The specific aim of this effort is to develop an understanding of how SARS-CoV-2 can be transmitted by infected persons into their environment throughout the course of their disease. Because COVID-19 can manifest as both severe and mild (even asymptomatic) respiratory disease and can progress from upper to severe acute respiratory distress syndrome throughout infection, the ways in which the disease is transmitted may vary from person to person and change throughout the course of illness. Measurements will be made using a suite of aerosol instrumentation to measure: the size of aerosol particles in the patient environment, size fractionated viral aerosol concentration and aggregated viral aerosol load. The relationships between clinical symptoms, patient viral load, the function of body systems and aerosol shedding of virus will be examined across all individuals. The combined data set will increase knowledge for SARS-CoV-2 transmission. For broader impacts, this study provides knowledge for use of the public health care system to improve safe working conditions for healthcare workers. It will inform best practices for personal protective equipment and help effective implementation of quarantines for infected individuals. For the general public, it will help inform public health organizations on how to advise people on the proper ways to protect themselves from infectious disease.

This project will combine size-segregated environmental aerosol measurements of SARS-CoV-2 around patients throughout their disease with clinical data of disease state, and renin?angiotensin system (RAS) function. Following initial diagnosis, patients will be monitored routinely throughout illness using an aerosol measurement approach developed based on preliminary sampling activities. Clinical data of viral activity will be obtained from each patient during the course of disease. In addition, patient serum samples will be analyzed for ACE2 and Angiotensin levels to investigate RAS activity as an independent measure of disease state. The relationships between clinical symptoms, patient viral load, RAS system activity and aerosol shedding of virus will be examined across all individuals. The combined data set will increase understanding of the biology of SARS-CoV-2 and its transmission over the course of disease progression. This type of longitudinal study of infectious disease transmission that considers both an investigation of modes of spread, coupled with quantifiable disease progression and interaction of the disease with the body?s regulatory systems represents a new model for understanding communicable disease and how to best protect healthcare workers and the general public. As such, the basic knowledge gained here is a broader impact. This RAPID award is made by the Symbiosis, Defense and Self-Recognition Program in the BIO Division of Integrative Organismal Systems, using funds from the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

National Science Foundation (NSF)
Division of Integrative Organismal Systems (IOS)
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Joanna Shisler
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University of Nebraska Medical Center
United States
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