Researchers at RCSI University of Medicine and Health Sciences have secured €1.29 million in funding under the Taighde Éireann – Research Ireland Frontiers for the Future programme to lead an innovative study examining the long-term health and developmental effects of the COVID-19 pandemic on children.

The funding was announced today by Minister for Further and Higher Education, Research, Innovation and Science, James Lawless TD, as part of the latest round of successful projects and awards which total €23.6 million across the programme.

The RCSI study, titled FLORAL, is led by Professor Jonathan Hourihane, Head of the Department of Paediatrics at RCSI and Consultant Paediatrician at Children’s Health Ireland (CHI) Temple Street and CHI Connolly.

Announcing the successful awardees Minister Lawless stated: “The Research Ireland Frontiers for the Future programme supports the development of world-class research across a range of disciplines. The awardees – spanning nine research institutions nationwide – have brought forward novel and innovative ideas with strong potential to deliver impactful solutions for major challenges facing society today. The programme itself promotes gender balance and provides opportunities for emerging investigators returning to research. I look forward to seeing the awardees’ progress over the coming years.”

Pandemic’s impact on child health

Professor Hourihane explained the importance of the research: “COVID-19 lockdowns significantly altered the early environments of newborns. Our previous CORAL study, the only one of its kind in the world, highlighted some unexpected benefits for ‘pandemic babies’, including improved gut microbes due to extended breastfeeding and lower rates of infection and less antibiotic use, as well as lower than expected rates of allergic conditions such as food allergies.

FLORAL (Follow on to CORAL) is the only study of its kind to investigate differences in health outcomes among children born during and five years after the pandemic.

“With FLORAL, we aim to determine whether the benefits seen in the original CORAL study persist as these children reach school age and explore how we can apply the lessons learned to benefit today’s infants to help us deliver pandemic readiness, which is a UN-WHO global aim.”

The FLORAL study will re-examine the original CORAL cohort at five years of age to assess long-term health outcomes while also recruiting a new cohort of 1000 infants born in 2025 to compare with the “lockdown babies” born in 2020. Researchers hope their findings will shed light on how early-life isolation and altered microbial exposure may influence lifelong health and development.

RCSI is working closely with Prof. Liam O'Mahony at the APC Microbiome Ireland, University College Cork, to identify the gut microbiome patterns that associate with immune development and allergy risk of both cohorts.

Shaping early life experiences

Professor Fergal O’Brien, Deputy Vice Chancellor for Research and Innovation at RCSI, welcomed the funding award, stating: “The FLORAL study represents a novel approach to understanding the long-term effects of early-life isolation, showcasing RCSI’s commitment to pioneering impactful health research. This funding enables our researchers to explore uncharted aspects of pandemic-era childhood development, with the potential to shape future healthcare policies and pandemic readiness strategies.”

A vital aspect of the study is its strong emphasis on public engagement. Two parent volunteers from the CORAL study cohort have joined the research team to contribute to public outreach efforts. These parents will help translate complex scientific findings into meaningful information for families, share their own experience and ensure that FLORAL remains a study informed by and responsive to the concerns of the families it seeks to support.

As part of FLORAL, the research team is seeking baby volunteers. Infants born between March and May 2025 in the partner Dublin maternity hospitals: The National Maternity Hospital Holles Street, Rotunda Hospital and The Coombe Hospital will be eligible to participate, helping to advance understanding of how early life experiences shape long-term health.

The Research Ireland Frontiers for the Future Programme funds high-risk, high-reward research programmes and innovative, collaborative research with the potential to deliver economic and societal impact.

The CORAL (Impact of Coronavirus Pandemic on Allergic and Autoimmune Dysregulation in Infants Born During Lockdown) project used online questionnaires to collect information on diet, home environment and health of newborns. Stool samples were collected at six, 12 and 24 months and allergy testing was performed at 12 and 24 months.

For more information on the FLORAL study or to express interest in participation, email FLORALstudy@rcsi.ie.