Queen's University Belfast

Academic Institute

Dr Helen Groves

E079

The emergence of the coronavirus disease 2019 (COVID-19) outbreak is an unparalleled global event. The response to the COVID-19 pandemic involved implementation of public health measures including: travel restrictions; messaging regarding handwashing, physical distancing and facemask use; targeted lockdowns and school closures. These measures contributed to an unprecedented decline in seasonal respiratory viruses including, cold and flu viruses, such that, during the 2020/2021 winter season an effective absence of most seasonal respiratory viruses occurred globally. It is known that serious respiratory virus infections in infants, particularly in those under one year of age, are associated with subsequent wheeze and asthma development. However, it is unclear whether these virus infections play a direct role in causing asthma or if they simply identify infants who are genetically more likely to develop asthma. Unlocking this is a key aspect to understanding asthma development in children. Presently, we have no effective way to prevent all respiratory virus infections in young children and so it has not previously been possible to clearly evaluate whether having serious viral infections in early life causes asthma. Importantly, the huge reduction in seasonal respiratory viral infections during the first year of the COVID-19 pandemic presents a unique natural opportunity to study this. The aim of this study is to determine whether a lack of exposure to seasonal respiratory viruses in the first year of life influences the subsequent development of asthma. To investigate this we will compare a cohort of children born during the COVID-19 pandemic to a cohort of children from a previous season where respiratory virus exposure is likely to have occurred during the first year. Our secondary aim is to evaluate whether children without seasonal respiratory virus exposure in the first year of life develop more severe illness when exposed to these viruses in later seasons.

Childhood asthma causes significant morbidity and mortality among children and adults in Northern Ireland. Viral respiratory tract infections in early life, particularly secondary to rhinovirus and respiratory syncytial virus infections, are associated with subsequent asthma development. However, it is not understood whether these infections trigger asthma development by, for example, initiating inflammation in the respiratory tract, or if these viral infections identify a genetic predisposition to subsequent recurrent wheezing and asthma development. Investigating the impact of a lack of respiratory viruses in the 2020/2021 winter season on subsequent recurrent wheeze and asthma development in early childhood presents a completely unique opportunity to help further our understanding of the pathogenesis of asthma. This is of vital importance for directing future research in the pathogenesis of asthma. In addition, understanding the role of viral infections in asthma may permit targeted use of respiratory virus preventative therapies such as monocloncal antibodies and future vaccines to help reduce asthma development in children. We therefore anticipate this work will contribute to research to identify novel preventative and therapeutic strategies against asthma in children and thus provide downstream benefits for Health and Social Care in terms of future reductions in medical care access.

31/08/2022

TRE