COVID-19 Research

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  1. Goal
  2. Background
  3. Gaps and Opportunities
  4. Specific Areas of Interest
  5. References

September 2020

Division of Extramural Research

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Goal

The overall objectives are to 1) encourage research that would inform prevention, detection, diagnosis, and treatment of Coronavirus Disease 2019 (COVID-19) and COVID-19-related illnesses, and 2) stimulate innovations in health surveillance and care delivery in an era of the COVID-19 pandemic, within the mission of NIDCR.

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Background

Globally, the death toll for COVID-19 caused by the coronavirus SARS-CoV-2 surpassed 828,000, and in the United States, more than 180,000 individuals have succumbed to the disease by late August 2020. While physical distancing, mask wearing, hand washing, contact tracing, and quarantining measures have curbed the disease by late May, challenges in adhering to personal behavioral change fueled a resurgence of infections, hospitalizations, and deaths in many parts of the country by late June. Thus, we must have long term mitigation approaches through safe and effective prevention and treatment, as well as rapid, accurate, and sensitive detection and diagnosis that would fundamentally alter the trajectory of infection, transmission, and disease manifestation rates. Additionally, dentists, dental assistants, and dental hygienists are three of the top five occupations with highest risk of exposure to SARS-CoV-2 at work. As such, at times of this lingering pandemic, transformation in care delivery is needed to protect practitioners and their patients, and to ensure that individual and population health is maintained, and disparities are eliminated.

In alignment with the NIH Strategic Plan for COVID-19 Research, NIDCR participates in developing several trans-NIH initiatives related to pathogenic mechanisms in organ systems, data science, diagnostics, pharma engagement, practice change, and behavioral, social, and economic impact. NIDCR also released two Notices of Special Interest encouraging research of immediate and high impact to protect and ensure the safety of personnel and patients in dental practices during the pandemic. These topics include prevention of SARS-COV-2 transmission and improvements in the detection and diagnosis of COVID-19; as well as acquisition of a more robust understanding of SARS-CoV-2 pathogenesis. Most recently, NIDCR has been active in the trans-NIH Rapid Acceleration of Diagnostics (RADx) initiative, which is a national call to speed innovation in the development, commercialization, and implementation of technologies for COVID-19 testing. Under the RADx Underserved Population (RADx-UP) program, NIDCR joins forces with NIH Institutes, Centers, and Offices, in four Funding Opportunities to solicit for community engagement projects across the United States, for assessing and expanding COVID-19 testing for underserved and/or vulnerable populations, which include health disparity populations, particularly African Americans and American Indians/Alaska Natives; those in nursing homes, jails, rural areas, or underserved urban areas; pregnant women; and the homeless. Further, under the RADx Radical (RADx-rad) program, NIDCR developed an initiative on “Novel Biosensing for Screening, Diagnosis and Monitoring of COVID-19 From Skin and The Oral Cavity”, in collaboration with NCATS, as well as another initiative on “Chemosensory Testing as a COVID-19 Screening Tool”, in collaboration with NIDCD. NIDCR also joined several other initiatives focusing on novel, non-traditional approaches to testing, including “Exosome-based Non-traditional Technologies Towards Multi-Parametric and Integrated Approaches for SARS-CoV-2”, and “Multimodal COVID-19 Surveillance Methods for High Risk Populations in Densely Populated Facilities”.

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Gaps and Opportunities

Through the two NIDCR Notices of Special Interest, we are supporting several projects that utilize the infrastructure of the National Dental Practice-Based Research Network to investigate the transmissibility of SARS-CoV-2 through aerosols or contaminated PPEs, and mitigation approaches, including barrier methods, practice modifications, and virtual visits. A Registry of dental practitioners has also been launched to investigate crucial safety issues associated with dental practices. Several research supplements have been awarded, including coordination of a clinical trial on the effectiveness of three oral rinses to decrease SARS-CoV-2 viral load, oral and overall health following stay-at-home and physical distancing measures affecting vulnerable populations, and role of host and oral microbial factors in modulating the engagement of SARS-CoV-2 and ACE2 for viral entry. To date, NIDCR is participating on several Funding Opportunity Announcements and Notices of Special Interest related to COVID-19 and COVID-19-related illnesses. Applications are pending receipt or review. Pursuing this seeded effort and sharpening the focus to address remaining knowledge gaps and capture emerging research opportunities unique to the mission of NIDCR is needed.

