School Inner-City Asthma Intervention Study : Human Epidemiology and Response to SARS-COV-2 (HEROS) Supplement

学校内城区哮喘干预研究：人类流行病学和对 SARS-COV-2 (HEROS) 补充剂的反应

• 批准号: 10162929
• 负责人: WANDA PHIPATANAKUL
• 金额: $ 30.2万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-19 至 2021-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10162929
• 关键词: 2019-nCoV; 21 year old; Adult; Affect; Air; Allergens; Allergic Disease; American; Asthma; Boston; COVID-19; Caregivers; Child; Clinical Research; Clinical Trials; Communicable Diseases; Databases; Detection; Effectiveness; Enrollment; Epidemiology; Exposure to; Family; Funding; Goals; Home environment; Hour; Household; Human; Human Subject Research; Hypersensitivity skin testing; IgE; Incidence; Infection; Infrastructure; Institutional Review Boards; Intervention; Intervention Studies; Letters; Lung diseases; Molds; Morbidity - disease rate; National Institute of Allergy and Infectious Disease; Nose; Parents; Participant; Phenotype; RNA; Research Design; Research Proposals; Sampling; Schools; Severe Acute Respiratory Syndrome; Siblings; Source; Students; Surveys; Symptoms; Testing; Time; United States National Institutes of Health; Visit; base; cohort; common rule; educational atmosphere; elementary school; environmental intervention; epidemiologic data; expectation; improved; indexing; infection burden; inner city; interest; mouse allergen; parent grant; particulate pollutant; phenotypic data; primary endpoint; prospective; recruit; response; sample collection; skin hypersensitivity; viral RNA; viral detection; virology

Project Summary/Abstract COVID-19, the infectious disease caused by SARS-CoV-2, is rapidly affecting humans around the globe. While initial epidemiological data have focused on cases that resulted in severe respiratory disease seen predominantly in adults, little information regarding the infection burden in children is available. This is complicated by the observation that many virologically-confirmed cases in children are asymptomatic. Home environments are established sources of exposure that exacerbate symptoms of asthma and home-based interventions are proven effective. Prior to the inception of the School Inner-City Asthma Study (SICAS-1), no American study had comprehensively evaluated the relationship between urban exposures in school, classroom, and home environments and asthma morbidity. Nearly all elementary school children spend 7 to 12 hours a day in school, and most of that time is spent in one classroom. From SICAS-1, we learned that student classroom-specific mouse allergen, mold, and particulate pollutant exposure is associated with worsening symptoms. We also demonstrated our ability to reduce these exposures in a busy, school setting. Our proposal builds upon our established, successful school-based infrastructure to determine whether a school/classroom intervention will efficiently and effectively improve asthma morbidity by reducing these exposures. Our goal is to determine the efficacy of school/classroom based environmental intervention in reducing asthma morbidity in urban schoolchildren. Our central hypothesis is that reducing classroom/school exposure to mouse allergen, mold, and particulate pollutants will decrease asthma morbidity in students with asthma. We plan to test this hypothesis in an intervention study of 250 elementary students with asthma from multiple classrooms in 40 Boston inner-city elementary schools. Our clinical trial aims are to determine the effectiveness of a school/classroom based environmental intervention (school integrated pest management and classroom air purifying filter units within these schools) to reduce asthma morbidity. The supplement to the parent grant is to leverage the cohort for the to participate in the multi-center survey entitled Human Epidemiology and Response to SARS-CoV-2 (HEROS), study. This study can be rapidly implemented and realistically conducted without necessitating any visits to a clinical research center. In addition to the need for surveying children for asymptomatic SARS-CoV-2 infection, this study will allow a comparison between children with asthma and other atopic conditions and children without those conditions through remote surveys and collection of samples. This study is an unprecedented, high impact opportunity to leverage the parent trial with in scope in understanding how SARS-C0V-2 differentially affects children with the condition of interest, compared to children without it.

项目概要/摘要 COVID-19 是由 SARS-CoV-2 引起的传染病，正在迅速影响全球人类。 虽然最初的流行病学数据集中于导致严重呼吸道疾病的病例 主要发生在成人中，有关儿童感染负担的信息很少。这是 由于观察到许多病毒学确诊的儿童病例没有症状，情况变得更加复杂。家 环境是加剧哮喘症状的既定暴露源，并且以家庭为基础 干预措施被证明是有效的。在学校内城哮喘研究 (SICAS-1) 启动之前，没有 美国的研究综合评估了学校中城市暴露程度之间的关系， 教室和家庭环境与哮喘发病率。几乎所有小学生都会花费 7 到 每天在学校上课12个小时，其中大部分时间都在一间教室里度过。从 SICAS-1 中我们了解到 学生课堂特定的小鼠过敏原、霉菌和颗粒污染物暴露与 症状恶化。我们还展示了在繁忙的学校环境中减少这些暴露的能力。 我们的建议建立在我们已建立的、成功的校本基础设施的基础上，以确定是否 学校/课堂干预将通过减少这些因素有效地改善哮喘发病率 曝光。我们的目标是确定基于学校/课堂的环境干预的有效性 降低城市学童的哮喘发病率。我们的中心假设是减少教室/学校 接触小鼠过敏原、霉菌和颗粒污染物会降低患有哮喘病的学生的哮喘发病率 哮喘。我们计划通过一项针对 250 名患有哮喘的小学生的干预研究来检验这一假设。 40 所波士顿市中心小学的多个教室。我们的临床试验目的是确定 基于学校/教室的环境干预措施的有效性（学校害虫综合管理 以及这些学校内的教室空气净化过滤装置），以减少哮喘发病率。的补充 家长补助金是为了利用队列参加题为“人类”的多中心调查 流行病学和对 SARS-CoV-2 (HEROS) 的反应，研究。这项研究可以快速实施并 无需访问任何临床研究中心即可实际进行。除了需要 这项研究对儿童进行无症状 SARS-CoV-2 感染情况的调查，以便对 通过远程调查对患有哮喘和其他特应性疾病的儿童以及没有这些疾病的儿童进行调查 和样本收集。这项研究是利用家长试验的前所未有的、具有高影响力的机会 有助于了解 SARS-C0V-2 如何对患有相关病症的儿童产生不同的影响， 与没有它的孩子相比。