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.