'REBRACOVID' - multicentre cohort study of the natural history and immunology of COVID-19 in Brazil

近几个月来，世界上许多地方都招募了COVID-19疾病队列并进行了研究，但仍有许多东西需要学习。巴西迫切需要更好地了解这种疾病：世卫组织的数据显示，巴西的COVID-19病例和死亡人数在世界上排名第二，该国面临着城市拥挤（包括贫民窟）、社会经济差距以及疾病负担（包括蚊媒感染）使医疗系统不堪重负的挑战。我们的目的是收集和分析来自全国9个中心的住院和社区病例的大型疾病队列的疾病参数。在这样做的过程中，我们还受益于建立一个联盟，该联盟与我们已建立的联盟研究REPLICK（巴西）和SPIICA（英国-巴西，MRC-Newton）相结合，旨在进行与基孔肯雅病毒感染的免疫病理学和慢性疾病表型相关的类似队列研究-一种蚊媒感染，也可导致慢性疾病症状。我们的目标是招募20，000名感染患者，以及家庭接触者和高危医护人员。我们的数据将使我们能够确定年龄，性别，职业，种族，其他健康状况，社会经济因素，血液标志物的影响，重要的是，保护性免疫及其持久性的措施。我们的目的是更好地了解这种疾病的易感性和机制，从巴西的严重局势中汲取具体见解，以影响当地的应对管理。

COVID-19 disease cohorts have been recruited and studied in many parts of the world in recent months, but there is still much to learn. There is a specific and urgent need to better understand this disease in Brazil: WHO data places Brazil 2nd in the world forCOVID-19 cases and deaths, and the country faces challenges of urban crowding (including favelas), socioeconomic disparities, and a healthcare system stretched by disease burden including the mosquito-borne infections. Our aim here is to collect andanalyse disease parameters in a large disease cohort of hospitalised and community cases, from 9 centres across the country. In doing so, we benefit also from building a consortium that bolts-on to our established consortium studies, REPLICK (Brazil) andSPIICA (Anglo-Brazil, MRC-Newton), designed to conduct analogous cohort studies in relation to the immunopathology and chronic disease phenotype in infection by Chikungunya virus - a mosquito-borne infection that can also lead to chronic diseasesymptoms. We aim to recruit a cohort of 20,000 total infected patients, as well as household contacts and at-risk healthcare workers. Our data will allow us to define impacts of age, gender, occupation, ethnicity, other health conditions, socio-economicfactors, blood markers and importantly, measures of protective immunity and its durability. Our intention is to better understand susceptibility and mechanisms underlying this disease, drawing on specific insights from the serious situation in Brazil to impact localmanagement of the response.