Interaction of Biopsychosocial Stress, Alcohol Misuse, and Neurobehavioral Sequelae of COVID-19

生物心理社会压力、酒精滥用和 COVID-19 神经行为后遗症的相互作用

• 批准号: 10471105
• 负责人: Scott Edwards
• 金额: $ 22.05万
• 依托单位: LSU HEALTH SCIENCES CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10471105
• 关键词: 2019-nCoV; Acute; Address; Affect; African American population; Alcohol consumption; Alcoholic beverage heavy drinker; Alcohols; Anxiety; Behavioral; Biological; Black race; COVID-19; COVID-19 diagnosis; COVID-19 impact; COVID-19 pandemic; COVID-19 pandemic effects; COVID-19 risk; Caring; Centers for Disease Control and Prevention (U.S.); Characteristics; Chronic; Cities; Cognitive; Cohort Studies; Coronavirus; Data; Decision Making; Depressive disorder; Development; Elements; Enrollment; Epidemiology; Event; Exposure to; Fiber; Government; HIV; HIV Infections; HIV Seronegativity; Health; Health Services Accessibility; Healthcare; Home; Hospitalization; Housing; Hurricane; Hydrocortisone; Hyperalgesia; Impaired cognition; Impulsivity; Incidence; Individual; Infrastructure; Intervention; Intervention Studies; Job loss; Link; Long COVID; Longitudinal cohort study; Louisiana; Measures; Mediating; Mental Depression; Mental Health; Minority Groups; Morbidity - disease rate; Motivation; Neurobehavioral Manifestations; Neurologic Deficit; Neuropathy; Outcome; Pain; Participant; Patients; Peripheral Nervous System; Persons; Post-Acute Sequelae of SARS-CoV-2 Infection; Post-Traumatic Stress Disorders; Prevalence; Public Health; Quarantine; Reporting; Research; Research Design; Research Project Grants; Risk; Risk Factors; SARS-CoV-2 infection; Science; Severities; Shelter facility; Short-Term Memory; Smoking; Social Distance; Social Network; Social isolation; Source; Stress; Substance Use Disorder; Symptoms; Syndrome; Testing; Time; Uncertainty; Underrepresented Populations; Unemployment; United States; Vaccines; Violence; Viral; Vulnerable Populations; alcohol effect; alcohol exposure; alcohol misuse; alcohol use disorder; asymptomatic COVID-19; behavioral pharmacology; biological adaptation to stress; biopsychosocial; biopsychosocial factor; cohort; comorbidity; disadvantaged population; disease phenotype; executive function; food insecurity; high risk; immunological status; infection rate; long term consequences of COVID-19; neurobehavioral; pain sensitivity; pandemic disease; post-COVID-19; prospective; psychosocial; psychosocial stressors; recruit; severe COVID-19; social determinants; social stressor; socioeconomic disadvantage

