Document text
Principal Investigator: Roger Detels
Organization: UNIVERSITY OF CALIFORNIA LOS ANGELES
Fiscal Year: 2020
Award: $110,256
Funding agency: National Heart Lung and Blood Institute
ABSTRACT
COVID-19 cases continue to rise, with over 3,000,000 cases and 130,000 deaths in the US and almost 12
million cases worldwide to date. Manifestations of SARS CoV-2 infection range from asymptomatic to mild,
moderate, or severe disease, and primarily affects the lung, but increasing data suggests involvement of other
organ and blood systems. Studies document more severe disease and higher mortality among people who are
older and/or have co-morbidities, such as hypertension, diabetes, obesity, and chronic lung disease. However,
there is a paucity of data regarding the acquisition, occurrence and severity of infection among people with HIV
(PWH). There is also little data to guide prevention and treatment recommendations for this population, many
of whom are older and have comorbidities that may increase not only their risk for acquiring infection, but also
the morbidity and mortality among those who acquire infection. Moreover, early reports suggest substantial
racial disparities in US COVID-19 rates, with increases in mortality among African Americans. The MACS-
WIHS Combined Cohort Study (MWCCS), the largest and longest-running observational cohort of men and
women living with or at risk for HIV in the US provides a unique opportunity to address important knowledge
gaps in the acquisition, occurrence, severity and outcomes of COVID-19. The MWCCS is a geographically and
racially/ethnically diverse cohort of aging men and women with a high prevalence of risk factors for progression
to severe COVID-19 disease including hypertension, diabetes, obesity, and smoking. The MWCCS has a rich
biorepository of specimens, collects rigorous clinical measures including pulmonary, cardiac, kidney,
neurocognitive, and physical function, body composition and has performed cohort-wide genome association
studies. The overarching goal of this application is to understand the impact of the COVID-19 epidemic among
US men and women with or at risk for HIV infection and to evaluate host factors that contribute to disease
acquisition, expression, severity and recovery. The proposed studies will determine COVID incidence, short-
term and long-term clinical outcomes, including thrombotic and pulmonary sequelae, and how racial and
geographic disparities; immune and genetic risk factors impact these outcomes in the MWCCS.
Terms: <1-Beta-D-ribofuranosyl-1,2,4-triazolo-3-carboxamide><1-Beta-D-ribofuranosyl-1H-1,2,4-triazole-3-carboxamide><2019 novel coronavirus><2019-nCoV><ACE Inhibitors><AIDS Virus><APOE e4><APOE-ε4><APOEε4><ARDS><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome Virus><Acute Respiratory Distress><Acute Respiratory Distress Syndrome><Address><Admission><Admission activity><Adult ARDS><Adult RDS><Adult Respiratory Distress Syndrome><Affect><African American><Afro American><Afroamerican><Age><Aging><Alleles><Allelomorphs><Angiotensin I-Converting Enzyme Inhibitors><Angiotensin-Converting Enzyme Antagonists><Angiotensin-Converting Enzyme Inhibitors><Anti-HIV Positivity><Anti-Retroviral Agents><Antiretroviral Agents><Antiviral Agents><Antiviral Drugs><Antivirals><Anxiety><Appointment><Area><Azadose><Azithromycin><Azitrocin><Azythromycin><Biological Markers><Black Populations><Blood><Blood Coagulation Factor I><Blood Coagulation Factor One><Blood Factor One><Blood Reticuloendothelial System><Body Composition><COVID><COVID-19><COVID-19 epidemic><COVID-19 pandemic><COVID19><COVID19 epidemic><COVID19 pandemic><Cardiac><Cardiac Diseases><Cardiac Disorders><Cardiac Failure Congestive><Cardiomyopathies><Cardiovascular><Cardiovascular Body System><Cardiovascular Organ System><Cardiovascular system><Caring><Cessation of life><Chlorochin><Chloroquine><Chronic lung disease><Clinical><Clotting><CoV disease><Coagulation><Coagulation Factor I><Coagulation Factor One><Coagulation Process><Cohort Studies><Concurrent Studies><Congestive Heart Failure><Da Nang Lung><Data><Death><Development><Diabetes Mellitus><Disease><Disease Outbreaks><Disease Outcome><Disorder><Epidemic><Estrogens><Ethnic Origin><Ethnicity><Exposure to><Factor I><Factor One><Fibrinogen><Future><GS-5734><GWA study><GWAS><Genetic><Genetic Risk><Genotype><Geographic Area><Geographic Locations><Geographic Region><Geographical Location><Geography><Goals><Guide