Alzheimer's Association International Cohort Study of Chronic Neuropsychiatric Sequeale of SARS‐CoV‐2 (CNS‐SARS‐CoV‐2): Developing topics. (7th December 2020) - de Erausquin, Gabriel A.
Abstract: Background: The pandemic of SARS‐CoV‐2 is focusing all energies on the impact on survival of affected individuals, treatment and prevention, but increasingly attention is focusing on its enduring consequences. We established a global consortium to study a longitudinal representative cohort of individuals, to characterize neurological and neuropsychiatric sequalae from direct viral, immune‐, vascular‐ or accelerated neurodegenerative injury to the central nervous system (CNS). Method: We propose to characterize the neurobehavioral phenomenology associated with SARS‐CoV‐2 in a large, multinational, longitudinal cohort of post COVID‐19 infection patients following three sampling strategies: 1) Opportunity sample of patients discharged after hospital admission for COVID‐19 related symptoms. 2) A stratified random sample from COVID‐19 testing registries (including asymptomatic and negative participants). 3) Ascertaining COVID‐19 exposure (antibody) status in ongoing longitudinal, community‐based cohort studies that are already collecting biosamples, cognitive, behavioral and neuroimaging data. We will obtain core data within 6 months of discharge or testing. Core characterization will include interviews with the Schedules of Clinical Assessment in Neuropsychiatry (SCAN), neurological exams, emotional reactivity scales and a neurocognitive assessment. Wherever feasible, we will also collect neuroimaging, biosamples and genetic data. Longitudinal follow up will be conducted at 9 and 18 months of the initial evaluation. An mHealth keeping‐in‐touch process will be set up to minimize attrition rates. The population cohorts provide a large, unbiased, normative and validation sample, albeit with more heterogenous outcome ascertainment. They also permit examination of pre‐ and post‐COVID trends in symptoms and biomarkers. Since some ethnic groups, as well as in individuals with blood type A, are at higher risk of COVID‐19 infection and death, a role of genetics in determining susceptibility to infection and poor outcomes seems well supported. We will collect genome‐wide genotypes from our cohort individuals to address the role of ancestry and genetic variation on susceptibility to neuropsychiatric sequelae. High rates of mutation in COVID‐19 strongly suggest that viral infectivity, including neurotropism, may not be uniform across countries affected by the pandemic. Results: Pending. Conclusion: Our consortium is in a unique position to address the interaction between genetics (including ancestral DNA), and viral strain variation on CNS sequelae of SARS‐CoV‐2.