Synergizing with a myriad of initiatives across NIH and responding to a palpable sense of public health urgency, NIDCR is positioned to address COVID-19 research knowledge gaps unique to our mission, as well as to facilitate broad and rapid dissemination of research findings. Outcomes from this initiative are expected to strengthen the knowledgebase of COVD-19 disease mechanisms and presentations in the oral cavity, expand the spectrum of SARS-CoV-2 detection and COVID-19 diagnosis, transform the practice of craniofacial, dental, and oral health care, and close the gap in oral health disparities and inequities through personalized risk assessment and technologies. Long term, biomedical and behavioral interventions to combat COVID-19 and COVID-19-related illness, as well as technologies for detecting and diagnosing the disease, and mitigating spread, could be mobilized and adapted to manage the next pandemics.

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Specific Areas of Interest

This initiative broadly covers COVID-19 research topics of high priority to NIDCR, spanning the spectrum from basic to implementation sciences. It is anticipated that one or more Funding Opportunity Announcements and/or Notices of Special Interest would be released to determine, as examples:

  • Transmissibility of SARS-CoV-2 through droplets, aerosols, and contaminated surfaces, and mitigation strategies, including containment, disinfection, and use of antiseptic oral rinses, in dental settings, or hospital settings delivering craniofacial, dental, and oral health care
  • Techniques to minimize aerosolization during dental procedures, non-aerosolizing procedures that are equally or more effective, use of robotics for dental care, and medical management of craniofacial, dental, and oral diseases to reduce the need for dental procedures
  • Strategies to triage and manage patients with oral care needs, including dental office on site SARS-CoV-2 testing, utilization of remote/virtual means, and digital health tools to provide a platform for supporting standard elements of oral health and hygiene and individualized care or consultation
  • Impact of dental care delivery delays on oral health needs and access to care, including care seeking at emergency departments, as well as food insecurity and adverse psychosocial, emotional, behavioral, and economic consequences of the COVID-19 pandemic that could negatively impact oral health, particularly in vulnerable, special needs, and underserved populations
  • Impact on dental practitioners, including their mental health, as they face unique challenges during this pandemic and uncertainties on reopening their practices, their risk of infection by specialties, practice types, and other risk factors, as well as chronic occupational health issues
  • Oral mucosal immune responses to SARS-CoV-2 infection, including genetic factors, immune defense mechanisms, oral and salivary reservoirs, viral replication and shedding, risk of co-infections, triggers of systemic cytokine storm, and long term effects of COVID-19 and treatment of COVID-19 on health across races, ethnicities, genders, and lifespan
  • Contribution of oral/nasal microbiota and ACE2 receptor on SARS-CoV-2 infectivity and carriage in oral fluids and nasal secretions, as gateways to the spread of infection into the respiratory tract, and therapeutic modulators of oral/nasal microbiota or blockers of viral-receptor interactions that may limit infectivity of SARS-CoV-2
  • Oral biomolecular signatures of onset, progression, and resolution of COVID-19, including viral loads in saliva and at oral sites, biomarkers of infection, inflammation, and immune response, as well as potentially, changes in lips and oral cavity environment, such as microbiota, blood supply, oxygenation, sense of taste, and volatile metabolites
  • Oral biosensing technologies for real-time, continuous or periodic measurements that will enable not only traditional rapid virus and antibodies detection from oral biospecimens, but also for novel oral biomolecular signatures, and integration of such technologies to everyday settings and routines for individual and population health surveillance
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References

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Last Reviewed
December 2024