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Principal Investigator: Heidi M. Crane
Organization: UNIVERSITY OF WASHINGTON
Fiscal Year: 2021
Award: $159,270
Funding agency: National Institute on Drug Abuse
This supplement is appropriate for PA-18-591 and responsive to research areas requested in the NIDA
supported NOSI on the 2019 Coronavirus (NOT-DA-20-047) including research to determine whether drug
use is a risk factor for the onset/progression of COVID-19 (the disease caused by SARS-CoV-2), research on
the onset and progression of COVID-19 and the impact of HIV and drug use; and research to understand the
broad impacts of COVID-19 on drug use. This supplement leverages and expands the comprehensive data
available in CNICS to better understand drug use and its impacts on COVID-19 and its complications among
people living with HIV (PLWH) including the impact of drug use on rates of COVID-19 symptomatic disease
and asymptomatic infection. We will examine the impact of drug use on poorer outcomes among those with
symptomatic COVID-19 disease. Furthermore, we will examine the impact of the pandemic itself on all
PLWH in CNICS including on drug use and access to harm reduction services. Specifically, we will:
1. Determine the incidence of clinically significant COVID-19-related illness and overall seroprevalence of
SARS-CoV-2 infection among PLWH who use different types of inhaled drugs, smoke, and vape in
comparison to PLWH who do not use substances. 2. Examine the association between drug use and
severity of COVID-19-related illness including COVID-19 hospitalizations, ICU admissions, need for
intubation, thrombotic complications, and mortality. 3. Determine one-year outcomes both among a) PLWH
who develop COVID-19 including 1-year mortality, quality of life, HIV viral suppression, changes in drug and
tobacco use, and whether outcomes differ by drug use and b) changes in the cohort overall including
changes in drug use and engagement to harm reduction services, engagement in care, depression, and
quality of life to better understand the impact of the pandemic and social isolation.
We leverage the comprehensive clinical data and specimen biorepository of the Centers for AIDS Research
Network of Integrated Clinical Systems (CNICS) cohort. This includes COVID-19 diagnoses and laboratory
testing from clinical care; a chart review validation approach that has been developed that confirms COVID-
19 diagnoses and captures information regarding course such as hospitalization, intensive care unit
admission, intubation, and death; state-of-the-art phenotype measurement including adjudication for
outcomes prevalent among PLWH who use drugs such as thrombotic events that may be occurring at high
rates with COVID-19; as well as rich on-going substance use information including prior and current
substance use, routes of use, and patterns and frequency of use. By combining rich CNICS data with
antibody testing of a random sample of PLWH in CNICS to determine the underlying seroprevalence rates,
we will be able to better understand both the incidence and likelihood of developing clinical disease among
those positive for SARS-CoV-2 virus, and the course of COVID-19 and to do so by patterns of drug use.
Terms: <19S Gamma Globulin><2019 novel corona virus><2019 novel coronavirus><2019-nCoV><7S Gamma Globulin><AIDS><AIDS Virus><Acquired Immune Deficiency><Acquired Immune Deficiency Syndrome><Acquired Immune Deficiency Syndrome Virus><Acquired Immuno-Deficiency Syndrome><Acquired Immunodeficiency Syndrome><Acquired Immunodeficiency Syndrome Virus><Acquired Immunologic Deficiency Syndrome><Admission><Admission activity><Area><Behavior><COVID disease severity><COVID severity><COVID-19><COVID-19 associated death><COVID-19 associated fatality><COVID-19 associated mortality><COVID-19 death><COVID-19 diagnosis><COVID-19 disease severity><COVID-19 fatality><COVID-19 induced death><COVID-19 induced fatality><COVID-19 induced mortality><COVID-19 infection><COVID-19 mortality><COVID-19 positive><COVID-19 positivity><COVID-19 related death><COVID-19 