ABSTRACT The SARS-CoV-2 coronavirus 2019 (COVID-19) pandemic continues to impact the world and the fourth wave of the pandemic has Louisiana and the city of New Orleans leading in per capita cases and hospitalizations. There is an urgent and ongoing need to determine asymptomatic cases, treatment and health impacts of COVID-19. The pandemic has caused weeks of uncertainly, anxiety, and social isolation imposed by alarming infection rates and mandates for social distancing, self-quarantine, and shelter-in-place measures. Alcohol consumption can increase during times of duress and uncertainty and is often misused to cope with stress, anxiety, and depression. Minority populations and PLWH are vulnerable populations who have an excessively high rate of exposure to chronic and lifetime social stressors, linked to elevated rates of poorer mental health including depressive disorders, alcohol use disorders (AUDs), and post-traumatic stress disorder. Cognitive and behavioral deficits associated with AUD are commonly attributed to persistent neuro adaptations, as both former and current AUD patients demonstrate cognitive impairments including deficits in working memory, executive functioning, and impulsivity, all contributing to maladaptive decision-making. Excessive alcohol exposure also damages elements of the peripheral nervous system to produce a characteristic small fiber neuropathy, and the resulting hyperalgesia (or increased pain sensitivity) is hypothesized to contribute to motivational factors to drink. Our preliminary data identifies a state of hyperalgesia (increased pain sensitivity) in PLWH relative to HIV- negative individuals. Neurological deficits, such as cognitive decline and pain, have been associated with post- acute sequelae of COVID-19 (PASC). Our preliminary data also demonstrates a significant increase in alcohol use, smoking, and psychosocial stressors post government-issued restrictions to control COVID-19 in a cohort of PLWH and HIV-negative individuals. Our overarching hypothesis is that alcohol misuse increases the risk and severity of PACS. To test this hypothesis, our research team is prepared to conduct an ambidirectional study leveraging the New Orleans Alcohol Use and HIV (NOAH) longitudinal study cohort including both PLWH and HIV-negative individuals. Utilizing the existing NOAH cohort, we can respond in a timely manner with minimal start up time identifying asymptomatic cases and increasing access to care for on-going under reported health concerns in a vulnerable population. Data from our proposed NOAH-PACS study will characterize the full spectrum of PACS and emerging phenotypes of disease and identify risk factors for their development. Results will advance the science behind social determinants of comorbidities, alcohol use, and care-related outcomes among PLWH and those that are HIV-negative. Results of this proposal will inform the management of PACS and will inform future research projects to develop targets for behavioral and pharmacological intervention to decrease maladaptive stress responses and alcohol misuse following traumatic societal events.

摘要 SARS-CoV-2冠状病毒2019年(新冠肺炎)大流行继续影响全球和第四波 大流行使路易斯安那州和新奥尔良市在人均病例和住院人数上处于领先地位。那里 目前迫切需要确定新冠肺炎的无症状病例、治疗和对健康的影响。 这种大流行已经造成了数周的不确定、焦虑和令人震惊的感染率造成的社会孤立 以及社会距离、自我隔离和就地避难措施的要求。饮酒可能会 在被迫和不确定的时候增加，经常被滥用来应对压力、焦虑和 抑郁症。少数族裔人口和PLWH是弱势群体，他们的发病率过高 暴露于慢性和终生社会压力源，与心理健康较差的比率上升有关，包括 抑郁障碍、酒精使用障碍(AUD)和创伤后应激障碍。认知和 与AUD相关的行为缺陷通常归因于持续性神经适应，因为前者 目前的AUD患者表现出认知障碍，包括工作记忆、执行能力 功能失调和冲动，所有这些都会导致不适应的决策。过度饮酒也是如此 损害周围神经系统的成分，产生一种特征性的小纤维神经病， 由此产生的痛觉过敏(或疼痛敏感度增加)被认为是导致饮酒动机因素的原因。 我们的初步数据确定了PLWH相对于HIV的一种痛敏状态(疼痛敏感性增加)。 消极的人。神经缺陷，如认知能力下降和疼痛，与后 新冠肺炎急性后遗症(PASC)。我们的初步数据也显示酒精含量显著增加 使用、吸烟和心理社会压力源发布了政府发布的限制措施，以控制新冠肺炎 人类免疫缺陷病毒感染者和艾滋病毒阴性者。我们最重要的假设是酒精滥用会增加患病风险 PACS的严重程度。为了验证这一假设，我们的研究团队准备进行一项双向研究 利用新奥尔良酒精使用和艾滋病毒(NOAH)纵向队列研究，包括PLWH和 HIV阴性的个人。利用现有的诺亚队列，我们可以用最少的时间及时做出反应 启动时间确定无症状病例并增加对报告健康状况持续不足的护理的机会 弱势群体的担忧。来自我们建议的诺亚-PACS研究的数据将描述完整的 PACS和新出现的疾病表型的范围，并确定其发展的风险因素。结果 将推动合并症、饮酒和护理相关结果的社会决定因素背后的科学 在PLWH和那些HIV阴性的人中。这项建议的结果将通知PACS管理层 并将为未来的研究项目提供信息，以开发行为和药物干预的目标 减少创伤社交事件后的适应不良应激反应和酗酒。