. The Moderna trial is currently enrolling patients.