Characterizing persistent subclinical neurobehavioral effects of COVID-19 in a diverse urban population

表征 COVID-19 对不同城市人群的持续亚临床神经行为影响

• 批准号: 10580856
• 负责人: Johanna Patricia Daily
• 金额: $ 69.09万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10580856
• 关键词: 2019-nCoV; Address; Anxiety; Area; Attention; Body mass index; Brain; Brain Injuries; Brain imaging; Brain region; COVID-19; COVID-19 impact; COVID-19 pandemic; COVID-19 patient; COVID-19 survivors; COVID-19 vaccination; Caring; Cellular Assay; Characteristics; Clinical; Data; Detection; Disadvantaged minority; Elderly; Enrollment; Ethnic Origin; Exhibits; Functional disorder; Future; Healthcare; High Prevalence; Hypoxia; Iceberg; Image; Impaired cognition; Individual; Infection; Influenza; Injury; Laboratories; Magnetic Resonance Imaging; Measures; Minority Groups; Moods; Morbidity - disease rate; Nature; Nerve Degeneration; Neurocognitive; Neurodegenerative Disorders; Neurologic; Neurologic Dysfunctions; New York City; Participant; Patients; Performance; Persons; Populations at Risk; Positioning Attribute; Race; Recording of previous events; Reporting; Respiratory Tract Infections; Risk; Risk Factors; SARS-CoV-2 infection; Sampling; Serology; Short-Term Memory; Signal Transduction; Social isolation; Stress; Stroke; Structure; Symptoms; T-Lymphocyte; Thick; Urban Population; Variant; Woman; acute stroke; brain dysfunction; brain magnetic resonance imaging; brain tissue; brain volume; cohort; comorbidity; daily functioning; ethnic diversity; executive function; experience; follow-up; longitudinal design; men; neurobehavioral; neurocognitive test; neuroimaging; neuropsychiatry; novel; pandemic disease; post SARS-CoV-2 infection; pre-pandemic; public health relevance; racial diversity; screening; severe COVID-19; sex; study population; systemic inflammatory response; young man; young woman

PROJECT SUMMARY/ABSTRACT Excess cognitive dysfunction has been identified in older adult survivors of COVID-19, compared to other respiratory infections. SARS-CoV-2 may thus adversely impact the brain beyond what the cases of acute stroke, etc. suggest. Unrecognized brain effects of SARS-CoV-2 infection may impact current brain functioning and presage future neurodegeneration and overt neurologic dysfunction. However, absent known baseline functioning, detection of subclinical effects will be confounded by normal variation between cases and controls. We will therefore leverage detailed pre-pandemic neurocognitive and imaging assessments to characterize subclinical effects on brain structure and function among a large cohort of younger patients who experienced mild or asymptomatic SARS-CoV-2 infection. We will identify 3 groups utilizing detailed serologic analysis and novel highly specific SARS-CoV-2 T-cell assays to allow confirmation of prior SARS-CoV-2 infection, even in the setting of COVID-19 vaccination: (1) M ild COVID-19: 35 patients with laboratory confirmed COVID-19 who were NOT hospitalized; (2) Asymptomatic: 35 with laboratory evidence of SARS-CoV-2 infection, but no history of COVID-19 symptoms; and (3) Controls: 70 matched individuals without laboratory or clinical evidence of prior SARS-CoV-2 infection. All participants were healthy prior to COVID-19, with no comorbid risk factors or brain imaging abnormality and normal neurocognitive performance. Against this robust quantitative baseline, we will assess change due to SARS-CoV-2 infection by repeating a suite of neurological assessments, including brain imaging and assessments of neurocognitive function, mood, anxiety, stress and social isolation due to the pandemic. In addition to their pre-pandemic baseline, we will assess participants (1) at entry into this proposed study, (2) 6 months after entry, (3) 18 months after entry and (3) three years after entry, to address the following: Aim 1 Brain Tissue Effects: Characterize change of macro/microstructure and functional connectivity frompre- pandemic, among SARS-CoV-2 infected patients and non-infected controls, over three years. Aim 2 Functional Effects: Assess change in neurocognitive function from pre-pandemic, among SARS-CoV-2 patients, and in non-infected controls, over three years, while accounting for mood, stress and social isolation. Aim 3 Individual Risk Factors [Exploratory]:Explore whether individual characteristics, such as sex, BMI, SES and race/ethnicity, modify the associations of SARS-CoV-2 infection with MRI and neurocognitive changes. Confirming neurological morbidity in mild SARS-CoV-2 will have key implications for screening, care and follow- up for brain dysfunction among those at risk. Theseproblems would otherwise go unrecognized, despite potential for long-term, yet-unrecognized morbidity. Our existing sample of previously healthy, young, ethnically diverse women and men from a high prevalence and high morbidity region, well-characterized prior to the COVID-19 pandemic, uniquely positions us to characterize subclinical brain injury and dysfunction due to SARS-CoV-2.

项目摘要/摘要 与其他相比 呼吸道感染。因此 等建议。 SARS-COV-2感染的无法识别的大脑影响可能会影响当前的大脑功能和 预先未来的神经退行性和明显的神经功能障碍。但是，缺乏已知基线 功能，检测亚临床效应将与病例和对照之间的正常变化混淆。 因此，我们将利用详细的遗传学前神经认知和成像评估来表征 在大量年轻患者中对大脑结构和功能的亚临床影响 轻度或无症状的SARS-COV-2感染。我们将确定使用详细的血清学分析和 新型高度特异性的SARS-COV-2 T细胞测定法，以确认先前的SARS-COV-2感染，即使在 联想-19疫苗接种的设置：（1）MILD COVID-19：35例实验室患者确认Covid-19是 没有住院； （2）无症状：35具有SARS-COV-2感染的实验室证据，但没有病史 2019冠状病毒病症状; （3）对照：70个没有实验室或临床证据的匹配的个体 SARS-COV-2感染。所有参与者都在Covid-19之前都很健康，没有合并的风险因素或大脑 成像异常和正常的神经认知性能。在这种强大的定量基线方面，我们将 通过重复一系列神经系统评估，包括SARS-COV-2感染引起的变化 对神经认知功能，情绪，焦虑，压力和社会隔离的成像和评估 大流行。除了其流行前基线外，我们还将评估参与者（1）进入该建议的 （2）进入进入后6个月，（3）进入后18个月，（3）进入后三年，以解决以下内容： AIM 1脑组织效应：表征宏观/微观结构的变化和功能连接性 在三年内，在SARS-COV-2感染患者和未感染的对照中，大流行。 AIM 2功能效应：在SARS-COV-2中评估流行前神经认知功能的变化 患者以及未感染的对照中的三年，同时考虑了情绪，压力和社会隔离。 AIM 3个个人风险因素[探索性]：探索个人特征，例如性别，BMI，SES是否存在 和种族/种族，修改SARS-COV-2感染与MRI和神经认知变化的关联。 在轻度SARS-COV-2中确认神经系统发病率将对筛查，关怀和跟随 - 在有危险的人中，大脑功能障碍。尽管潜力 长期，尚未公认的发病率。我们现有的以前健康，年轻，种族多样的样本 来自高流行率和高发病率区域的男性和男性在Covid-19之前进行了充分的特征 大流行，唯一地定位了由于SARS-COV-2引起的亚临床脑损伤和功能障碍。