'REBRACOVID' - multicentre cohort study of the natural history and immunology of COVID-19 in Brazil

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COVID-19 disease cohorts have been recruited and studied in many parts of the world in recent months, but there is still much to learn. There is a specific and urgent need to better understand this disease in Brazil: WHO data places Brazil 2nd in the world forCOVID-19 cases and deaths, and the country faces challenges of urban crowding (including favelas), socioeconomic disparities, and a healthcare system stretched by disease burden including the mosquito-borne infections. Our aim here is to collect andanalyse disease parameters in a large disease cohort of hospitalised and community cases, from 9 centres across the country. In doing so, we benefit also from building a consortium that bolts-on to our established consortium studies, REPLICK (Brazil) andSPIICA (Anglo-Brazil, MRC-Newton), designed to conduct analogous cohort studies in relation to the immunopathology and chronic disease phenotype in infection by Chikungunya virus - a mosquito-borne infection that can also lead to chronic diseasesymptoms. We aim to recruit a cohort of 20,000 total infected patients, as well as household contacts and at-risk healthcare workers. Our data will allow us to define impacts of age, gender, occupation, ethnicity, other health conditions, socio-economicfactors, blood markers and importantly, measures of protective immunity and its durability. Our intention is to better understand susceptibility and mechanisms underlying this disease, drawing on specific insights from the serious situation in Brazil to impact localmanagement of the response.