Enhancing the Risk Stratification of Severe Arboviral diseases using host-response Biomarkers in Brazil.

Arboviruses such as dengue, Zika, and chikungunya, are experiencing a rapid surge in incidence and geographical distribution, representing a global public health threat. Improved risk assessment tools for arboviral diseases are urgently needed to enhance clinical management, since current risk stratification is based on algorithms with limited prognostic accuracy. Strong evidence suggests that immune and endothelial activation markers can reliably identify infections likely to progress to severe outcomes; however, data on specific arboviruses are scarce and conflicting. The main aim of RISE-ARBB is to enhance early identification of severe arboviral diseases. The specific objectives are to: (1) evaluate head-to-head a wide panel of host-response biomarkers for early identification of severe arboviral diseases, using a large prospective cohort study and Luminex platform; (2) assess the prognostic performance of two novel point-of-care rapid triaging tests based on the quantification of sTREM1 and Angpt2 markers; (3) develop an evidence-based algorithm integrating the best performing marker(s) with clinical severity indicators to improve clinical guidelines; and (4) develop an exploitation strategy, including regulatory and go-to-market plan. Such objectives will be addressed through a prospective cohort study involving ~2,000 individuals over 1 year-old presenting with symptomatic arbovirus infection at emergency departments of 3 hospitals in Brazil, the global epicenter of arbovirus epidemics. The results have the ground-breaking potential to avoid preventable deaths and decrease health system costs during future arbovirus outbreaks and epidemics globally. This fellowship will enable me to upgrade my training in translational research on arboviral diseases in endemic settings and prognostic strategies for their management, while establishing a global network and laying the foundation for a successful ERC application and independent academic career.