Coord Core - Atkinson

迫切需要广泛的临床研究，以告知患者管理策略和开发 对抗2019年新型冠状病毒病（COVID-19）的药物对策。目前， COVID-19感染和住院人数在佛罗里达州激增;因此，我们建议 建立佛罗里达大学（UF）作为受试者招募和样本收集中心， 佛罗里达三所卫生科学中心的COVID-19队列研究（IMPACC）中的免疫表型评估 中心.在这项全国性的前瞻性观察性研究中，外周血和鼻拭子将经常 收集自确诊COVID-19的知情同意住院患者，气管内抽吸物也 如果患者需要插管，则收集。受试者出院后，将采集血液和鼻拭子 在一年内每隔三个月举行的门诊访视期间收集， 在活动性感染期间和感染后病毒对免疫系统影响的纵向分析 复苏通过OneFlorida临床研究联盟（CRC），我们已经建立了 基础设施，包括经过培训的工作人员，以支持参与者知情同意/入组和样本采集，以及 作为用于样品处理的现场实验室设施。在目标1中，我们建议整合三个OneFlorida CRC 收集地点（坦帕综合医院/南佛罗里达大学，UF健康杰克逊维尔医疗中心， 和盖恩斯维尔的UF Health Shands医院）纳入IMPACC研究。这些网站有足够的COVID-19 在为期四个月的征聘期间，将有100名参与者参加。在Aim中 2，样本将在采集后立即处理，并运送到六个核心实验室进行精密度检测 医学基因分型、病毒测序、蛋白质组学/代谢组学、抗体测量和同种型， 以及通过CyTOF进行免疫表型分析。根据这些收集的数据，IMPACC试图将病毒负荷与 作为急性疾病严重程度、死亡率、持久免疫力发展的生物标志物的免疫特征， 以及幸存者的长期结果。此外，广泛的免疫表型数据有可能 发现新的治疗靶点以减轻疾病的严重程度。最初，COVID-19死亡率归因于 细胞因子风暴和增强的血栓形成，支持患者使用免疫抑制药物治疗 患有严重疾病。然而，为了支持免疫表型分析的力量，以提供关键 信息，我们提供的初步数据表明，免疫抑制是一个主要的一致性特征， 这种疾病，可能反对常规使用免疫抑制剂药物。这些数据还 展示我们进行单细胞RNA测序（scRNAseq）、scATACseq、光谱流 流式细胞术和ELISpot来评估基因表达、染色质可及性、蛋白质表达和免疫原性。 细胞功能。在财团批准使用残余IMPACC样品后， 可以通过外部机制资助分析，并在IMPACC联盟中共享数据。

Extensive clinical research studies are urgently needed to inform patient management strategies and develop pharmaceutical countermeasures to combat the 2019 novel coronavirus disease (COVID-19). Currently, COVID-19 infections and hospitalizations are surging across the state of Florida; hence, we propose to establish the University of Florida (UF) as a subject-enrollment and sample collection center for the Immunophenotyping Assessment in a COVID-19 Cohort (IMPACC) study at three Florida health science centers. In this nationwide prospective observational study, peripheral blood and nasal swabs will be frequently collected from consented hospitalized patients with confirmed COVID-19, with endotracheal aspirates also collected if the patient requires intubation. After participants are discharged, blood and nasal swabs will be collected during outpatient visits held at three-month intervals over the course of one year, allowing for longitudinal analysis of the virus’s effects on the immune system both during active infection and following recovery. Through the OneFlorida Clinical Research Consortium (CRC), we already have established infrastructure including trained staff to support participant consenting/enrollment and sample collection, as well as on site laboratory facilities for sample processing. In Aim 1, we propose to integrate three OneFlorida CRC collection sites (Tampa General Hospital/University of South Florida, UF Health Jacksonville Medical Center, and UF Health Shands Hospital in Gainesville) into the IMPACC study. These sites have sufficient COVID-19 caseload to support enrollment of 100 participants over the course of the four-month recruitment period. In Aim 2, samples will be processed immediately upon collection and shipped to six core laboratories for precision medicine genotyping, viral sequencing, proteomics/metabolomics, antibody measurement and isotyping, as well as immunophenotyping by CyTOF. From these collective data, IMPACC seeks to link viral burden with immune signatures as biomarkers of acute disease severity, mortality, the development of durable immunity, and long-term outcomes in survivors. Moreover, extensive immunophenotyping data has the potential to uncover new therapeutic targets to mitigate the disease severity. Initially, COVID-19 mortality was attributed to a cytokine storm and enhanced thrombosis, supporting treatment with immunosuppressive drugs in patients with severe disease. However, in an effort to support the power of immmuophenotyping to provide key information, we provide preliminary data suggesting that immunosuppression is a primary concordant feature of the disease, potentially arguing against the routine use of immunosuppressant medications. These data also demonstrate our ability to perform single cell RNA sequencing (scRNAseq), scATACseq, spectral flow cytometry, and ELISpot to evaluate gene expression, chromatin accessibility, protein expression, and immune cell function, respectively. With the consortium’s approval to use residual IMPACC samples, these site-specific assays could be funded through outside mechanisms and the data shared across the IMPACC consortium.