COVID-19 Neurological Georgia Cohort Study

The SARS-CoV-2 virus, like other coronaviruses, is neurotropic. A clue to early invasion and involvement of thenervous system in COVID-19 patients are the early symptoms of anosmia and hypogeusia. These may be seenin over 60% of COVID-19 positive patients. There is evidence from the humanized ACE2 transgenic mouse thatthe SARS-CoV-1 virus rapidly invades the olfactory bulb and spreads transneuronally throughout the olfactorypathwaysOur overall goal is to determine if there are long term neurological sequelae to SARS-CoV-2 viral infection inboth asymptomatic and symptomatic COVID-19 positive patients and to understand the contributing health andgenetic factors. To achieve this goal, we will establish a longitudinal prospective cohort of COVID-19 positivepatients and follow them long-term for neurological sequelae. COVID-19 preferentially affects African Americans(AA) and we will be enrolling in the Central Savannah River Area (CSRA) of Georgia where we expect abouthalf of our patients to be AA. Our hypothesis is that long term neurological sequela will occur over timein COVID-19 positive patients and there will be clinical, racial and genetic predictors of occurrence andseverity of neurological sequelae. To test this hypothesis, we will recruit 500 COVID-19 positive patientsat baseline and conduct follow-up annually. The specific aims are:Aim 1: Determine if COVID-19 positive patients have an increased risk to develop neurological complicationsand cognitive impairment over time and if there is disparity in occurrence and severity of complications in AA.Aim 2: Determine the relative contributions of pre-existing comorbidities, the initial clinical presentation (e.g.,anosmia) and genetic contributions to the development and severity of neurological complications.The technical goal of Year 1 is to recruit 500 COVID-19 positive patients for the baseline testing and conductyear 1 follow-up. The specific aims for Year 1: Aim 1. Determine the 1-year incidence rates of persistentanosmia, hypogeusia and neuropsychiatric disorders (i.e. cognition, depression and anxiety) and whether thereare differences between gender, ethnicity and age groups; Aim 2. Identify the potential contributing factors (i.e.severity of the COVID-19, pre-existing health conditions, the initial clinical presentation of neurological symptomsand unhealthy lifestyles including smoking and use of alcohol and illegal drugs) to the 1-year incidence ofpersistent anosmia, hypogeusia and neuropsychiatric disorders.