DISCOVAR:Disparities in Immune Response to SARS-CoV-2 in ARkansas

修改后的项目摘要/摘要部分 项目总结 严重急性呼吸综合征冠状病毒2(SARS-CoV-2)是一种新的冠状病毒，是引起严重急性呼吸综合征的病原体。 2019年冠状病毒病(新冠肺炎)，并对当前的大流行负责，总数为1,440万 2019年冠状病毒病确诊病例(新冠肺炎) 截至2020年7月19日，死亡人数为60.4万人。其中，383万例和14.3万例死亡发生在美国 州(美国)。大多数公共卫生和临床控制大流行的长期方法都是基于 推定感染SARS-CoV-2可使人在至少1年内对再次感染具有免疫力。然而， 对SARS-CoV-2免疫反应的了解极其有限，也是授予免疫的证据 预防再感染或其持续时间都是缺乏的。最令人担忧的是，种族/少数民族承受着 SARS-CoV-2感染的发病率、发病率和死亡率负担不成比例。到目前为止， 对这种差异的解释被假设为结构性种族主义和歧视，较高的预先存在的比率 健康状况，以及延迟或限制获得医疗保健的机会。然而，在免疫反应方面的差异 SARS-CoV-2也可能是造成这种差异的原因之一。免疫反应中的种族/民族差异很好 记录了其他病毒疾病和疫苗，但对SARS-CoV-2的免疫反应知之甚少 在种族/少数民族中。为了解决这一关键的知识差距，我们将评估和表征免疫 阿肯色州少数民族对SARS-CoV-2感染的反应。为了实现这一目标，我们建议 一项以人群为基础的观察性前瞻性队列研究，由男性和女性组成，这是一项种族方面的研究， 居住在中国的所有非制度化成年人的种族和地理多样性的代表性样本 阿肯色州新冠肺炎的实时荧光逆转录聚合酶链式反应检测 2020年11月和2021年4月。450人的队列将从全州范围的新冠肺炎测试中抽样 数据库，并在测试后进行长达48个月的跟踪调查。我们的首要目标是确定病毒的血清学反应 在阿肯色州RT-PCR确诊的阳性成年人中，SARS-CoV-2感染随时间按种族/民族变化。在这 目的比较NH黑人和西班牙裔成人与NH白人成人的血清学反应。 我们的第二个目标是确定随着时间的推移对SARS-CoV-2感染的血清学反应的持久性 RT-PCR证实了阿肯色州成年人中的种族/民族。在目标3中，我们将确定心理社会如何 以及行为因素，如慢性压力、抑郁、焦虑、社会支持、吸烟、饮酒、 和久坐不动的生活方式，通过种族/民族影响随着时间推移对SARS-CoV-2的血清学反应。我们 期望我们的结果将为临床治疗和预后提供信息。 新冠肺炎和疫苗研发。我们的发现也将对长期的公共健康产生重大影响 控制大流行的公共卫生政策。

Modified Project Summary/Abstract Section PROJECT SUMMARY Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, is the causative agent of coronavirus disease 2019 (COVID-19) and is responsible for the current pandemic, with 14.4 million total confirmed cases of coronavirus disease 2019 (COVID-19) in over 200 countries and territories and more than 604,000 deaths as of July 19, 2020. Of these, 3.83 million cases and 143,000 deaths occurred in the United States (US). Most long-term public health and clinical approaches to pandemic containment are based on the presumption that infection with SARS-CoV-2 confers immunity against reinfection for at least 1 year. However, understanding of immune responses to SARS-CoV-2 is extremely limited and evidence of conferred immunity against reinfection or its duration are lacking. Most concerning is that racial/ethnic minorities bear a disproportionate burden of the incidence, morbidity, and mortality from SARS-CoV-2 infection. To date, explanations for this disparity are postulated as structural racism and discrimination, higher rates of pre-existing health conditions, and delayed or limited access to healthcare. However, differences in immune response to SARS-CoV-2 may also play a part in this disparity. Racial/ethnic differences in the immune response are well documented for other viral diseases and vaccines, but little is known about immune response to SARS-CoV-2 in racial/ethnic minorities. To address this critical gap in knowledge, we will assess and characterize the immune response to SARS-CoV-2 infection in racial/ethnic minorities in Arkansas. To achieve this objective we propose a population-based, observational prospective cohort study comprised of men and women that is a racially, ethnically, and geographically diverse, representative sample of all noninstitutionalized adults residing in Arkansas tested by real-time, reverse transcriptase polymerase chain reaction (RT-PCR) for COVID-19 between November 2020 and April 2021. The 450-person cohort will be sampled from the statewide COVID-19 test database and followed up to 48 months posttesting. Our first aim is to determine the serological responses to SARS-CoV-2 infection over time by race/ethnicity among RT-PCR confirmed, positive adults in Arkansas. In this aim we will assess serological response among NH black and Hispanic adults in comparison to NH white adults. Our second aim is to determine the durability of the serological response to SARS-CoV-2 infection over time by race/ethnicity among RT-PCR confirmed positive adult Arkansans. In Aim 3 we will determine how psychosocial and behavioral factors such as, chronic stress, depression, anxiety, social support, tobacco use, alcohol intake, and sedentary lifestyle, influence the serological response over time to SARS-CoV-2 by race/ethnicity. We expect that our results will inform clinical management and prognosis of racial/ethnic minority patients with COVID-19 and vaccine development. Our findings will also have a significant public health impact for long-term public health policies for pandemic containment.