The emergence of coronavirus disease 2019 (COVID-19) prompted a surge in research activity. Funding bodies swiftly allocated resources to establish research infrastructures and partnerships to study the novel virus. The scientific community realigned existing research and launched new studies to define the clinical course of COVID-19 and identify therapeutic candidates. Overall, comparatively fewer studies were initiated in children relative to adults,1 in part due to the lower prevalence and disease morbidity recorded in pediatric populations. However, characterizing the disease in pediatric patients is critical to elucidate transmission dynamics, inform public health measures, and generate evidence on best practices for clinical care and therapeutic interventions. The life-threatening multisystem inflammatory syndrome further underscores the need for natural history studies and drug development in pediatric populations.2

Numerous observational studies have been established to collect information on pediatric patients with laboratory-confirmed COVID-19, including children in inpatient and outpatient settings, and those with specific underlying conditions (Table 1). These efforts have been driven largely by single institutions and research organizations. As would be expected during a pandemic response, there was initially limited opportunity to establish extensive regional or international collaborations, and there has been little coordination across existing initiatives. However, as we approach a steady state in morbidity and gain a better view of the long-term trajectory of the pandemic, it is important that we re-assess our approaches and take a deliberate and strategic approach to further resource investments. If the current fragmented approach is maintained, many studies will not yield the sample sizes needed to support robust analyses—especially as infection rates decline in certain areas—and resources will be wasted on inefficient enrollment and duplicative efforts. For example, as illustrated in Table 1, we identified at least three unique non-interventional studies focused on pediatric patients requiring critical care in hospitals in North America.

Table 1 Sample of observational pediatric-specific registries and studies on COVID-19.
Full size table

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