We will investigate SARS-CoV-2 infection in African children including spectrum of illness, risk factors for infection, associated inflammation and impact on long-term health. We will measure antibodies to SARS-CoV-2 and evaluate whether antibodies to seasonal coronavirus (sHCoV), prior to the epidemic, protect against COVID. We will compare inflammation and gene expression patterns in children with SARS-CoV-2 to that in pneumonia from other causes. To do this, we will leverage the existing expertise and infrastructure from two studies (i) Drakenstein Child Health Study (DCHS), a birth cohort study following children until at least 6 years (ii) a study of children hospitalized with pneumonia at the largest Childrens Hospital in sub-Saharan Africa. Children in DCHS will be repeatedly tested for SARS-CoV-2, for antibodies, for patterns of inflammation and for patterns of gene expression. Stored blood samples will be used to test for prior inflammation, immune responses and antibodies that may protect against COVID. Children in the pneumonia study will be tested for SARS-CoV-2 and for other viruses to compare clinical features, risk factors, outcome, markers of inflammation and gene expression. All children will be followed for 12 months to evaluate long term health. The study will provide new information on disease spectrum, risk factors, long-term outcome, the role of antibody testing, and identify new targets for treatment in children.

We will investigate SARS-CoV-2 infection in African children including spectrum of illness, risk factors for infection, associated inflammation and impact on long-term health. We will measure antibodies to SARS-CoV-2 and evaluate whether antibodies to seasonal coronavirus (sHCoV), prior to the epidemic, protect against COVID. We will compare inflammation and gene expression patterns in children with SARS-CoV-2 to that in pneumonia from other causes