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Principal Investigator: DAVID C. HESS
Organization: AUGUSTA UNIVERSITY
Fiscal Year: 2020
Award: $308,000
Funding agency: National Institute of Neurological Disorders and Stroke
The SARS-CoV-2 virus, like other coronaviruses, is neurotropic. A clue to early invasion and involvement of the
nervous system in COVID-19 patients are the early symptoms of anosmia and hypogeusia. These may be seen
in over 60% of COVID-19 positive patients. There is evidence from the humanized ACE2 transgenic mouse that
the SARS-CoV-1 virus rapidly invades the olfactory bulb and spreads transneuronally throughout the olfactory
pathways
Our overall goal is to determine if there are long term neurological sequelae to SARS-CoV-2 viral infection in
both asymptomatic and symptomatic COVID-19 positive patients and to understand the contributing health and
genetic factors. To achieve this goal, we will establish a longitudinal prospective cohort of COVID-19 positive
patients and follow them long-term for neurological sequelae. COVID-19 preferentially affects African Americans
(AA) and we will be enrolling in the Central Savannah River Area (CSRA) of Georgia where we expect about
half of our patients to be AA. Our hypothesis is that long term neurological sequela will occur over time
in COVID-19 positive patients and there will be clinical, racial and genetic predictors of occurrence and
severity of neurological sequelae. To test this hypothesis, we will recruit 500 COVID-19 positive patients
at baseline and conduct follow-up annually. The specific aims are:
Aim 1: Determine if COVID-19 positive patients have an increased risk to develop neurological complications
and cognitive impairment over time and if there is disparity in occurrence and severity of complications in AA.
Aim 2: Determine the relative contributions of pre-existing comorbidities, the initial clinical presentation (e.g.,
anosmia) and genetic contributions to the development and severity of neurological complications.
The technical goal of Year 1 is to recruit 500 COVID-19 positive patients for the baseline testing and conduct
year 1 follow-up. The specific aims for Year 1: Aim 1. Determine the 1-year incidence rates of persistent
anosmia, hypogeusia and neuropsychiatric disorders (i.e. cognition, depression and anxiety) and whether there
are differences between gender, ethnicity and age groups; Aim 2. Identify the potential contributing factors (i.e.
severity of the COVID-19, pre-existing health conditions, the initial clinical presentation of neurological symptoms
and unhealthy lifestyles including smoking and use of alcohol and illegal drugs) to the 1-year incidence of
persistent anosmia, hypogeusia and neuropsychiatric disorders.
Terms: <2019 novel coronavirus><2019-nCoV><Active Follow-up><Address><Affect><African American><Afro American><Afroamerican><Age><Alcohol Drinking><Alcohol consumption><Anosmia><Anxiety><Area><Biology><Black Populations><Blood Coagulation Factor I><Blood Coagulation Factor One><Blood Factor One><Brain><Brain Nervous System><Brain Stem><Brainstem><COVID-19><COVID-19 epidemic><COVID-19 pandemic><COVID19><COVID19 epidemic><COVID19 pandemic><Clinical><Coagulation Factor I><Coagulation Factor One><Cognition><Cognitive Disturbance><Cognitive Impairment><Cognitive decline><Cognitive function abnormal><Cohort Studies><Concurrent Studies><Coronaviridae><Coronavirus><Development><Diagnosis><Distorted Taste><Disturbance in cognition><Drugs><Dysgeusia><Encephalitis Lethargica><Encephalon><Endothelial Cells><Enrollment><EtOH drinking><EtOH use><Ethnic group><Factor I><Factor One><Fibrinogen><Funding><Gasser's Ganglion><Gasserian Ganglion><Gender><Genetic><Goals><Grippe><Gustation><H1N1><H1N1 