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.

新冠肺炎与多器官功能障碍综合征：病理生理学、影响及转归 摘要 新冠肺炎病例继续上升，美国有300多万病例和130,000人死亡[1]，近12 到目前为止，全世界有100万个病例[2]。SARS CoV-2感染的表现从无症状到轻微， 中度或严重疾病，主要影响肺部，但越来越多的数据表明参与了其他 器官和血液系统。[3]研究记录表明，更严重的疾病和更高的死亡率。 年龄较大和/或有高血压、糖尿病、肥胖症和慢性肺部疾病等共病。 然而，关于感染的获得、发生和严重程度的数据很少。 艾滋病毒携带者(PWH)。也几乎没有数据来指导对此的预防和治疗建议。 他们中的许多人年龄较大，并患有共病，这不仅可能增加他们感染 这不仅与感染有关，还与感染者的发病率和死亡率有关。此外，早期的报道 表明美国新冠肺炎发病率存在显著的种族差异，非洲人的死亡率上升 美国人。[8]MACS-WIHS联合队列研究(MWCCS)，规模最大，运行时间最长 美国艾滋病毒携带者或有感染风险的男性和女性的观察性队列提供了一个独特的机会 解决在新冠肺炎的获得、发生、严重程度和结果方面的重要知识差距。这个 MWCCS是一个地理和种族/民族多样化的老年男性和女性队列，具有高 进展为严重新冠肺炎病的危险因素的患病率，包括高血压、糖尿病、 肥胖和吸烟。MWCCS拥有丰富的标本生物库，收集严格的临床措施 包括肺、心、肾、神经认知和身体功能、身体成分和 进行全队列基因组关联研究。这个应用程序的首要目标是理解 新冠肺炎疫情对感染艾滋病毒或有感染艾滋病毒风险的美国男性和女性的影响 评估影响疾病获得、表现、严重程度和康复的宿主因素。建议数 研究将确定COVID的发生率、短期和长期临床结果，包括血栓和 肺部后遗症，以及种族和地理差异；免疫和遗传风险因素如何影响这些 在MWCCS中的结果。