Antibody Profiles and Genetics of Pernio-Like Lesions during the COVID-19 pandemic

2019年冠状病毒病（COVID-19）患者的一部分出现严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）感染的皮肤表现，包括脚和手的腹膜，称为“COVID脚趾”。这些患者往往病程较轻，这可能表明宿主成功地控制了病毒。通过利用马萨诸塞州总医院（MGH）现有的患者队列和NIH广泛的实验室基础设施，本提案旨在阐明COVID-19独特表型的复杂决定因素：pernio/“COVID - toes”，目的如下。目的1：评估对SARS-CoV-2感染反应的腹股沟样病变（“COVID - toes”）的遗传决定因素。目的2：研究作为COVID-19症状出现腹股骨样病变的SARS-CoV-2患者急性感染和恢复期的炎症和血清学反应。生物样本将在MGH获得，并送到NIH的合作实验室。特别是，这一建议将帮助我们了解宿主对COVID-19的免疫反应，重点关注那些已经控制疾病并且临床病程相对较轻的患者，因为他们的皮肤病变。成功实现我们的目标将立即和直接地弥补我们在轻度/无症状COVID-19知识方面的重要空白，这反过来可以帮助我们了解如何利用这种成功的控制方法来控制其他患者。

A subset of patients with coronavirus disease-2019 (COVID-19) develop cutaneous manifestations of their severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, including pernio of their feet and hands, known as “COVID toes.” These patients tend to have a mild disease course, which may indicate successful viral control by the host. By leveraging an existing patient cohort at Massachusetts General Hospital (MGH), and the extensive laboratory infrastructure at the NIH, this proposal aims to elucidate the complex determinants of a unique phenotype of COVID-19: pernio/ “COVID toes,” with the following Aims. Aim 1: To evaluate genetic determinants of pernio-like lesions (“COVID toes”) in response to SARS-CoV-2 infection. Aim 2: To characterize the inflammatory and serological response during acute infection and convalescence of patients with SARS-CoV-2 who develop pernio-like lesions as a symptom of COVID-19. Biological samples will be obtained at MGH and sent to collaborating labs at the NIH. In particular, this proposal will help us understand the host immune response to COVID-19 by focusing on patients who have controlled the disease and have had relatively mild clinical courses, as characterized by their skin lesions. Successful completion of our aims will immediately and directly respond to important gaps in our knowledge regarding mild/asymptomatic COVID-19, which in turn can help inform our understanding of how to harness this type of successful control for other patients.