The Ontario COVID-19 Prospective Cohort Study [Funder: Institutional Funding]

In December 2019, a novel coronavirus (COVID-19)infected pneumonia was identified in Wuhan, China, and is a current global pandemic. Early studies are emerging, but it is still unclear what may determine better or worse outcomes for these patients and their caregivers, and what the long-term consequences that having this virus might be. COVID-19 leads to severe respiratory, cardiac, neurologic and kidney complications that may warrant hospital and ICU admission. Current data suggests that 80-85% of people infected with COVID-19 have mild symptoms and are not hospitalized. Of those who are hospitalized, 60-80% will be discharged from hospital after a few days, and 20-40% may require ICU care and mechanical ventilation (approximately 4-6% of all COVID-19 positive patients). The determining factors of these varied clinical paths are urgently needed and unknown. Our investigator group is proposing an Ontario COVID-19 Prospective Cohort Study (OnCovP). This will be a multi-centre, one-year follow-up of COVID-19 patients who are hospitalized in acute care hospitals in Ontario. Our overall objectives are to determine short- (in hospital) and longer-term (1, 3, 6 and 12 months post-acute hospital discharge) outcomes in patients and their caregivers, and the clinical, sociodemographic, genetic/ transcriptomic/epigenomic predictors of these outcomes. Our overall hypothesis is that clinical risk factors (including but not limited to age, baseline health, socio-demographic status, comorbid illness and candidate genetic/transcriptomic/epigenomic risk factors) are determinants of short- and long-term outcomes in patients with COVID-19. We will prospectively recruit 500 consecutive patients (>age 16) who are COVID-19+ and admitted to hospitals in Ontario through the GEMINI (general internal medicine) and RECOVER (critical care) networks of investigators, as well as their caregivers. By leveraging expertise from investigators across disciplines and divisions, we have constructed a suite of five complementary projects that explore the genetic, transcriptomic and epigenomic evaluation of COVID-19 infection across the illness and recovery trajectory during the acute illness and in the context of multidimensional long-term outcomes. We will access electronic data through the GEMINI network, and explore AI analyses and linkages to ICES data. This project will contribute new knowledge to outcomes in patients with COVID-19 infections and will inform large-scale public health planning, clinical care, and ongoing resource needs.