COVID-19 and the MWCCS: Pathophysiology, Impact and Outcomes

COVID-19 和 MWCCS：病理生理学、影响和结果

• 批准号: 10223572
• 负责人: Jeremy James Martinson
• 金额: $ 35.96万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-04-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10223572
• 关键词: 2019-nCoV; Address; Admission activity; Adult Respiratory Distress Syndrome; Affect; African American; Age; Aging; Alleles; Angiotensin-Converting Enzyme Inhibitors; Anti-Retroviral Agents; Antiviral Agents; Anxiety; Appointment; Area; Azithromycin; Biological Markers; Blood; Body Composition; COVID-19; COVID-19 pandemic; Cardiac; Cardiomyopathies; Cardiovascular system; Cessation of life; Chloroquine; Chronic lung disease; Clinical; Coagulation Process; Cohort Studies; Congestive Heart Failure; Data; Development; Diabetes Mellitus; Disease; Epidemic; Estrogens; Ethnic Origin; Exposure to; Fibrinogen; Functional disorder; Genetic; Genetic Risk; Genotype; Geographic Locations; Geography; Goals; Guide prevention; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; Health Insurance; Healthcare; Heart Diseases; Hepatitis B Virus; Hepatitis C virus; High Prevalence; Hospitalization; Hydroxychloroquine; Hypertension; Immune; Impairment; Incidence; Individual; Infection; Inflammation; Integration Host Factors; Intensive Care Units; Interruption; Kidney; Knowledge; Lopinavir/Ritonavir; Lung; Measures; Mechanical ventilation; Mental Depression; Morbidity - disease rate; National Heart, Lung, and Blood Institute; Neurocognitive; Neurologic; Obesity; Organ; Outcome; Participant; Patients; Personal Satisfaction; Physical Function; Population; Poverty Areas; Race; Recommendation; Recovery; Reporting; Research; Respiratory physiology; Ribavirin; Risk; Risk Factors; Running; Severe Acute Respiratory Syndrome; Severities; Severity of illness; Smoking; Social support; Specimen; Spirometry; Survivors; Symptoms; System; Time; Viral; Woman; apolipoprotein E-4; biobank; cerebrovascular; clinical predictors; co-infection; cohort; comorbidity; coronavirus disease; ethnic diversity; experience; genetic risk factor; genome wide association study; health care availability; health difference; immune activation; men; metropolitan; mortality; pandemic disease; racial and ethnic; racial disparity; remdesivir; respiratory; response; sex

COVID-19 and the MWCCS: Pathophysiology, Impact and Outcomes ABSTRACT COVID-19 cases continue to rise, with over 3,000,000 cases and 130,000 deaths in the US[1] and almost 12 million cases worldwide[2] to date. Manifestations of SARS CoV-2 infection range from asymptomatic to mild, moderate, or severe disease, and primarily affects the lung, but increasing data suggests involvement of other organ and blood systems.[3] Studies document more severe disease and higher mortality among people who are older and/or have co-morbidities, such as hypertension, diabetes, obesity, and chronic lung disease.[4-7] However, there is a paucity of data regarding the acquisition, occurrence and severity of infection among people with HIV (PWH). There is also little data to guide prevention and treatment recommendations for this population, many of whom are older and have comorbidities that may increase not only their risk for acquiring infection, but also the morbidity and mortality among those who acquire infection. Moreover, early reports suggest substantial racial disparities in US COVID-19 rates, with increases in mortality among African Americans.[8] The MACS-WIHS Combined Cohort Study (MWCCS), the largest and longest-running observational cohort of men and women living with or at risk for HIV in the US provides a unique opportunity to address important knowledge gaps in the acquisition, occurrence, severity and outcomes of COVID-19. The MWCCS is a geographically and racially/ethnically diverse cohort of aging men and women with a high prevalence of risk factors for progression to severe COVID-19 disease including hypertension, diabetes, obesity, and smoking. The MWCCS has a rich biorepository of specimens, collects rigorous clinical measures including pulmonary, cardiac, kidney, neurocognitive, and physical function, body composition and has performed cohort-wide genome association studies. The overarching goal of this application is to understand the impact of the COVID-19 epidemic among US men and women with or at risk for HIV infection and to evaluate host factors that contribute to disease acquisition, expression, severity and recovery. The proposed studies will determine COVID incidence, short-term and long-term clinical outcomes, including thrombotic and pulmonary sequelae, and how racial and geographic disparities; immune and genetic risk factors impact these outcomes in the MWCCS.

COVID-19 和 MWCCS：病理生理学、影响和结果 抽象的 COVID-19 病例持续上升，美国病例数超过 3,000,000 例，死亡人数 130,000 人[1]，近 12 人死亡 迄今为止，全球有 100 万例病例[2]。 SARS CoV-2 感染的表现范围从无症状到轻度， 中度或重度疾病，主要影响肺部，但越来越多的数据表明其他部位也参与其中 器官和血液系统。[3]研究表明，患有以下疾病的人疾病更严重，死亡率更高 年龄较大和/或有合并症，如高血压、糖尿病、肥胖和慢性肺病。[4-7] 然而，关于感染的获得、发生和严重程度的数据却很少。 艾滋病毒感染者（PWH）。也很少有数据来指导这方面的预防和治疗建议 人群，其中许多人年龄较大，患有合并症，这不仅可能增加他们感染病毒的风险 感染，还包括感染者的发病率和死亡率。此外，早期报道 表明美国 COVID-19 发病率存在巨大种族差异，非洲人死亡率增加 美国人。[8] MACS-WIHS 联合队列研究 (MWCCS)，规模最大、运行时间最长的研究 美国艾滋病毒感染者或有感染艾滋病毒风险的男性和女性的观察队列提供了一个独特的机会 解决有关 COVID-19 的获得、发生、严重程度和结果的重要知识差距。这 MWCCS 是一个地理和种族/族裔多样化的老年男性和女性群体，具有较高的 进展为严重 COVID-19 疾病的危险因素的患病率，包括高血压、糖尿病、 肥胖、吸烟。 MWCCS拥有丰富的标本生物库，收集严格的临床测量数据 包括肺、心、肾、神经认知和身体功能、身体成分等 进行了队列范围的基因组关联研究。该应用程序的总体目标是了解 COVID-19 疫情对美国感染 HIV 或有感染 HIV 风险的男性和女性的影响，以及 评估导致疾病获得、表达、严重程度和恢复的宿主因素。拟议的 研究将确定新冠肺炎的发病率、短期和长期临床结果，包括血栓形成和 肺部后遗症，以及种族和地域差异如何；免疫和遗传风险因素影响这些 MWCCS 的成果。