Mid-America Regional Coordinating Center (MARCC)

摘要 新冠肺炎引起的亚急性神经系统改变(感染后六个月至一年)仍然很差 特色化的。这可能会变得越来越重要，因为以前的大流行，如1918年的流感， 证明神经状况(如精神错乱、脑炎和神经退行性变) 病情)在亚急性和慢性(&gt；一年)阶段更为普遍。轶事 新冠肺炎阳性患者的描述表明，在治疗过程中会出现“脑雾”和疲劳 亚急性期，特别是在受影响更严重的人。这项提议利用了两个现有的 在巴恩斯-犹太医院和传染病临床研究单位登记的患者队列 在圣路易斯的华盛顿大学。急性队列由以下参与者组成： 症状与新冠肺炎一致的急诊室，并在整个过程中进行跟踪 住院，如果入院，并在门诊感染后。第二组，一名康复者 队列，正在招募确诊的新冠肺炎阳性参与者，他们主要是无症状或 症状轻微，并在门诊环境中对感染后的患者进行跟踪。这项建议具有 三个目标。目的1将评估感染COVID后6个月观察到的亚急性认知变化- 19例阳性患者。AIM 2将评估6个月后观察到的亚急性神经影像变化 新冠肺炎阳性患者的感染情况。AIM 3将评估观察到的亚急性多组体血液变化 新冠肺炎阳性患者感染后6个月。总体而言，我们假设新冠肺炎是积极的 症状更严重的患者(入住重症监护病房)将有更多的认知能力 缺陷、神经影像改变以及血液转录组、蛋白质组、代谢组和脂组 新冠肺炎阳性患者感染后6个月的异常情况 住院或没有症状的人。因此，这项提议是一个对时间敏感的机会 描述感染后6个月的100名患者的神经系统变化 新冠肺炎积极人士的多样化队列。

Abstract Subacute neurological changes due to COVID-19 (six months – one year post infection) remain poorly characterized. This may be increasingly important as previous pandemics, e.g. 1918 influenza, have demonstrated that neurological conditions (e.g. delirium, encephalitis, and neurodegenerative conditions) are more prevalent during the subacute and chronic (> one year) phases. Anecdotal accounts of COVID-19 positive patients have suggested that “brain fog” and fatigue develop during the subacute period, especially in more severely affected individuals. This proposal leverages two existing cohorts of patients enrolled at Barnes-Jewish Hospital and the Infectious Disease Clinical Research Unit at Washington University in Saint Louis. An acute cohort consists of participants who present to the emergency room with symptoms consistent with COVID-19 and who are followed throughout their hospital stay, if admitted, and post infection in the outpatient setting. A second cohort, a convalescent cohort, is enrolling confirmed COVID-19 positive participants who were primarily asymptomatic or mildly symptomatic and who are followed post infection in the outpatient setting. This proposal has three aims. Aim 1 will evaluate subacute cognitive changes observed six months post infection in COVID- 19 positive patients. Aim 2 will evaluate subacute neuroimaging changes observed six months post infection in COVID-19 positive patients. Aim 3 will evaluate subacute multi-omic blood changes observed six months post infection in COVID-19 positive patients. Overall, we hypothesize that COVID-19 positive patients with more severe symptoms (intensive care unit (ICU) admission) will have more cognitive deficits, neuroimaging changes, and blood transcriptomic, proteomic, metabolomic, and lipidomic abnormalities at six months post infection compared to COVID-19 positive patients who were hospitalized or who were asymptomatic. This proposal is therefore a time sensitive opportunity to characterize the neurological changes seen at six months post infection within 100 patients from these diverse cohorts of COVID-19 positive individuals.