Since the beginning of the COVID-19 pandemic, NICHD has worked to understand the effects of the virus among populations central to the NICHD mission, including pregnant and postpartum women, children and adolescents, people with intellectual and developmental disabilities, and people with physical disabilities or mobility impairments.
The institute has generated research proposals and projects; collaborated with other NIH institutes, centers, and offices (ICOs) and federal agencies; and initiated studies to help build a research base on SARS-CoV-2 virus. NICHD also continues to advocate for the inclusion of its key populations in major trans-NIH programs, including the Rapid Acceleration of Diagnostics (RADx) initiative, the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) Initiative, and other projects.
This information highlights some of NICHD’s COVID-19 research activities.
- COVID-19 during Pregnancy and Postpartum
- COVID-19 in Children
- COVID-19 in Underserved Populations (UPs)
- COVID-19 and Basic Science
- COVID-related Funding Notices (NOTs) and Funding Opportunity Announcements (FOAs)
NICHD aims to improve understanding of how SARS-CoV-2 infection and disease affect women who are pregnant or have just given birth, as well as their newborns. These efforts seek to determine whether pregnancy influences the course of COVID-19 disease, to establish the risk of transmitting the SARS-CoV-2 virus to the fetus during pregnancy or to the infant during breastfeeding, to delineate how COVID-19 affects long-term health of mothers and their children, and to ensure that any COVID-related treatments are adequately formulated and tested for their specific needs.
Some newly initiated NICHD research projects include:
- NICHD-funded researchers will analyze medical records of up to 21,000 women who have given birth recently at a clinical center within NICHD’s Maternal-Fetal Medicine Units (MFMU) Network. This group of 12 U.S. clinical centers covers more than 160,000 deliveries a year, and has appropriate racial, ethnic, and geographic diversity to allow researchers to generalize study findings to the U.S. population. The study will evaluate whether healthcare changes implemented because of the pandemic have led to higher rates of pregnancy-related complications and cesarean delivery. MFMU researchers also seek to establish the risk of SARS-CoV-2 infection transmission from pregnant women to their fetuses. For details, visit https://www.nichd.nih.gov/newsroom/news/051920-MFMU-COVID-19.
- A similar study will be conducted to estimate the prevalence of SARS-CoV-2 infection during pregnancy at eight sites within the NICHD-funded Global Network for Women’s and Children’s Health Research. Using antibody testing at delivery, the study seeks to compare the maternal, fetal, and neonatal outcomes of SARS-CoV-2-infected women to those of non-infected women. The study will enroll approximately 2,000 pregnancies for each site in Kenya, Zambia, Guatemala, India (Belagavi and Nagpur), Democratic Republic of the Congo, Pakistan, and Bangladesh.
- NICHD’s Perinatology Research Branch is also studying the effects of COVID-19 on pregnant women who give birth at Detroit Medical Center in Detroit, Michigan.
There is a great deal to learn about how SARS-CoV-2 infection affects children. Despite substantial numbers of children becoming infected globally, most have minimally symptomatic or asymptomatic disease, unless co-morbidities such as obesity are present.
More recently, though, physicians around the world have reported an increase in cases and deaths linked to a multisystem inflammatory syndrome, called MIS-C, that seems to be related to previous exposure to the SARS-CoV-2 virus. MIS-C is a spectrum of inflammatory processes with features that overlap with toxic shock syndrome and are similar to the heart condition known as Kawasaki disease. MIS-C can present with symptoms seemingly unrelated to COVID-19, such as severe abdominal pain. Most MIS-C cases affect school-age children, specifically those who were previously healthy and who may have initially had only mild symptoms or no symptoms at all.
Among NICHD’s recently launched activities related to COVID-19 in children and MIS-C is the following:
- The NICHD-funded Pediatric Trials Network (PTN) recently incorporated into one of its protocols research on the dosing and safety of drugs currently being used clinically to treat children with COVID-19. Researchers in the PTN, funded as part of NICHD’s Best Pharmaceuticals for Children Act program, are analyzing blood samples collected from routine medical procedures to understand how drugs move through the bodies of children, from newborns to adolescents younger than 21 years of age. They also will collect information on potential side effects and patient outcomes, such as the type of respiratory support needed and length of hospital stay. The study is not designed to evaluate which drug is the best treatment for COVID-19. You can learn more about this study at https://www.nichd.nih.gov/newsroom/news/061020-COVID-19-BPCA.
