School Inner-City Asthma Intervention Study : Human Epidemiology and Response to SARS-COV-2 (HEROS) Supplement

学校内城区哮喘干预研究：人类流行病学和对 SARS-COV-2 (HEROS) 补充剂的反应

• 批准号: 10162929
• 负责人: WANDA PHIPATANAKUL
• 金额: $ 30.2万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-19 至 2021-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10162929
• 关键词: 2019-nCoV; 21 year old; Adult; Affect; Air; Allergens; Allergic Disease; American; Asthma; Boston; COVID-19; Caregivers; Child; Clinical Research; Clinical Trials; Communicable Diseases; Databases; Detection; Effectiveness; Enrollment; Epidemiology; Exposure to; Family; Funding; Goals; Home environment; Hour; Household; Human; Human Subject Research; Hypersensitivity skin testing; IgE; Incidence; Infection; Infrastructure; Institutional Review Boards; Intervention; Intervention Studies; Letters; Lung diseases; Molds; Morbidity - disease rate; National Institute of Allergy and Infectious Disease; Nose; Parents; Participant; Phenotype; RNA; Research Design; Research Proposals; Sampling; Schools; Severe Acute Respiratory Syndrome; Siblings; Source; Students; Surveys; Symptoms; Testing; Time; United States National Institutes of Health; Visit; base; cohort; common rule; educational atmosphere; elementary school; environmental intervention; epidemiologic data; expectation; improved; indexing; infection burden; inner city; interest; mouse allergen; parent grant; particulate pollutant; phenotypic data; primary endpoint; prospective; recruit; response; sample collection; skin hypersensitivity; viral RNA; viral detection; virology

Project Summary/Abstract COVID-19, the infectious disease caused by SARS-CoV-2, is rapidly affecting humans around the globe. While initial epidemiological data have focused on cases that resulted in severe respiratory disease seen predominantly in adults, little information regarding the infection burden in children is available. This is complicated by the observation that many virologically-confirmed cases in children are asymptomatic. Home environments are established sources of exposure that exacerbate symptoms of asthma and home-based interventions are proven effective. Prior to the inception of the School Inner-City Asthma Study (SICAS-1), no American study had comprehensively evaluated the relationship between urban exposures in school, classroom, and home environments and asthma morbidity. Nearly all elementary school children spend 7 to 12 hours a day in school, and most of that time is spent in one classroom. From SICAS-1, we learned that student classroom-specific mouse allergen, mold, and particulate pollutant exposure is associated with worsening symptoms. We also demonstrated our ability to reduce these exposures in a busy, school setting. Our proposal builds upon our established, successful school-based infrastructure to determine whether a school/classroom intervention will efficiently and effectively improve asthma morbidity by reducing these exposures. Our goal is to determine the efficacy of school/classroom based environmental intervention in reducing asthma morbidity in urban schoolchildren. Our central hypothesis is that reducing classroom/school exposure to mouse allergen, mold, and particulate pollutants will decrease asthma morbidity in students with asthma. We plan to test this hypothesis in an intervention study of 250 elementary students with asthma from multiple classrooms in 40 Boston inner-city elementary schools. Our clinical trial aims are to determine the effectiveness of a school/classroom based environmental intervention (school integrated pest management and classroom air purifying filter units within these schools) to reduce asthma morbidity. The supplement to the parent grant is to leverage the cohort for the to participate in the multi-center survey entitled Human Epidemiology and Response to SARS-CoV-2 (HEROS), study. This study can be rapidly implemented and realistically conducted without necessitating any visits to a clinical research center. In addition to the need for surveying children for asymptomatic SARS-CoV-2 infection, this study will allow a comparison between children with asthma and other atopic conditions and children without those conditions through remote surveys and collection of samples. This study is an unprecedented, high impact opportunity to leverage the parent trial with in scope in understanding how SARS-C0V-2 differentially affects children with the condition of interest, compared to children without it.

项目总结/摘要 由SARS-CoV-2引起的传染病COVID-19正在迅速影响地球仪各地的人类。 虽然最初的流行病学数据集中在导致严重呼吸道疾病的病例上， 主要是在成人中，关于儿童感染负担的信息很少。这是 由于观察到许多病毒学确诊的儿童病例没有症状，情况更加复杂。家 环境是加剧哮喘症状的既定暴露源， 干预措施已被证明是有效的。在学校内城哮喘研究（SICAS-1）开始之前， 美国的一项研究全面评估了城市学校暴露与城市环境的关系， 教室、家庭环境和哮喘发病率。几乎所有的小学生花7到 每天在学校12个小时，大部分时间都花在教室里。从SICAS-1，我们了解到， 学生教室特异性小鼠过敏原、霉菌和颗粒污染物暴露与 症状恶化我们还证明了我们在忙碌的学校环境中减少这些暴露的能力。 我们的建议建立在我们建立的，成功的校本基础设施，以确定是否 学校/课堂干预将有效地改善哮喘发病率， 暴露。我们的目标是确定学校/教室为基础的环境干预的有效性， 降低城市学童的哮喘发病率。我们的核心假设是，减少教室/学校 暴露于小鼠过敏原、霉菌和颗粒污染物将降低患有哮喘的学生的哮喘发病率。 哮喘我们计划在一项对250名患有哮喘的小学生的干预研究中验证这一假设， 波士顿市中心40所小学的多个教室。我们的临床试验目的是确定 以学校/教室为基础的环境干预（学校综合虫害管理）的有效性 以及这些学校内的教室空气净化过滤装置），以减少哮喘发病率。补编 父母补助金是为了利用队列参与多中心调查，题为人类 流行病学和响应SARS-CoV-2（HEROS），研究。这项研究可以迅速实施， 实际进行，而无需访问临床研究中心。除了需要 调查儿童的无症状SARS-CoV-2感染，这项研究将允许比较 通过远程调查，患有哮喘和其他特应性疾病的儿童以及没有这些疾病的儿童 并收集样本。这项研究是一个前所未有的，高影响力的机会，利用母公司试验 在理解SARS-C 0 V-2如何不同地影响具有感兴趣的病症的儿童的范围内， 与没有它的孩子相比。