This project will study severe COVID-19 related factors, host genes, biomarkers, and
prognosis of severe encephalitis in children, and conduct:
- Retrospective clinical analysis of children with COVID-19, to analyze the clinical
manifestations of children with new crown infection, and to find the relevant factors of
- Prospective acceptance in the acute phase: mainly to understand the correlation between
the interaction of host factors, viruses and microorganisms and the severity.
- Children's long COVID-19 Tracking Team An integrated outpatient clinic for "Long
COVID-19 Syndrome in Children" will be established to conduct systematic tracking of
body, lung function, nerves and psychology. Children with neurological complications or
other confirmed diagnoses will undergo physical, neurological, pulmonary function and
brain MRI and neurophysiological examinations, sleep examinations, and conduct
psychiatric clinical diagnostic interviews to establish a psychiatric diagnosis. Status
and family social function, the intelligence development status was examined by
intelligence test, and cognitive function was measured by neuropsychological test.
Understand the microbial phase, immune function and incidence of allergic diseases after
long-term new coronavirus infection.
- Seroepidemiological Study Group Exploring the seroepidemiology of different groups of
health care workers and non-health care workers will allow us to better understand the
magnitude of natural infection among children and age groups in the community and the
infection profile of health care workers during this period.
This trial includes multiple groups of prospective cases to explore the impact of the new
coronavirus on children and the mechanism of severe illness, and integrates various
specialties and branches of the Children's Hospital to conduct a summary trial, which is
expected to understand children's new crown and community epidemiology, children infected
with new crown Clinical manifestations of the virus, risk factors and effects on various
systems, combined with host microbiome, immune function analysis and whole-exome sequencing,
to improve the detection of new coronavirus (including long-term new coronary syndrome and
pediatric multisystem inflammatory syndrome). Mechanisms of host factors and interactions
with microbes to improve outcomes and severe incidence in children.
- "Clinical Characteristics of pediatric COVID-19）" by the retrospective research group
- Subject inclusion criteria: COVID-19 positive cases younger than 18 years old from
January 1, 2020 to June 13, 2022.
- Subject exclusion conditions: (none) The number of people to be included is
expected to be 3000, and a retrospective case study data collection will be
conducted. 2. Prospective case receiving group: divided into four groups: "acute case receiving group"
(including children with multisystem inflammatory syndrome), "children's long COVID-19
tracking group", "seroepidemiological research group", "healthy control group" ", in
which the "Acute Case Receipt Team" will simultaneously accept cases in Hsinchu and
- "Acute Receiving Group" (including children with multisystem inflammatory syndrome)
- Subject inclusion conditions: Novel coronavirus positive sick children younger than 18
- Subject exclusion conditions: (none) The above is expected to be included in the number
of 200 people will carry out the following (A) Complications caused by new coronavirus
infection such as pneumonia (Pneumonia), Multisystem Inflammatory Syndrome in Children
(MIS-C), encephalitis (Encephalitis), croup (Croup), sepsis (Sepsis), acute Respiratory
distress syndrome (ARDS) and other host gene studies (Host factors) by whole exome
(B) Testing the respiratory tract, intestinal tract, and central nervous system of 2019-nCoV,
microbiota, host inflammatory biomarkers (biomarker: CRP, procalcitonin, DIC profiles…),
serum antibody titers and antibody library/ Cell receptor library (spike specific B cell
repertoire and T cell repertoire), chemokines (chemokines), cytokines (cytokines: IL-6...),
cell-regulated immune response, epitope mapping, immune function test (such as IgG, IgA, IgM,
Lymphocyte subset...), host transcriptome research. (see table below) (C) Patients with
neurological complications will undergo neurological, pulmonary function, brain MRI and
neurophysiological examinations, as well as brain injury biomarkers (Biomarker) changes in
acute and chronic phases. (see table below) (D) Physiological monitor of heart rate
variability or ECG signal collection over 7 to 14 days and compared with recovery period
(E) Abdominal ultrasound and other tests will be performed for those with abnormal liver
(F) Related tests for acute renal failure (CBC+DC, BUN/creatinine/uric acid/Na/K/Cl/LDH/blood
gas and urinalysis)
2. "Children's long COVID-19 Tracking Group"
- Subject inclusion conditions: COVID-19 positive cases
- Exclusion conditions for subjects: It is necessary for those who are not suitable to
perform "MRI". If there is a metal substance that cannot be removed from the body or a
serious disease cannot cooperate with this examination, it is necessary to avoid
unexpected occurrences when performing "MRI". Risk considerations, sensory or motor
impairments and pregnancy are also inconvenient to perform MRI. For the purpose of the
study, those with other causes of encephalitis or those with hypoxic conditions that may
affect the cognitive function of the brain are also included in the exclusion conditions
in order to avoid errors in the interpretation of the test results.
