Longitudinal Study of HIV and Aging in Brazil

巴西艾滋病毒与老龄化的纵向研究

• 批准号: 10613799
• 负责人: Jessica L Castilho
• 金额: $ 37.12万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10613799
• 关键词: 2019-nCoV; Acute; Adult; Age; Aging; Blood Vessels; Brazil; CD4 Lymphocyte Count; CD8-Positive T-Lymphocytes; COVID-19; COVID-19 complications; COVID-19 pandemic; COVID-19 risk; COVID-19 survivors; COVID-19 susceptibility; COVID-19 vaccination; COVID-19 vaccine; Cessation of life; Clinical; Clinical Data; Cognition; Cognitive; Cognitive deficits; Complication; Cross-Sectional Studies; Data; Elderly; Epidemiology; Fatigue; Frequencies; Funding; HIV; Immune; Immune response; Immunologics; Immunology; Impaired cognition; Incidence; Income; Individual; Infection; Inflammation; Intervention; Investigation; Knowledge; Lead; Long COVID; Longitudinal Studies; Measures; Mental Depression; Neurocognitive; Outcome; Outcome Measure; Participant; Persons; Phenotype; Population; Post-Acute Sequelae of SARS-CoV-2 Infection; Quality of life; Recording of previous events; Risk; Risk Factors; SARS-CoV-2 antibody; SARS-CoV-2 infection; Standardization; Symptoms; Syndrome; T-Lymphocyte; Testing; Time; United States National Institutes of Health; Vaccination; Virus Diseases; adverse outcome; biobank; cell age; circulating biomarkers; clinical phenotype; cohort; comorbidity; coronavirus disease; disability; exhaustion; experience; frailty; high risk; human old age (65+); improved; insight; long-term sequelae; low and middle-income countries; low socioeconomic status; meetings; mortality; neurocognitive test; neuroinflammation; neuropsychiatric symptom; neuropsychiatry; neutralizing antibody; novel; pandemic disease; post SARS-CoV-2 infection; post-COVID-19; senescence; symptomatic COVID-19; systemic inflammatory response

PROJECT SUMMARY This study will investigate the epidemiology and immunology of neurocognitive symptoms of post-acute sequelae of COVID-19 (PASC, or “long COVID”) in older people living with HIV (PWH). Cognitive decline remains a common and important complication of aging with HIV and is associated with adverse outcomes including frailty, poor quality of life, disability, and death. Lasting neurocognitive symptoms of COVID-19 may be more common in older PWH given their risk factors for PASC as well as differences in underlying immune senescence and inflammation. However, the clinical burden and immunologic phenotypes of neurocognitive symptoms of PASC in older PWH have not been described to date. This information is particularly needed in low- and middle-income countries where heterologous SARS-CoV-2 vaccinations and high COVID-19 incidence were observed. This study will examine (1) the clinical phenotypes and determinants of neuropsychiatric outcomes measures among older PWH with PASC and will seek to determine (2) the immunologic and clinical profiles of older PWH with discordant immunologic and clinical sequelae of SARS- CoV-2 infection. A nested, cross-sectional study using the rich baseline clinical data and biospecimens of the NIA-funded Longitudinal Study of HIV and Aging in Brazil will collect detailed data of COVID-19 infections, symptoms, and prior vaccination to identify older PWH with PASC. A cohort of 300 participants with and without PASC will undergo additional neurocognitive testing to describe specific cognitive phenotypes in older PWH with and without PASC. Further, we will use stored biospecimens to identify older PWH with poor immunologic response to COVID-19 infection and vaccination as well as those with and without PASC to examine differences in adaptive immune senescence and systemic measures of neuroinflammation to identify clues of the immunologic mechanisms contributing to adverse COVID-19 outcomes in this population. Located in one of the epicenters of the COVID-19 pandemic and led by experts in HIV and COVID-19 epidemiology and immunology, this study will offer novel and needed insights into a critical complication of the COVID-19 pandemic in PWH.

项目摘要 本研究将从流行病学和免疫学的角度探讨急性脑梗死后神经认知症状的发病机制 艾滋病病毒感染者（PWH）的COVID-19后遗症（PASC，或“长期COVID”）。认知能力下降 仍然是艾滋病毒感染者衰老的常见和重要并发症，并与不良结局相关 包括虚弱、生活质量差、残疾和死亡。COVID-19的持续神经认知症状可能 由于PASC的风险因素以及潜在免疫功能的差异， 衰老和炎症。然而，神经认知障碍的临床负担和免疫表型 迄今为止，还没有关于老年威尔斯亲王医院PASC症状的描述。这一信息尤其需要在 低收入和中等收入国家， 观察发病率。本研究将检查（1）临床表型和决定因素， 在患有PASC的老年PWH中测量神经精神结局，并将寻求确定（2） 有严重急性呼吸系统综合症（SARS）免疫学和临床后遗症的老年威尔斯亲王的免疫学和临床特征- CoV-2感染。一项巢式横断面研究，使用了丰富的基线临床数据和生物标本， NIA资助的巴西艾滋病毒和老龄化纵向研究将收集COVID-19感染的详细数据， 症状，以及之前的疫苗接种，以识别患有PASC的老年PWH。一组300名参与者， 没有PASC的患者将接受额外的神经认知测试，以描述老年人的特定认知表型。 PWH有和没有PASC。此外，我们将使用存储的生物标本来识别较旧的PWH和较差的PWH 对COVID-19感染和疫苗接种的免疫反应以及有和没有PASC的免疫反应， 研究适应性免疫衰老和神经炎症系统测量的差异，以确定 在这一人群中导致不利COVID-19结果的免疫机制的线索。位于 在艾滋病毒和COVID-19流行病学专家的带领下， 免疫学，这项研究将为COVID-19的关键并发症提供新的和必要的见解 威尔斯亲王医院的大流行病。