Mid-America Regional Coordinating Center (MARCC)

摘要 COVID-19引起的亚急性神经系统变化（感染后6个月至1年）仍然很差 表征了这可能越来越重要，因为以前的大流行病，如1918年流感， 表明神经系统疾病（如谵妄、脑炎和神经退行性疾病） 在亚急性和慢性（>一年）阶段，这些疾病更为普遍。轶事 对COVID-19阳性患者的描述表明，在治疗过程中会出现“脑雾”和疲劳。 亚急性期，特别是在更严重的影响个人。该提案利用了现有的两个 在Barnes-Jewish医院和传染病临床研究中心入组的患者队列 在圣刘易斯的华盛顿大学。一个急性队列由参与者组成， 症状与COVID-19一致的急诊室，并在整个 住院时间（如果入院）和门诊感染后。第二批，一个康复者 队列，正在招募确诊的COVID-19阳性参与者，他们主要是无症状或 症状轻微，感染后在门诊接受随访。这一建议 三个目标。目标1将评估COVID感染后6个月观察到的亚急性认知变化- 19例阳性患者。目的2将评估6个月后观察到的亚急性神经影像学变化 感染COVID-19阳性患者。目的3将评价观察到的亚急性多组学血液变化 感染后六个月的COVID-19阳性患者。总体而言，我们假设COVID-19阳性 症状更严重的患者（重症监护室（ICU）入院）将有更多的认知 缺陷、神经影像学变化以及血液转录组学、蛋白质组学、代谢组学和脂质组学 与感染后6个月的COVID-19阳性患者相比， 住院或无症状。因此，这一建议是一个时间敏感的机会， 描述100名患者感染后6个月的神经系统变化， 不同的COVID-19阳性人群。

Abstract Subacute neurological changes due to COVID-19 (six months – one year post infection) remain poorly characterized. This may be increasingly important as previous pandemics, e.g. 1918 influenza, have demonstrated that neurological conditions (e.g. delirium, encephalitis, and neurodegenerative conditions) are more prevalent during the subacute and chronic (> one year) phases. Anecdotal accounts of COVID-19 positive patients have suggested that “brain fog” and fatigue develop during the subacute period, especially in more severely affected individuals. This proposal leverages two existing cohorts of patients enrolled at Barnes-Jewish Hospital and the Infectious Disease Clinical Research Unit at Washington University in Saint Louis. An acute cohort consists of participants who present to the emergency room with symptoms consistent with COVID-19 and who are followed throughout their hospital stay, if admitted, and post infection in the outpatient setting. A second cohort, a convalescent cohort, is enrolling confirmed COVID-19 positive participants who were primarily asymptomatic or mildly symptomatic and who are followed post infection in the outpatient setting. This proposal has three aims. Aim 1 will evaluate subacute cognitive changes observed six months post infection in COVID- 19 positive patients. Aim 2 will evaluate subacute neuroimaging changes observed six months post infection in COVID-19 positive patients. Aim 3 will evaluate subacute multi-omic blood changes observed six months post infection in COVID-19 positive patients. Overall, we hypothesize that COVID-19 positive patients with more severe symptoms (intensive care unit (ICU) admission) will have more cognitive deficits, neuroimaging changes, and blood transcriptomic, proteomic, metabolomic, and lipidomic abnormalities at six months post infection compared to COVID-19 positive patients who were hospitalized or who were asymptomatic. This proposal is therefore a time sensitive opportunity to characterize the neurological changes seen at six months post infection within 100 patients from these diverse cohorts of COVID-19 positive individuals.