The main goal of this study is to characterize the adaptive immune responses toSARS-CoV-2 infection in a cohort of children with cancer and impaired immuneresponsiveness and prolonged viral shedding of SARS-CoV-2, and to identify SARS-CoV-2variants that might arise during poorly controlled virus replication
Although the adaptive immune response plays an important role in improving clinical
outcomes of patients infected with SARS2, variability in clinical disease and outcome in
patients with SARS2 infection has not been explained by the variation in qualitative and
quantitative antiviral immune responses. It has been observed that immunocompromised
children shed the virus from the upper respiratory tract for prolonged periods of time,
even after the resolution of clinical symptoms. Thus deficits in adaptive immune
responses might lead to ineffective control of virus replication and prolonged virus
shedding. The proposed studies will define the relationship between adaptive immunity and
virus replication/shedding, including the contribution of viral variants that could arise
during poorly controlled virus replication in children with ineffective immune responses.
The specific aims of the proposed study are: (a) To measure (quantify and qualify) the
adaptive immune responses (humoral and cell-mediated immune responses) after infection
with SARS-CoV-2 in a cohort of hospitalized children with cancer and impaired immune
response. (b) To define the long-term kinetics of the antibody response, cell-mediated
immune responses following infection with SARS-CoV-2 in a cohort of hospitalized children
with cancer and impaired immune response, and to estimate the duration of protective
immunity.(c) to statistically assess whether impaired humoral immunity is associated with
prolonged viral replication and shedding (persistence) following infection with
SARS-CoV-2 in a cohort of children with cancer and impaired immune response, (d) To
genetically trace SARS-CoV-2 mutations, and statistically assess the association between
persistent SARS-CoV-2 infection and the frequency of viral mutations and the emergence of
viral variants in a cohort of children with cancer and impaired immune response, after
their infection with SARS-CoV-2 This will be a prospective, observational cohort study
design. The study population will include pediatric and adolescent patients undergoing
cancer chemotherapy with a confirmed SARS-CoV-2 infection (PCR Positive). Eligible
subjects will be followed prospectively for three months from the time they tested
positive for SARS-CoV-2 by PCR. SARS-CoV-2 RNA, antibody, and cell-mediated immune
responses will be assessed at specified time points and compared between the children
with persistent SARS-CoV-2 infection, and those who cleared SARS-CoV-2 virus. Sequence
viral variants in the persistent SARS-COV-2 infected group Assess the association between
the emergence of viral variants and mutations and strain virulence and clinical outcome
Inclusion Criteria:
1. Children (<18) of both genders undergoing cancer chemotherapy
2. Symptomatic SARS-CoV-2 infection, confirmed by (positive PCR test).
3. Patients with hematologic malignancies (ALL, AML, HL & NHL) on active treatment or
under follow up < 3 months from end of treatment protocol
Exclusion Criteria:
1. Children (<18 years) of both genders undergoing cancer chemotherapy with (PCR
negative) test result for SARS-CoV-2.
2. Children who are PCR positive but are diagnosed with an immune disorder that may
confound the study results.
Children's Cancer Hospital Egypt 57357 Cairo, Egypt
Cairo, Egypt
Mohamed Diaaeldin Hashem, MBBCh, MSc
+2-02-25351500 - 7204
mohamed.diaaeldin@57357.org
Mohamed Diaaeldin Hashem, MBBCh, MSc, Principal Investigator
Children's Cancer Hospital Egypt