Epidemiologic and Translational Investigation of Long-Term Kidney Outcomes After COVID-19

项目概要/摘要 候选人 Steven Menez，医学博士、MHS，是约翰霍普金斯大学肾病科的医学讲师 大学医学院教授，将于2020年7月1日晋升为医学助理教授。他 寻求 K23 指导的以患者为导向的研究职业发展奖，以开发和执行 他提出的研究项目旨在调查住院患者的长期肾脏结局 被诊断患有 2019 年新型冠状病毒病 (COVID-19)，幸存并出院。这个提议 另外还详细介绍了一个五年计划，其中包括分析方法和研究方面的高级培训 设计以及 Chirag Parikh（医学博士、哲学博士）和 Morgan Grams（医学博士、哲学博士）的指导。梅内斯博士的 近期的职业目标包括调查住院患者的肾损伤和炎症表型 COVID-19 患者存活出院以及长期肾脏结局和死亡率的评估 COVID-19 住院幸存者。他的长期目标是成为一名独立的医师科学家 专注于 AKI 转化研究，特别关注预防 AKI 后 CKD 的进展， 特别是病毒相关的 AKI。在整个获奖过程中，他将丰富自己的教育和培训 通过约翰霍普金斯大学彭博公共卫生学院的额外课程，除了工作 与他的导师和顾问团队密切合作。 Menez 博士提议的工作将有助于他过渡到 R01- 资助独立调查员。 项目 全球已有超过 600 万人被诊断出患有 COVID-19.1,2 急性肾损伤 (AKI) 是一种常见的疾病 COVID-19 住院并发症与短期预后不良有关， 包括院内死亡率。3,4 该提案的目标是调查死亡率升高的患病率 250 名患者出院后 3 个月时的蛋白尿以及肾损伤和炎症的其他生物标志物 与 COVID-19 住院存活，并将这些标志物与肾功能衰退和 24个月时的死亡率。这项研究还将量化更大范围的肾功能随时间的变化。 约翰·霍普金斯医疗系统中所有入院的 COVID-19 患者 (N~2000)。候选人 假设因 COVID-19 住院且出现临床 AKI 并存活至出院的患者将 3 岁时蛋白尿明显增多，肾损伤和炎症生物标志物水平更高 出院后几个月，这些表型将与更糟糕的肾脏结果和死亡率相关 24个月。此外，他假设在医院出现临床 AKI 的患者的肾脏状况会更差。 与无临床 AKI 的患者相比，24 个月时功能下降且死亡率更高。

PROJECT SUMMARY/ABSTRACT Candidate Steven Menez, MD, MHS, is an Instructor of Medicine in the Division of Nephrology at Johns Hopkins University School of Medicine, who will be promoted to Assistant Professor of Medicine on July 1, 2020. He seeks a K23 Mentored Patient-Oriented Research Career Development Award in order to develop and execute his proposed research project aimed at investigating the long-term kidney outcomes in hospitalized patients diagnosed with the novel Coronavirus Disease 2019 (COVID-19) surviving to discharge. This proposal additionally details a five-year plan consisting of advanced training in analytic methods and research study design, as well as mentorship by Chirag Parikh, MD, PhD, and Morgan Grams, MD, PhD. Dr. Menez’s immediate career goals include the investigation of kidney injury and inflammation phenotypes in hospitalized patients with COVID-19 surviving to discharge and the evaluation of long-term kidney outcomes and mortality in COVID-19 hospitalization survivors. His long-term goal is to become an independent physician-scientist specializing in translational AKI research, with a specific focus on preventing the progression of CKD after AKI, in particular viral-associated AKI. Throughout this award process he will enrich his education and training through additional classes at the Johns Hopkins Bloomberg School of Public Health, in addition to working closely with his team of mentors and advisors. Dr. Menez’s proposed work will help in his transition to an R01- funded independent investigator. Project Over 6 million people worldwide have been diagnosed with COVID-19.1,2 Acute kidney injury (AKI) is a frequent complication in hospitalizations for COVID-19, which has been associated with poor short-term outcomes, including in-hospital mortality.3,4 The goals of this proposal are to investigate the prevalence of elevated albuminuria and other biomarkers of kidney injury and inflammation at 3 months post-discharge in 250 patients with COVID-19 surviving hospitalization, and to associate these markers with kidney function decline and mortality at 24 months. This study will also quantify changes in kidney function over time in a larger cohort of all patients in the Johns Hopkins Health System admitted with COVID-19 (N~2000). The candidate hypothesizes that patients hospitalized with COVID-19 who develop clinical AKI and survive to discharge will have significantly greater albuminuria and higher levels of biomarkers of kidney injury and inflammation at 3 months post-discharge, and these phenotypes will associate with worse kidney outcomes and mortality up to 24 months. Further, he hypothesizes that patients with clinical AKI in the hospital will have worse kidney function decline and higher mortality at 24 months than patients without clinical AKI.