RAPID: Evolutionary Nutritional Adaptations and COVID-19 Risk among Healthcare Workers

这个快速项目将从进化的角度检查冠状病毒(新冠肺炎)的疾病风险，重点关注营养和传染病之间的交集。利用美国国家科学基金会资助的一个现有项目的基础设施，研究人员将测试两个营养假说，即轻度缺铁会降低患新冠肺炎的风险，肥胖会增加这种风险。有证据表明，在人类宿主和传染病病原体之间的进化“军备竞赛”的背景下，轻度缺铁可能是一种营养适应，以降低感染疾病的风险。目前尚不清楚轻度缺铁是否对新冠肺炎有保护作用，因为这种病毒对人类的适应历史并不长。证据还表明，肥胖可能是早年适应以在营养不良的环境中保存能量的晚年后果。在这种情况下，免疫系统的发育也可能被置于更节能的轨道上，这可能会增加感染疾病的风险。该项目专注于医护人员，因为他们患上包括新冠肺炎在内的新发传染病的风险特别高，尤其是在医疗系统变得紧张的情况下。该项目将促进对营养和传染病之间复杂交集的基本了解，特别是关于新出现的传染病。这一研究结果可能会为保护医护人员和公众免受新冠病毒感染的公共卫生努力提供参考。研究人员将评估铁含量和肥胖对医护人员患新冠肺炎风险的影响，因为他们所在的医院入院人数急剧增加。参与的医护人员(医生、护士和支持人员)将在一开始就接受缺铁、贫血和肥胖的评估。首先将评估新冠肺炎免疫力(表明过去感染)，然后每周监测参与者是否有新冠肺炎病毒DNA(表明当前感染)以及新冠肺炎症状或住院情况。铁缺乏和肥胖对医护人员感染新冠肺炎的概率(以及他们因住院或死亡而经历严重新冠肺炎后果的概率)的影响将进行评估，并控制混淆变量(包括社会经济地位、医疗保健角色和实施的程序、患者护理负荷以及合并慢性疾病)。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的智力价值和更广泛的影响审查标准进行评估，被认为值得支持。

This RAPID project will examine coronavirus (COVID-19) disease risk from an evolutionary perspective, focusing on the intersection between nutrition and infectious disease. Leveraging the infrastructure of an existing NSF-funded project, the researchers will test two nutritional hypotheses, that mild iron deficiency decreases COVID-19 risk and that obesity increases this risk. Evidence suggests that mild iron deficiency may serve as a nutritional adaptation to reduce infectious disease risk in the context of an evolutionary ‘arms race’ between human host and infectious agents. Whether mild iron deficiency is protective against COVID-19 is unknown, as the virus does not have a long history of adaptation to humans. Evidence also suggests that obesity may be a later-life consequence of an early-life adaptation to conserve energy in environments of under-nutrition. In such cases, immune system development may also be set on a more energy-conserving track, which might increase risk of infectious disease. The project focuses on healthcare workers because they are at particularly high risk for emerging infectious diseases, including COVID-19, particularly as healthcare systems become strained. The project will advance fundamental understanding of the complex intersection between nutrition and infectious disease, particularly with regard to emerging infectious diseases. The research findings may inform public health efforts to protect healthcare workers and the public against COVID-19.The researchers will evaluate the impact of iron status and obesity on COVID-19 risk among healthcare workers as COVID-19 admissions increase dramatically in their hospital. Participating healthcare workers (physicians, nurses, and support staff) will be evaluated at the outset for iron deficiency, anemia, and obesity. COVID-19 immunity (indicating past infection) will be assessed at the outset, and then participants will be monitored weekly for COVID-19 virus DNA (indicating current infection) and COVID-19 symptoms or hospitalization. The impact of iron deficiency and obesity on the probability that health care workers contract COVID-19 (and the probability they experience severe COVID-19 outcomes of hospitalization or death) will be evaluated, controlling for confounding variables (including socioeconomic status, healthcare role and procedures performed, patient care load, and co-morbid chronic conditions).This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.