Document text
Principal Investigator: Conall Michael O'Cleirigh
Organization: MASSACHUSETTS GENERAL HOSPITAL
Fiscal Year: 2020
Award: $166,958
Funding agency: National Institute on Drug Abuse
Early data indicate that smoking increases the severity of coronavirus disease (COVID-19) symptoms.
Individuals living with HIV are more likely to smoke and less likely to quit than those in the general population,
placing them at high risk for poor COVID-19 outcomes. Comorbidities associated with HIV, including
cardiovascular disease and chronic lung disease, further heighten risk for a severe course of COVID-19 illness,
which has been linked to over 40,000 deaths in the U.S. thus far. To mitigate COVID-19 related health
disparities and inform intervention strategies, it is crucial to assess the degree to which nicotine dependence
and HIV disease stage affect the onset and progression of COVID-19 in smokers living with HIV.
Disruptions to engagement in HIV care and antiretroviral therapy regimens may compromise efforts to
maintain viral suppression and lead to increases in rates of anxiety and depression, both of which are already
elevated in individuals living with HIV compared to the general population. Increases in negative affect (anxiety
and depression) are established pathways to smoking relapse among smokers living with HIV who may use
cigarettes to regulate their negative mood; therefore, increases in anxiety and depression resulting from the
COVID-19 pandemic could impact smoking cessation and relapse. Given the primary outcomes of the parent
grant, we will also examine the ways in which COVID-19 related mental health responses COVID-19influence
uptake of smoking cessation treatments, smoking abstinence, and other relevant smoking outcomes.
This proposed Administrative Supplement is responsive to the Notice of Special Interest regarding the
Availability of Administrative Supplements Research on the 2019 Novel Coronavirus (NOSI - NOT-DA-20-047)
issued by NIDA and is appropriate to PA-18-591 (Administrative Supplements to Existing NIH Grants).
Specifically, our application is responsive to 3 areas of research requested by the NOSI: (1) “Research to
determine whether substance use (especially smoking tobacco…) is a risk factor for the onset and progression
of COVID-19,” (2) “Research on how HIV among persons who use substances may impact the onset and
progression of COVID-19,” and (3) “Research using ongoing studies to understand the broad impacts of
COVID-19 (e.g., anxiety...) on …, substance use, substance use disorders, and access to addiction treatment.”
Through this administrative supplement application we directly address these three areas and propose the
following specific aims: (1) to quantify the relationship among baseline nicotine dependence severity, baseline
HIV disease stage and their interaction), with COVID-19 outcomes (COVID-19 susceptibility, clinical symptom
burden, level of treatment, COVID-19 disease outcome) over up to 2 years of follow up; and (2) quantify
manifestations of negative affect that have emerged in response to the COVID-19 pandemic and the degree to
which these different manifestations impact uptake of smoking cessation treatments over the follow up period.
We will achieve these aims by leveraging the of our parent R01 grant.
Terms: <2019 novel coronavirus><2019-nCoV><21+ years old><AIDS Virus><AOD use><Abstinence><Access to Care><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome Virus><Active Follow-up><Address><Administrative Supplement><Adult><Adult Human><Affect><Alcohol or Other Drugs use><Anxiety><Area><CD4 Cells><CD4 Positive T Lymphocytes><CD4 T cells><CD4 helper T cell><CD4 lymphocyte><CD4+ T-Lymphocyte><CD4-Positive Lymphocytes><COVID><COVID-19><COVID-19 epidemic><COVID-19 pandemic><COVID19><COVID19 epidemic><COVID19 pandemic><Cardiovascular Diseases><Caring><Cell Count><Cell Number><Cessation of life><China><Chinese><Chinese People><Chronic lung disease><Clinical><CoV disease><CoV emergence><Collaborations><Data><Death><Disease><Disease Outbreaks><Disease Outcome><Disorder><Drugs><Effectiveness><Emotional Depression><Future><General Population><General Public><Grant><HIV><Health><Health Services Accessibility><History><Human Immunodeficiency Viruses><Individual><Infection><Infrastructure><Intervention><Intervention Strategies><Knowledge><LAV-HTLV-III><Lead><Link><Lymphadenopathy-Associated Virus><Mainland China><Mechanical ventilation><Medication><Mental Depression><Mental Health><Mental Hygiene><NIDA><NIH><National Institute of Drug Abuse><National Institute on Drug Abuse><National Institutes of Health><Nicotine Dependence><Outbreaks><Outcome><Parents><Participant><Pathological anxiety><Pathway interactions><Patients><Pb element><Persons><Pharmaceutic Preparations><Pharmaceutical Preparations><Population><Predisposition><Prevalence><Psychological Health><Psychological Impact><Randomized><Recording of previous events><Regimen><Relapse><Reporting><Research><Respiratory physiology><Respondent><Risk><Risk Factors><SARS-CoV-2><SARS-CoV2><SARS-associated coronavirus 2><SARS-coronavirus-2><SARS-related coronavirus 2><Sampling><Severe acute respiratory syndrome coronavirus 2><Severities><Smoke><Smoker><Smoking><Smoking Cessation Intervention><Specific qualifier value><Specified><Substance Use Disorder><Survey Instrument><Surveys><Susceptibility><Symptoms><T4 Cells><T4 Lymphocytes><Time><Tobacco><Tobacco Consumption><Tobacco use><Uncertainty><United States><United States National Institutes of Health><Viral><Viremia><Virus><Virus-HIV><Wuhan coronavirus><access to health services><access to services><access to treatment><accessibility to health services><active followup><addiction><addictive disorder><adulthood><adverse consequence><adverse outcome><anti-retroviral therapy><anti-retroviral treatment><antiretroviral therapy><antiretroviral treatment><anxiety sensitivity><anxiety symptoms><anxious symptom><availability of services><cardiovascular disorder><care access><cease smoking><cigarette smoking><cigarette use><co-morbid><co-morbidity><comorbidity><corona virus disease><corona virus disease 2019><corona virus disease 2019 epidemic><corona virus disease 2019 pandemic><coronavirus disease><coronavirus disease 2019><coronavirus disease 2019 epidemic><coronavirus disease 2019 pandemic><coronavirus emergence><depression><depression symptom><depressive><depressive symptoms><disparity in health><doubt><drug/agent><emergent CoV><emergent coronavirus><emerging CoV><emerging coronavirus><follow up><follow-up><followed up><followup><health disparity><health service access><health services availability><heavy metal Pb><heavy metal lead><high risk><interest><interventional strategy><lung function><mechanical respiratory assist><mortality><nCoV><negative affect><negative affectivity><negative mood><new CoV><new coronavirus><nicotine addiction><nicotine dependent><non-smoker><nonsmoker><novel CoV><novel coronavirus><over-treatment><overtreatment><pandemic><pandemic disease><parent grant><pathway><primary outcome><psychologic><psychological><quit smoking><randomisation><randomization><randomly assigned><respiratory function><response><service availability><severe anxiety><smoking abstinence><smoking cessation><smoking cessation treatment><smoking relapse><stop smoking><substance use><substance using><treatment access><uptake><using substances><viraemia><viral sepsis><virusemia>