RAPID: Evolutionary Nutritional Adaptations and COVID-19 Risk among Healthcare Workers

该RAPID项目将从进化的角度研究冠状病毒（COVID-19）疾病风险，重点关注营养和传染病之间的交叉点。利用现有NSF资助项目的基础设施，研究人员将测试两种营养假设，即轻度缺铁会降低COVID-19风险，而肥胖会增加这种风险。有证据表明，轻度缺铁可能作为一种营养适应，以减少感染性疾病的风险，在人类宿主和感染因子之间的进化“军备竞赛”的背景下。轻度缺铁是否对COVID-19有保护作用尚不清楚，因为该病毒对人类的适应历史并不长。证据还表明，肥胖可能是早年在营养不良的环境中保存能量的适应性的后期后果。在这种情况下，免疫系统的发育也可能会走上更节能的轨道，这可能会增加感染疾病的风险。该项目重点关注医护人员，因为他们感染包括COVID-19在内的新型传染病的风险特别高，特别是在医疗系统变得紧张的情况下。该项目将促进对营养和传染病之间复杂交叉点的基本理解，特别是在新出现的传染病方面。研究结果可能会为公共卫生工作提供信息，以保护医护人员和公众免受COVID-19的影响。研究人员将评估铁状况和肥胖对医护人员COVID-19风险的影响，因为COVID-19入院人数在他们的医院急剧增加。参与的医疗保健工作者（医生，护士和支持人员）将在一开始就进行缺铁，贫血和肥胖的评估。首先将评估COVID-19免疫力（表明既往感染），然后每周监测参与者的COVID-19病毒DNA（表明当前感染）和COVID-19症状或住院治疗。缺铁和肥胖对医护人员感染COVID-19概率的影响（以及他们经历住院或死亡的严重COVID-19后果的概率）将进行评估，控制混杂变量（包括社会经济地位、医疗保健角色和执行的程序、患者护理负荷，该奖项反映了NSF的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

This RAPID project will examine coronavirus (COVID-19) disease risk from an evolutionary perspective, focusing on the intersection between nutrition and infectious disease. Leveraging the infrastructure of an existing NSF-funded project, the researchers will test two nutritional hypotheses, that mild iron deficiency decreases COVID-19 risk and that obesity increases this risk. Evidence suggests that mild iron deficiency may serve as a nutritional adaptation to reduce infectious disease risk in the context of an evolutionary ‘arms race’ between human host and infectious agents. Whether mild iron deficiency is protective against COVID-19 is unknown, as the virus does not have a long history of adaptation to humans. Evidence also suggests that obesity may be a later-life consequence of an early-life adaptation to conserve energy in environments of under-nutrition. In such cases, immune system development may also be set on a more energy-conserving track, which might increase risk of infectious disease. The project focuses on healthcare workers because they are at particularly high risk for emerging infectious diseases, including COVID-19, particularly as healthcare systems become strained. The project will advance fundamental understanding of the complex intersection between nutrition and infectious disease, particularly with regard to emerging infectious diseases. The research findings may inform public health efforts to protect healthcare workers and the public against COVID-19.The researchers will evaluate the impact of iron status and obesity on COVID-19 risk among healthcare workers as COVID-19 admissions increase dramatically in their hospital. Participating healthcare workers (physicians, nurses, and support staff) will be evaluated at the outset for iron deficiency, anemia, and obesity. COVID-19 immunity (indicating past infection) will be assessed at the outset, and then participants will be monitored weekly for COVID-19 virus DNA (indicating current infection) and COVID-19 symptoms or hospitalization. The impact of iron deficiency and obesity on the probability that health care workers contract COVID-19 (and the probability they experience severe COVID-19 outcomes of hospitalization or death) will be evaluated, controlling for confounding variables (including socioeconomic status, healthcare role and procedures performed, patient care load, and co-morbid chronic conditions).This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.