related fatality><COVID-19 related mortality><COVID-19 severity><COVID-19 testing><COVID-19 virus><COVID19><COVID19 associated death><COVID19 associated fatality><COVID19 associated mortality><COVID19 death><COVID19 diagnosis><COVID19 disease severity><COVID19 fatality><COVID19 induced death><COVID19 induced fatality><COVID19 induced mortality><COVID19 infection><COVID19 mortality><COVID19 positive><COVID19 positivity><COVID19 related death><COVID19 related fatality><COVID19 related mortality><COVID19 severity><COVID19 testing><COVID19 virus><CV-19><CV19><Cardiac infarction><Caring><Cessation of life><Clinical><Clinical Data><Clinical assessments><CoV-2><CoV2><Collection><Coronaviridae><Coronaviridae Infections><Coronavirus><Coronavirus Infections><Crystal Meth><Data><Death><Deoxyephedrine><Desoxyephedrine><Diagnosis><Disease><Disorder><Drug usage><Drugs><ELISA><Environmental Factor><Environmental Risk Factor><Enzyme-Linked Immunosorbent Assay><Event><Frequencies><Future><Genes><Genetic><Geography><Goals><HIV><Harm Minimization><Harm Reduction><Health><Homelessness><Hospital Admission><Hospitalization><Human Immunodeficiency Viruses><IgG><IgM><Immune><Immune response><Immunes><Immunoglobulin G><Immunoglobulin M><Immunological response><Imprisonment><Incidence><Infection><Inhalation><Inhaling><Intensive Care Units><Intubation><LAV-HTLV-III><Laboratories><Lung><Lung Respiratory System><Lymphadenopathy-Associated Virus><Marijuana><Measurement><Medication><Mental Depression><Methamphetamine><Methylamphetamine><Morbidity><Morbidity - disease rate><Myocardial Infarct><Myocardial Infarction><N-Methylamphetamine><NIDA><National Institute of Drug Abuse><National Institute on Drug Abuse><Opiates><Opioid><Outcome><Patient Outcomes Assessments><Patient Reported Measures><Patient Reported Outcomes><Pattern><Pharmaceutic Preparations><Pharmaceutical Preparations><Phase><Phenotype><Physical activity><Population Heterogeneity><Preventative strategy><Prevention strategy><Preventive strategy><Procedures><QOL><Quality of life><RT-PCR><RTPCR><Recommendation><Recurrence><Recurrent><Relapse><Research><Research Specimen><Reverse Transcriptase Polymerase Chain Reaction><Risk><Risk Factors><Role><Route><SARS><SARS corona virus 2><SARS coronavirus disease><SARS-CoV disease><SARS-CoV-2><SARS-CoV-2 associated death><SARS-CoV-2 associated fatality><SARS-CoV-2 associated mortality><SARS-CoV-2 death><SARS-CoV-2 diagnosis><SARS-CoV-2 disease severity><SARS-CoV-2 fatality><SARS-CoV-2 induced death><SARS-CoV-2 induced fatality><SARS-CoV-2 induced mortality><SARS-CoV-2 infection><SARS-CoV-2 mortality><SARS-CoV-2 positive><SARS-CoV-2 positivity><SARS-CoV-2 related death><SARS-CoV-2 related fatality><SARS-CoV-2 related mortality><SARS-CoV-2 severity><SARS-CoV-2 testing><SARS-CoV2><SARS-CoV2 infection><SARS-associated corona virus 2><SARS-associated coronavirus 2><SARS-coronavirus-2><SARS-related corona virus 2><SARS-related coronavirus 2><SARSCoV2><Sampling><Seroprevalences><Services><Severe Acute Respiratory Distress Syndrome CoV 2><Severe Acute Respiratory Distress Syndrome Corona Virus 2><Severe Acute Respiratory Distress Syndrome Coronavirus 2><Severe Acute Respiratory Syndrome><Severe Acute Respiratory Syndrome CoV 2><Severe Acute Respiratory Syndrome CoV disease><Severe Acute Respiratory Syndrome coronavirus disease><Severe Acute Respiratory Syndrome-associated coronavirus 2><Severe Acute Respiratory Syndrome-related coronavirus 2><Severe acute respiratory syndrome associated corona virus 2><Severe acute respiratory syndrome corona virus 2><Severe acute respiratory syndrome coronavirus 2><Severe acute respiratory syndrome coronavirus 2 infection><Severe acute respiratory syndrome coronavirus 2 positive><Severe acute respiratory syndrome coronavirus 2 positivity><Severe acute respiratory syndrome related corona virus 2><Severities><Smoke><Social Distance><Social isolation><Specimen><Symptoms><System><Testing><Tobacco Consumption><Tobacco smoke><Tobacco use><Transmission><United States><Validation><Venous><Viral><Virus><Virus-HIV><Wuhan coronavirus><adjudication><adjudicative