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

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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.