REBRACOVID' - multicentre cohort study of the natural history and immunology of COVID-19 in Brazil

While a number of COVID-19 cohort disease demographic and mechanism studies are in progress, many unknowns remain, and each setting has offered distinctive insights. The clinical imperative to better understand the specific challenges in Brazil is strong: WHO data places Brazil 2nd in the world for COVID-19 cases and deaths. Furthermore, this huge country poses challenges of urban crowding and socioeconomic disparities and a healthcare system stretched by disease burden. On a COVID-19 disease trajectory lagging about 1-month behind Europe, there is potential to establish a large cohort during acute disease, taking into account mechanistic insights already gained. In doing so, we benefit also from building a consortium that bolts-on to our established consortium, international,collaborative studies, REPLICK (Brazil) and SPIICA (Anglo-Brazil, MRCNewton ref MR/S019553/1), designed to conduct analogous cohort studies in relation to the immunopathology and chronic disease phenotype in Chikungunya virus infection. We aim to recruit a cohort of 20,000 total infected, PCR+ COVID-19 cases from 9 centres across Brazil, as well as household contacts and healthcare workers. We will characterise basic demographics of those affected, including impacts of age, gender, occupation, ethnicity, co-morbidities, socio-economic factors, blood biochemistry, antibody and T cell immunity (and durability), CT findings, as well as defining chronic sequelae. We will also investigate treatment modalities and co-infections in relation to disease outcome. Communication of findings from this cohort study will be valuable to inform management of the pandemic in Brazil and elsewhere.