HEROS study probes COVID-19 infection in children and families

Every two weeks, families across the country pull out surveys and nasal swab kits. They are participating in HEROS (Human Epidemiology and Response to SARS-CoV-2), a study that aims to understand the transmission and impact of the coronavirus that causes COVID-19 in children and families.

Enrollment in HEROS is complete, with 1,913 families, including 5,599 participants and nearly 2,000 children from infancy to college age across 12 cities and regions in the United States. Families are being followed for six months.

“The study is novel in asking families to do all of the sample collections remotely to avoid what would have otherwise been frequent interaction with research staff or the health care system,” said Tina Hartert, MD, MPH, Lulu H. Owen Professor of Medicine at Vanderbilt University School of Medicine. Hartert is leading the nationwide HEROS study, which is funded by the National Institute of Allergy and Infectious Diseases.

The HEROS study will provide insight into how many children up to age 21 have been infected, the percentage of those infected who develop symptoms of COVID-19 and any differences in immune responses to the virus between children and adults within the same household.

“It’s not known whether children are more resistant to the virus or whether they are infected by the virus just as frequently as adults but don’t get symptoms. Children don’t appear to become as critically ill compared with adults, but this doesn’t equate to children not getting infected,” Hartert said. “Settling this debate requires large, high-quality population studies that include longitudinal sampling, like HEROS.”

Hartert noted that HEROS differs from most current transmission studies by starting with healthy families, rather than with an acutely ill or hospitalized participant — study designs that miss an asymptomatic family member as the initial household infection.

The HEROS study team rapidly enrolled families that were already participating in NIH-funded pediatric research studies of asthma and other allergic conditions. The study population will allow investigators to also examine whether infection rates differ between children who have asthma or other allergies and children who do not, including the impact of topical steroids used to treat asthma and allergies.

In addition to biweekly questionnaires and nasal swabs, families collect baseline stool samples and periodic blood samples using a capillary blood self-collection device. If someone in the family shows symptoms of a viral illness, the family completes additional questionnaires and sampling.

Results from the HEROS study are expected in early 2021.

– by Leigh MacMillan

Hope – Winter 2021

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