Grant: Op Grant: Emerging COVID-19 Research Gaps & Priorities - Post COVID-19 condition

COVID-19 has infected over 135 million and killed over 3 million people worldwide. In Canada, over one million individuals have been infected by the virus and 24,000 have succumbed to the disease. Even in survivors of COVID-19, many are left with long-term disability and symptoms, which is now referred to as the "post-covid syndrome". Although the data are still scarce, it is thought that approximately 10% of COVID-19 survivors develop a post-covid syndrome, which is frequently characterized by symptoms of fatigue, headache, breathlessness, and loss of smell beyond 12 weeks post-infection. The mechanisms driving post-covid syndrome are largely unknown. However, recent studies indicate that the common risk factors for post-covid syndrome are: 1) increasing age; 2) increased body mass index; 3) female sex; and 4) lung comorbidities. The largest study of its kind to date indicates that the most common co-morbidity in this syndrome is asthma, followed by "lung disease" (other than asthma). Together, pulmonary disorders (asthma and "lung disease") were found in one-third of all those who experienced the post-covid syndrome. In contrast, only 5% had heart disease or diabetes and less than 1% had kidney disease. These data suggest that airway diseases are the leading predisposing factor for post-covid syndrome (Sudre et al Nat Med 2021). Here, we will investigate the mechanisms behind this observation. Our hypothesis is that SARS-CoV2 infection in individuals with airways disease such as asthma or COPD results in inflammatory responses that damage the airway, leading to persistent long covid symptoms in susceptible individuals. We will investigate this hypothesis by evaluating imaging and genomic changes in the airways of COVID survivors and determine whether these changes are associated with the post-covid syndrome. These results will lead to novel biomarkers to predict and diagnose post-covid syndrome.