Exploring immunologic and genetic factors in COVID-19 with relevance for respiratory disease; a new BAMSE follow-up

Background:

The global pandemic with coronavirus (SARS-CoV-2) and COVID-19 poses a huge public health threat in the short-term with severe disease and increased mortality, and in the long-term with the risk of major sequalae in affected individuals. We propose to perform a new COVID-19 focused follow-up of participants in our longitudinal BAMSE cohort.

Objectives and research questions: 1. How does immunity to coronavirus (SARS-CoV2) develop among young adults during a 6-month period? 2. How does immunity develop in Sweden compared to individuals in Spain and the US?

3. Which clinical, environmental and lifestyle factors are associated with a) positive coronavirus serology and b) confirmed COVID-19 disease?

4. Which genetic and immunologic factors are associated with a) positive coronavirus serology and b) confirmed COVID-19 disease?

5. What are the individual and public health consequences of COVID-19 disease with respect to a) immunity and immune response b) lung function and pulmonary disease c) cardiometabolic outcomes? Work plan: All study participants in the BAMSE birth cohort (n=4,089) will be invited. Time plan:

Phase 1, June-Jul 2020: A short web survey on COVID-19 symptoms and lifestyle (incl. smoking and e-cig / snuff use) will be answered. Filter paper will be sent home to the participants with instructions and special device for personal home blood sampling. Analysis of IgG against SARS-CoV-2 will be done consecutively.

Phase 2, Sept-Dec 2020: All participants will be invited to the BAMSE clinic at Forskningscentrum SÖS for height, weight, blood pressure and lung function (spirometry, diffusing capacity) measurements, and blood sampling. A short web question will be answered. Phase 3, Jan – March 2021: As above (Phase 1).

Linkage with national and regional registers will be done. Immune phenotyping from the 24-year-follow-up (completed 2019) will be compared with new phenotyping and analyses of cellular immunity. Large-scale proteomics data (OLINK) and Genome-wide genotype (GWAS) data are available; new proteomics, transctiptomics and epigenomic analyses are now planned.

Significance: In the population-based BAMSE study, we have a unique opportunity in this project to study how SARS-Cov2 immunity develops in young adults, and thanks to our rich, longitudinal database and biobank, to evaluate key risk factors and health effects consequences of coronavirus infection.