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COVID-19 Lung Microvascular and Parenchymal Sequelae (Lung-MaPS)

COVID-19 肺微血管和实质后遗症 (Lung-MaPS)

基本信息

批准号：
10185337
负责人：
Elizabeth Oelsner
金额：
$ 73.48万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-15 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10185337
关键词：
2019-nCoV Acute Adult Age Alveolar Biological Markers Blood Vessels Blood Volume Blood capillaries Body mass index C-reactive protein COVID-19 COVID-19 mortality Carbon Monoxide Caring Cessation of life Chronic lung disease Clinical Cohort Studies Complement Complement 5a Complement Activation Critical Care Defect Deposition Development Diagnosis Diffuse Diffusion Endothelial Cells Endothelium Epithelial Epithelial Cells Ethnic Origin Etiology Fibrin fragment D Fibrosis Follow-Up Studies Glass Gold Health Heterogeneity Histopathology Hospitalization Hospitals Hypoxemia Image Inflammation Inpatients Interleukin-6 Intubation Investigation Longterm Follow-up Lung Lung Capacity Maps Measurement Measures Mechanical ventilation Medical center Modeling Neighborhoods New York City Participant Patients Pattern Perfusion Phenotype Policies Prognosis Protocols documentation Public Health Pulmonary Emphysema Questionnaires Race Recording of previous events Recovery Residual state SARS-CoV-2 antibody Sampling Spirometry Structure Survivors Testing Texture Therapeutic Intervention Thrombophilia Universities Venous blood sampling Visit Work X-Ray Computed Tomography angiogenesis cell injury clinical care complement pathway contrast enhanced coronavirus disease design experience imaging approach improved in vivo innovation insight lung imaging lung injury multi-ethnic posthospitalization care prognostic risk mitigation risk stratification severe COVID-19 sex targeted treatment vascular abnormality

项目摘要

The long-term health impact of COVID-19 remains uncertain. We are already providing post-hospitalization care for thousands of COVID-19 survivors at Columbia University Irving Medical Center (CUIMC) in New York City. This study is designed to help our and other medical centers care for COVID-19 survivors by using gold- standard imaging approaches to describe the major sequelae of severe COVID-19. The possibility of significant vascular and parenchymal sequelae of severe COVID-19 is suggested by the prominent Alverolar- arterial gradients observed clinically, plus histopathology confirming substantial endothelial and epithelial damage. Nonetheless, precise assessments of vascular and parenchymal sequelae in vivo have been limited, especially for the vasculature, and long-term follow-up to assess recovery or progression is lacking. Our investigative team has developed and refined a dual-energy computed tomography (CT) protocol to provide direct measures of the pulmonary vasculature, including pulmonary parenchymal perfused blood volume (PBV); and, detailed phenotyping of the parenchyma, including ground glass opacity (GGO) textures, which we have identified by an adaptive multiple features model (AMFM) approach in preliminary work among COVID-19 survivors. In multiethnic cohort studies, we have associated these CT measures with development and progression of chronic lung diseases. To strengthen our investigation into potential microvascular mechanisms of COVID-19 lung injury, this application will also test if PBV is associated with biomarkers of inflammation, hypercoagulability, and complement activation. We will randomly sample 200 adults without a prior diagnosis of chronic lung disease who were hospitalized for COVID-19 at CUIMC and did not require intubation, plus 100 seronegative controls matched on age, sex, race, ethnicity, body mass index, and neighborhood. All participants will undergo contrast-enhanced dual-energy CT, diffusing capacity of the lung for carbon monoxide, spirometry, questionnaires, and phlebotomy for SARS-CoV-2 antibodies and biomarkers. These measures will be performed 3-12 months and 27-36 months post-COVID hospital discharge to accomplish three specific aims. Aim 1 is to define lung microvascular sequelae of COVID-19. We hypothesize that PBV in COVID-19 survivors will be lower and more heterogeneous, and that these abnormalities will be associated with levels of IL-6, CRP, d-dimer, C5a, MBL, and MASP-2. Aim 2 is to define lung parenchymal sequelae of COVID-19. We hypothesize that there will be greater GGO texture patterns in COVID-19 survivors. Aim 3 is to explore if COVID-related differences in lung structure and procoagulant biomarkers are maintained up to 3 years after acute illness. We hypothesize that two years following the baseline study visit, parenchymal and biomarker abnormalities will normalize, but vascular abnormalities will progress. Accomplishment of the Aims will guide post-COVID care and risk stratification, suggest targets for therapeutic interventions, and inform policies for risk mitigation and public health in the COVID-19 era.

COVID-19对健康的长期影响仍不确定。我们已经提供了住院治疗后的服务