Exclusions: Anyone who has any of the following conditions cannot participate in this study:
- You have metal substances that cannot be removed or implanted, such as: braces, metal
nails, artificial electronic ears, heartbeat pacemakers, etc. Because of the inability
to perform brain MRI, it is not suitable to participate in this trial.
- Have major physical diseases.
- Sensory impairment, such as deafness.
- Movement disorders, such as cerebral palsy.
- Uncontrolled and stable epilepsy.
- Pregnant women are not suitable to participate in this test. (If you are pregnant or not
sure if you are pregnant, please let the researcher know in advance so that a pregnancy
test can be performed).
- Those who have suffered from hypoxia due to encephalitis or other reasons not caused by
enterovirus infection are not suitable to participate in this test.
The number of people expected to be included above is 1,000, and the following will be
carried out (A) Establish an integrated outpatient tracking of "Long COVID-19" to conduct
systematic tracking of body, lung function, nerves, and psychology. Children with
neurological complications or other confirmed diagnoses will undergo physical, neurological,
pulmonary function and brain MRI and neurophysiological examinations, sleep examinations, and
conduct psychiatric clinical diagnostic interviews to establish a psychiatric diagnosis.
Status and family social function, the intelligence development status was examined by
intelligence test, and cognitive function was measured by neuropsychological test.
(B) Microbial phase, immune function and incidence of allergic diseases after long-term
3. "Seroepidemiological Research Group"
- Subject inclusion conditions:
- Voluntarily join the medical staff receiving blood draws. The medical staff of
National Taiwan University Hospital, including physicians, nurses, administrative
staff, research assistants, cleaning and delivery staff, etc., receive cases in
groups according to age. 20-29, 30-39, 40-49, 50-59, and over 60 years old, each
group received 60 cases, a total of 300 people. Voluntary participation in
non-medical staff receiving blood draws.
- The general public who solicited voluntary non-medical workers from the community,
received 60 cases in each group of 0-9, 10-19, 20-29, 30-39, 40-49, 50-59, and over
60 years old. people, a total of 420 people.
- Subject exclusion conditions: those who are unwilling to accept blood draws. The above
is expected to include 720 people. "Seroepidemiology of novel coronavirus" will be
performed, and blood will be drawn three times, once after consent and once after 3
months and 6 months.
- COVID-19 antibody test Serum samples will be tested with commercially available
validated test kits, such as Roche's Elecsys Anti-SARS-CoV-2 Assay (Roche Molecular
System Inc., CA, USA). Antibodies tested include anti-S and anti-N antibodies. Verify by
in-house ELISA or Western blot if necessary. 4. "Healthy Control Group"
- Inclusion criteria for subjects: "No" healthy individuals with complications after new
coronavirus infection or long-term new coronary syndrome Test the respiratory tract and
intestinal microbiota (Microbiota), host inflammatory biomarkers, serum antibody titers
and antibody library/receptor library of novel coronavirus, chemokines, cytokines, and
cell-regulated immunity in healthy control groups Response, epitope mapping, brain MRI,
neurophysiological examination (nerve conduction, brain wave, sleep watch examination,
etc.), brain injury biomarkers (biomarker), host transcriptome research
- Subject exclusion conditions: (none) The above is expected to include 200 people, and
the "acute receiving group" will be matched with the same sex and a normal control group
of plus or minus 1 year old.