process and procedure><antibody based test><antibody test><biobank><biorepository><cardiac infarct><clinical care><clinical significance><clinically significant><co-morbid><co-morbidity><cohort><comorbidity><corona virus><corona virus disease 2019><coronary attack><coronary infarct><coronary infarction><coronavirus disease 2019><coronavirus disease 2019 associated death><coronavirus disease 2019 associated fatality><coronavirus disease 2019 associated mortality><coronavirus disease 2019 death><coronavirus disease 2019 diagnosis><coronavirus disease 2019 disease severity><coronavirus disease 2019 fatality><coronavirus disease 2019 induced death><coronavirus disease 2019 induced fatality><coronavirus disease 2019 induced mortality><coronavirus disease 2019 infection><coronavirus disease 2019 mortality><coronavirus disease 2019 positive><coronavirus disease 2019 positivity><coronavirus disease 2019 related death><coronavirus disease 2019 related fatality><coronavirus disease 2019 related mortality><coronavirus disease 2019 severity><coronavirus disease 2019 testing><coronavirus disease 2019 virus><coronavirus disease severity><death due to COVID-19><death due to COVID19><death due to SARS-CoV-2><death due to coronavirus disease 2019><death due to severe acute respiratory syndrome coronavirus 2><death in COVID><death in COVID-19><death in SARS-CoV-2><death in coronavirus disease><death in coronavirus disease 2019><death in severe acute respiratory syndrome coronavirus 2><depression><diagnosed with COVID-19><diagnosed with COVID19><diagnosed with SARS-CoV-2><diagnosed with coronavirus 2019><diagnosed with coronavirus disease 2019><diagnostic platform><diagnostic system><diverse populations><drug inhalation><drug use><drug/agent><environmental risk><fatality due to COVID-19><fatality due to COVID19><fatality due to SARS-CoV-2><fatality due to coronavirus disease 2019><fatality due to severe acute respiratory syndrome coronavirus 2><hCoV19><heart attack><heart infarct><heart infarction><heterogeneous population><high risk><homeless><host response><immune system response><immunoresponse><incarcerated><incarceration><infected with COVID-19><infected with COVID19><infected with SARS-CoV-2><infected with SARS-CoV2><infected with coronavirus disease 2019><infected with severe acute respiratory syndrome coronavirus 2><interest><marihuana><medical attention><mortality><mortality due to COVID-19><mortality due to COVID19><mortality due to SARS-CoV-2><mortality due to coronavirus disease 2019><mortality due to severe acute respiratory syndrome coronavirus 2><nCoV2><pandemic><pandemic disease><population diversity><prospective><pulmonary><racial diversity><racially diverse><reverse transcriptase PCR><service engagement><severe acute respiratory syndrome coronavirus 2 associated death><severe acute respiratory syndrome coronavirus 2 associated fatality><severe acute respiratory syndrome coronavirus 2 associated mortality><severe acute respiratory syndrome coronavirus 2 death><severe acute respiratory syndrome coronavirus 2 diagnosis><severe acute respiratory syndrome coronavirus 2 disease severity><severe acute respiratory syndrome coronavirus 2 fatality><severe acute respiratory syndrome coronavirus 2 induced death><severe acute respiratory syndrome coronavirus 2 induced fatality><severe acute respiratory syndrome coronavirus 2 induced mortality><severe acute respiratory syndrome coronavirus 2 mortality><severe acute respiratory syndrome coronavirus 2 related death><severe acute respiratory syndrome coronavirus 2 related fatality><severe acute respiratory syndrome coronavirus 2 related mortality><severe acute respiratory syndrome coronavirus 2 severity><severe acute respiratory syndrome coronavirus 2 testing><smoke inhalation><social factors><social role><substance use><substance using><symptomatic COVID-19><symptomatic COVID19><symptomatic coronavirus disease 2019><thromboembolic complications><thrombosis complications><thrombotic><thrombotic complications><tobacco product use><transmission process><treatment strategy><unhoused><vaping>