SARS-coV2 variants Evaluation in pRegnancy and paeDIatrics cohorts

Variants of concern (VoC) of SARS-CoV-2 raise the possibility of increases in transmissibility, severity and immune evasion. Children and pregnant women who have not been prioritised in the pandemic, are likely to be the last population for whom vaccines are approved and may have low uptake, increasing the risk of VoC arising in this population. Monitoring this group across regions is crucial given rapid changes in epidemiology due to interventions, vaccine rollout and viral evolution. VERDI (SARS-CoV-2 variants Evaluation in pRegnancy and paeDIatrics cohorts) will build on a long-standing infectious disease research and trial network (Penta) to address research questions on the impact of VoC in these vulnerable groups.Mpox virus (known as monkeypox or MPX, when this application was originally written) is a zoonotic Orthopox virus first described in the Democratic Republic of Congo (DRC) in 1970. It is an infection of global significance, with cases reported in 11 African countries and sporadic cases reported outside Africa as a result of zoonotic transmission and travellers returning from endemic areas. However, despite the global burden of mpox disease, research into mpox has historically been neglected. This current outbreak of mpox is, like many communicable and non-communicable diseases, a complex biosocial phenomenon, disproportionately impacting marginalised communities, whilst exposing and amplifying global health inequities.Since May 2022, large numbers of mpox cases have been reported in non-endemic countries. As of 9 September 2022, there have been 57,527 confirmed cases of mpox since the start of the 2022 outbreak, with the vast majority being reported in non-endemic countries. Of the 103 countries reporting cases in this current outbreak, 96 are countries which have not historically reported mpox cases. A recently published case series of 528 patients in 16 countries, reported that 98% of cases were in gay or bisexual men, with 41% also living with HIV. Sexual contact has been found to be the dominant method of transmission in this current outbreak. In this case series, 13% of cases were hospitalised, mainly for pain management, bacterial super-infection, and fluid management. More recently there has been an ongoing mpox outbreak in DRC, mainly affecting children <15 years of age.VERDI’s objectives are: i) track and characterise VoC and mpox in paediatric and pregnant populations and other high risk populations across the globe;ii)understand effects of VoC and mpox on clinical outcomes (short/longer term), vaccine effectiveness and transmission characteristics; iii) model outcomes and impacts of VoC and mpox; iv) develop evidence-based recommendations for control of COVID-19 and mpox and other emerging or re-emerging infections.VERDI will achieve these objectives by bringing together a diverse range of cohort studies including large scale national and regional level population-based cohort studies from the EU and beyond, providing a unique opportunity for harmonised analysis of data on VoC and mpox from a range of sources (e.g. electronic health records, bespoke cohort studies, household transmission studies, screening programmes). We will facilitate expansion of existing studies, e.g. replicating ongoing European household studies elsewhere. Through this approach, VERDI will expand and enhance existing cohort networks, including promoting flexibility to adapt to future emerging infections. The project will improve understanding of the epidemiology and impact of VoC and mpox, leading to robust recommendations for control in a range of global settings as well as developing preparedness for future health emergencies.