NICHD is also participating in NIH’s RADx-UP program to understand the factors associated with disparities in COVID-19 morbidity and mortality and to reduce disparities for those underserved and vulnerable populations who are disproportionately affected by, have the highest infection rates of, and/or are most at risk for complications or poor outcomes from the COVID-19 pandemic.
RADx-UP, part of the overall RADx initiative, will work closely with and within communities to develop and rapidly implement interventions and increase access and use of U.S. Food and Drug Administration-approved tests for COVID-19 and antibody testing for present and past infection among underserved populations. RADx-UP’s objective is to collect high-quality testing data to understand the prevalence, treatment, and outcome disparities amid the COVID-19 pandemic and to identify the effects of public health measures among underserved populations.
NICHD researchers who lead their own laboratories and research programs at NIH are also leveraging their areas of expertise to address the pandemic. To learn more about NICHD’s intramural program, visit https://www.nichd.nih.gov/research/atNICHD.
Some of this research focuses on understanding the biology of the SARS-CoV-2 virus, its effects on the placenta and on lung tissue, and what mechanisms lead to severe symptoms and death among older people and those with underlying health conditions. Other NICHD researchers are studying possible targets for prevention and treatment measures.
NICHD researchers are also working to develop and improve technologies and resources to help advance COVID-19 research. These activities include creating materials that protect surfaces from viral particles, as well as improving methods of testing possible vaccines and treatments.
NICHD is participating in the following NOTs and FOAs related to COVID-19:
- NOT-MD-20-022: Notice of Special Interest (NOSI): Competitive and Administrative Supplements for Community Interventions to Reduce the Impact of COVID-19 on Health Disparity and Other Vulnerable Populations
- NOT-MD-20-023: Notice of Intent to Publish an FOA for Community Interventions to Address the Consequences of the COVID-19 Pandemic for Health Disparity and Vulnerable Populations (R01 - Clinical Trial Optional)
- NOT-MH-20-053: NOSI: Digital Healthcare Interventions to Address the Secondary Health Effects Related to Social, Behavioral, and Economic Impact of COVID-19
- NOT-MH-20-058: Notice of Intent to Publish an FOA for Digital Healthcare Interventions to Address the Secondary Health Effects Related to Social, Behavioral, and Economic Impact of COVID-19 (R01 - Clinical Trial Optional)
- NOT-OD-20-097: NOSI Regarding the Availability of Administrative Supplements and Urgent Competitive Revisions for Research on the 2019 Novel Coronavirus and the Behavioral and Social Sciences
- NOT-OD-20-112: Notice of Intent to Publish FOAs for the RADx-UP Initiatives
- NOT-OD-20-119: NOSI: Emergency Competitive Revisions for Social, Ethical, and Behavioral Implications (SEBI) Research on COVID-19 Testing among Underserved and/or Vulnerable Populations
- NOT-OD-20-120: NOSI: Emergency Competitive Revisions for Community-Engaged Research on COVID-19 Testing among Underserved and/or Vulnerable Populations
- NOT-OD-20-121: NOSI: Limited Competition for Emergency Competitive Revisions for Community-Engaged Research on COVID-19 Testing among Underserved and/or Vulnerable Populations
- RFA-OD-20-013: Emergency Awards: RADx-UP Coordination and Data Collection Center (CDCC) (U24 - Clinical Trial Optional)
- COVID-19: Information for NIH Applicants and Recipients of NIH Funding (includes list of current NOTs and FOAs for all of NIH)
- NIH Information on COVID-19 Research and Activities
- NIH’s Rapid Acceleration of Diagnostics (RADx) initiative (includes details on RADx TECH and RADx-UP programs)
- Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) Initiative
- https://www.coronavirus.gov/ provides information about COVID-19 symptoms, diagnoses, and treatments