Virus><Health><Heart><Hypogeusia><Immune><Immunes><Impaired cognition><Incidence><Infection><Influenza><Influenza A Virus, H1N1 Subtype><Invaded><Knowledge><Long-term cohort><Longitudinal cohort><Longterm cohort><MERS><MERS coronavirus disease><MERS-CoV disease><Medication><Memory><Mental Depression><Middle East Respiratory Syndrome><Middle East Respiratory Syndrome CoV disease><Middle East Respiratory Syndrome coronavirus disease><Middle Eastern Respiratory Syndrome><Middle Eastern Respiratory Syndrome CoV disease><Middle Eastern Respiratory Syndrome coronavirus disease><Mission><NINDS><Nasopharynx><National Institute of Neurological Diseases and Stroke><National Institute of Neurological Disorders and Stroke><Nerve Cells><Nerve Unit><Nervous System><Nervous System Diseases><Nervous system structure><Neural Cell><Neurocyte><Neurologic><Neurologic Body System><Neurologic Disorders><Neurologic Manifestations><Neurologic Organ System><Neurologic Signs and Symptoms><Neurologic Symptoms><Neurological><Neurological Disorders><Neurological Manifestations><Neurological Signs and Symptoms><Neurons><Olfaction><Olfactory Pathways><Olfactory system><Oropharyngeal><Oropharynx><Oropharynxs><Parageusia><Parkinsonian><Parkinsonian Condition><Parkinsonian Diseases><Parkinsonian Disorders><Parkinsonian Syndrome><Parkinsonism><Participant><Pathway interactions><Patients><Pharmaceutic Preparations><Pharmaceutical Preparations><Prospective cohort><Receptor Protein><Recrudescences><Rhinopharynx><Risk><Rivers><SARS><SARS Virus><SARS corona virus><SARS coronavirus><SARS coronavirus disease><SARS-Associated Coronavirus><SARS-CoV><SARS-CoV disease><SARS-CoV-2><SARS-CoV2><SARS-Related Coronavirus><SARS-associated coronavirus 2><SARS-coronavirus-2><SARS-related coronavirus 2><Sampling><Semilunar Ganglion><Severe Acute Respiratory Syndrome><Severe Acute Respiratory Syndrome CoV disease><Severe Acute Respiratory Syndrome Virus><Severe Acute Respiratory Syndrome corona virus><Severe Acute Respiratory Syndrome coronavirus><Severe Acute Respiratory Syndrome coronavirus disease><Severe acute respiratory syndrome coronavirus 2><Severities><Smell><Smell Perception><Smoking><Stress><Structure of trigeminal ganglion><Symptoms><Taste><Taste Perception><Testing><Thalamic structure><Thalamus><Thinking><Time><Transgenic Mice><Trigeminal Ganglias><Trigeminal Ganglion><Vascular System><Viral Diseases><Virus><Virus Diseases><Visit><Wuhan coronavirus><active followup><age group><ages><alcohol ingestion><alcohol intake><alcohol product use><alcohol use><alcoholic beverage consumption><alcoholic drink intake><anosphrasia><black American><co-morbid><co-morbidity><cognitive dysfunction><cognitive loss><comorbidity><corona virus><corona virus disease 2019><corona virus disease 2019 epidemic><corona virus disease 2019 pandemic><coronavirus disease 2019><coronavirus disease 2019 epidemic><coronavirus disease 2019 pandemic><depression><developmental><drug/agent><enroll><ethanol consumption><ethanol drinking><ethanol ingestion><ethanol intake><ethanol product use><ethanol use><ethnicity group><flu infection><follow up><follow-up><followed up><followup><genetic predictors><gustatory perception><gustatory processing><gustatory response><improved><influenza infection><nasopharnygeal><nervous system disorder><neural manifestation><neurological disease><neuronal><neuropsychiatric disease><neuropsychiatric disorder><neurotropic><odor perception><olfactory bulb><olfactory circuitry><olfactory circuits><olfactory perception><oral pharyngeal><pandemic><pandemic disease><pathway><receptor><recruit><severe acute respiratory syndrome-CoV><taste processing><taste response><thalamic><thoughts><unhealthy lifestyle><viral infection><virus infection><virus-induced disease>