Thursday, April 18, 2024
4/18/2024
PROJECT SUMMARY Amidst the rapidly growing body of evidence regarding risks and outcomes associated with coronavirus disease 2019 (COVID-19), many knowledge gaps persist. We and others have reported on how certain comorbidities, including cardiovascular risk factors, predispose some individuals more than others to the severest forms of COVID-19 illness. The natural history, diversity, and determinants of end-organ sequelae following COVID-19 illness remain unknown. Extending beyond lung injury, accumulating data have highlighted not only short-term but also potentially long-term adverse effects involving the heart. In fact, multiple reports have indicated a high prevalence of subclinical as well as clinical abnormalities in cardiac structure and function seen among patients recovering from even mild cases of COVID-19 illness. Based on the emerging evidence and our own clinical experience to date, we hypothesize that SARS-Cov-2 provokes a systemic immune-inflammatory response that leads to under-recognized myocardial disease in a large proportion of infected individuals – in a manner that persists over time and represents elevated risk for the longer-term post-acute sequelae of COVID-19. Thus, we propose to expand the application of novel cardiac imaging methods to comprehensively characterize the post- infectious cardiac effects of COVID-19. Our specific aims are: (1) to identify and characterize the longitudinal trajectories of cardiac disease and associated outcomes following the post-acute phase of COVID-19 illness; and, (2) to characterize the longitudinal trajectories of immune-inflammatory response to COVID-19 illness, and their relations with post-infectious cardiac disease and associated outcomes. From our growing source sample of >12,500 hospitalized treated since 3/8/2020 for rt-PCR confirmed positive or negative COVID-19 status, we will prospectively enroll COVID-19 positive patients (cases) representing the spectrum of COVID-19 illness severity; we will simultaneously enroll hospitalized COVID-19 negative patients (controls) matched on age, sex, ethnicity/race, comorbidities, and illness severity. We will use serial multi-modality imaging to characterize trajectories of persistent cardiac disease versus functional and structural recovery over time. We will also use advanced high-throughput mass spectrometry methods to serially profile bioactive lipid eicosanoids, which are recognized as upstream molecular mediators of the systemic immune-inflammatory response to stress (including COVID-19). We will relate eicosanoid measures with trajectories of post-infectious cardiac disease persistence versus recovery. For significant associations, will examine heterogeneity in trajectories by sex, age, race/ethnicity, socioeconomic status, and host-environment modifiers.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