prevention><HBV><HCV><HIV><HIV Infections><HIV Positive><HIV Positivity><HIV Seroconversion><HIV Seronegativities><HIV Seronegativity><HIV Seropositivity><HIV antibody positive><HIV negative><HTLV-III Infections><HTLV-III Seroconversion><HTLV-III Seronegativities><HTLV-III Seronegativity><HTLV-III Seropositivity><HTLV-III-LAV Infections><Health><Healthcare><Heart Decompensation><Heart Diseases><Heart Vascular><Hepatitis B Virus><Hepatitis C virus><High Prevalence><Homologous Serum Hepatitis Virus><Hospital Admission><Hospitalization><Host Factor><Host Factor Protein><Human Immunodeficiency Viruses><Human T-Lymphotropic Virus Type III Infections><Hydroxychlorochin><Hydroxychloroquine><Hypertension><Immune><Immune Cell Activation><Immunes><Impairment><Incidence><Individual><Infection><Inflammation><Integration Host Factors><Intensive Care Units><Interruption><Kaletra><Khingamin><Kidney><Kidney Urinary System><Kininase II Antagonists><Kininase II Inhibitors><Knowledge><LAV-HTLV-III><Lopinavir/Ritonavir><Lung><Lung Respiratory System><Lymphadenopathy-Associated Virus><Measures><Mechanical ventilation><Mental Depression><Morbidity><Morbidity - disease rate><Myocardial Diseases><Myocardial Disorder><Myocardiopathies><NHLBI><National Heart, Lung, and Blood Institute><Neurocognitive><Neurologic><Neurological><Obesity><Organ><Outbreaks><Outcome><Oxychlorochin><Oxychloroquine><Participant><Patients><Personal Satisfaction><Physical Function><Population><Poverty Areas><RTCA><Race><Racial Group><Racial Stocks><Recommendation><Recovery><Reporting><Research><Research Specimen><Respiratory physiology><Ribavirin><Ribovirin><Risk><Risk Factors><Running><SARS><SARS coronavirus disease><SARS-CoV disease><SARS-CoV-2><SARS-CoV2><SARS-associated coronavirus 2><SARS-coronavirus-2><SARS-related coronavirus 2><Severe Acute Respiratory Syndrome><Severe Acute Respiratory Syndrome CoV disease><Severe Acute Respiratory Syndrome coronavirus disease><Severe acute respiratory syndrome coronavirus 2><Severities><Severity of illness><Shock Lung><Smoking><Social support><Specimen><Spirometry><Stiff lung><Survivors><Symptoms><System><Therapeutic Estrogen><Time><Tribavirin><Ultreon><Vascular Hypertensive Disease><Vascular Hypertensive Disorder><Viral><Virus-HIV><Vulnerable Populations><Woman><Wuhan coronavirus><Zithromax><Zitromax><access to health care><access to healthcare><accessibility of health care><accessibility to health care><accessibility to healthcare><adiposity><ages><anti-retroviral><anti-viral agents><anti-viral drugs><anti-virals><antiretroviral><apo E-4><apo E4><apo epsilon4><apoE epsilon 4><apoE-4><apoE4><apolipoprotein E epsilon 4><apolipoprotein E-4><apolipoprotein E4><bio-markers><biobank><biologic marker><biomarker><biorepository><black American><cerebral vascular><cerebro-vascular><cerebrovascular><chronic heart failure><circulatory system><clinical predictors><co-infection><co-morbid><co-morbidity><cohort><coinfection><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><corpulence><corpulency><corpulentia><depression><develop therapy><developmental><diabetes><differences in health><disease severity><disparities in race><ethnic diversity><ethnically diverse><experience><genetic risk factor><genome wide association><genome wide association scan><genome wide association studies><genome wide association study><genomewide association scan><genomewide association studies><genomewide association study><geographic site><health care><health care access><health care availability><health care service access><health care service availability><health difference><healthcare access><healthcare accessibility><healthcare availability><healthcare service access><healthcare service availability><heart disorder><high blood pressure><hyperpiesia><hyperpiesis><hypertensive disease><immune activation><improved><inherited factor><intervention development><lung function><mechanical respiratory assist><men><men's><metropolitan><mortality><myocardium disease><myocardium disorder><obese><obese people><obese person><obese population><pandemic><pandemic disease><pulmonary><race disparity><racial and ethnic><racial disparity><remdesivir><renal><respiratory><respiratory function><response><sex><social factors><social support network><therapy development><treatment development><vulnerable group><well-being><wellbeing><wet lung><whole genome association analysis><whole genome association studies><whole genome association study>