The North American ? AIDS Cohort Collaboration on Research and Design (NA-ACCORD), the Region 1 representative of the IeDEA network, aims to describe the HIV epidemic in the US and Canada and answer questions important to the contemporary care and health of persons with HIV. We propose to leverage the research infrastructure of the NA-ACCORD to support our infectious disease epidemiologists and clinical co- investigators as they pivot to answer urgent COVID-19 questions in people with (PWH) and without (PWOH) HIV among existing and new cohorts. By supporting a) 2 existing cohorts and the establishment of 3 longitudinal COVID-19 clinical cohorts curated from available electronic health record (EHR data), b) data management and analytic expertise specific to the profound health impacts of infectious disease, c) a library of COVID-19 data collection tools, and d) the sharing of EHR-based algorithms for COVID-19, we will accelerate the answers to the following urgent COVID-19 questions: 1) Who is getting tested for SARS-Cov-2, what proportion are positive, and what are predictors of a positive test? 2) What are risk factors for hospitalization after testing positive for SARS-Cov-2? 3) Do angiotensin-converting enzymes (ACE) inhibitors or angiotensin II type-I receptor blockers (ARBs) increase the risk of severe COVID-19 illness? 4) What is the impact of the healthcare system?s adaptation to the surge of people becoming ill with COVID-19 on the all-cause mortality among those with HIV (a chronic condition that requires routine care)? Infectious disease epidemiologists and clinicians are needed to answer urgent COVID-19 questions. The NA-ACCORD will support co-investigators and their analytic teams, provide the infrastructure to share information, and examine the heterogeneity in answering these COVID-19 questions investigated expeditiously in 5 existing and new cohorts.
Urgent COVID-19 questions need answers. We propose using the NA-ACCORD research infrastructure to support our infectious disease epidemiologists and clinical co-investigators as they pivot to answer urgent COVID-19 questions about testing, risk factors for hospitalization with COVID-19, the risk of angiotensin- converting enzymes (ACE) inhibitors or angiotensin II type-I receptor blockers (ARBs) with more severe COVID-19 disease, and the impact of the healthcare system?s adaptation to COVID-19 on people who have a chronic condition that requires routine care (such as HIV). Using data from 2 existing cohorts of people with and without HIV and 3 new cohorts following people with COVID-19 (regardless of their HIV status), we will generate evidence to answer these urgent COVID-19 questions.
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