Covid 19: Pilot: Center for Appalachian Research in Environmental Sciences: Home Air Particulate Concentration Contributes to the Development of Lung Fibrosis in COVID 19 ARDS Survivors

Examining the Contribution of Home Air Particulates to the Development of Lung Fibrosis Post COVID 19 ARDS There have been over 400,000 Kentuckians who have contracted SARS-CoV-2. With advances in care, mortality has dropped however; this leaves a large portion of survivors who may suffer long-term effects of viral infection. Patients admitted to the intensive care unit from COVID-19 pneumonia require supplementary oxygen support in the form of high flow nasal cannula and/or mechanical ventilation. These patients are at heightened risk for post-ICU sequelae. Here at UK, we have one of the leading ICU recovery clinics in the US and have been able to better characterize and follow these patients after discharge. Many patients who require this type of oxygen support can go on to develop lung scarring or fibrosis. While post-COVID-19 fibrosis has been reported in the literature, the exact pathobiological mechanisms for development are not well understood, thus research is warranted. Work by our team and others have also highlighted a role for poor air quality leading to poor respiratory outcomes. Thus, this proposal builds on our expertise in post-ICU and environmental science to better understand the contributions of indoor air quality to the risk of post-COVID-19 pulmonary fibrosis. Using a transdisciplinary approach, we will work with community stakeholders to follow patients post-COVID-19 to examine home air quality, long-term quality of life, pulmonary function, and healthcare utilization. This is the first known study to investigate the potential negative effect of home air quality on healing rates of COVID19 pneumonia. This work may change the paradigm of how we approach post-ICU care.