Improving the Care Cascade for HIV-associated Kaposi's Sarcoma in sub-Saharan Africa

Project SummaryA subset of patients with coronavirus disease-2019 (COVID-19) develop cutaneous manifestations of theirsevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, including pernio of their feet andhands, known as “COVID toes.” These patients tend to have a mild disease course, which may indicatesuccessful viral control by the host.

By leveraging an existing patient cohort at Massachusetts General Hospital(MGH), and the extensive laboratory infrastructure at the NIH, this proposal aims to elucidate the complexdeterminants of a unique phenotype of COVID-19: pernio/ “COVID toes,” with the following Aims. Aim 1: Toevaluate genetic determinants of pernio-like lesions (“COVID toes”) in response to SARS-CoV-2 infection.

Aim2: To characterize the inflammatory and serological response during acute infection and convalescence ofpatients with SARS-CoV-2 who develop pernio-like lesions as a symptom of COVID-19. Biological samples willbe obtained at MGH and sent to collaborating labs at the NIH.

In particular, this proposal will help usunderstand the host immune response to COVID-19 by focusing on patients who have controlled the diseaseand have had relatively mild clinical courses, as characterized by their skin lesions.

Successful completion ofour aims will immediately and directly respond to important gaps in our knowledge regardingmild/asymptomatic COVID-19, which in turn can help inform our understanding of how to harness this type ofsuccessful control for other patients.