Disparities in COVID Disease Severity and Outcomes in New York City

纽约市新冠疾病严重程度和结果的差异

基本信息

批准号：
10159057
负责人：
JULIANNE L IMPERATO-MCGINLEY
金额：
$ 74.92万
依托单位：
WEILL MEDICAL COLL OF CORNELL UNIV
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-09-05 至 2022-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10159057
关键词：
2019-nCoV Acute Admission activity Affect African American Area Artificial Intelligence Asians Beds Biological Biological Factors Biology Blood COVID-19 Caring Caucasians Center for Translational Science Activities Chicago Cities Clinical Clinical Medicine Communities Coronavirus Infections Country Coupled Cytometry Database Management Systems Databases Diabetes Mellitus Disease Disease Outbreaks Disease Outcome Economics Education Environmental Risk Factor Epidemic Equilibrium Ethics Ethnic Origin Ethnic group Exposure to Fatality rate Frequencies Genetic Genetic Polymorphism Genotype Goals Health Health Services Accessibility Healthcare Systems Hispanics Hospitals Housing Hypertension Immune Immune system Immunologic Factors Immunologics Individual Infection Inflammation Institutes Intensive Care Units Intervention Kidney Diseases Life Low income Lung diseases Machine Learning Medical Minority Modeling Natural Immunity Neighborhoods New York New York City Obesity Occupations Outcome Pathology Patients Phenotype Population Predisposition Presbyterian Church Prevalence Preventive Process Proteomics Public Health Race Reporting Research Resources Risk Risk Factors Sampling Severities Severity of illness Shapes Societies Socioeconomic Status Syndrome Testing Thrombosis Unemployment Variant Virus Virus Diseases Vulnerable Populations base coronavirus disease experience falls genetic signature health care availability health equity high risk hospitalization rates insight mortality multidisciplinary nutrition pandemic disease parent grant patient stratification polygenic risk score precision medicine predictive modeling prevent racial and ethnic racial and ethnic disparities respiratory response social social determinants social health determinants socioeconomics supervised learning underserved minority

项目摘要

PROJECT SUMMARY This application is being submitted in response to Notice Number: NOT-TR-20-011 to highlight the urgent need for research on the 2019 novel Coronavirus (COVID-19), and is an administration supplement to our parent grant. The outbreak of COVID-19 and the life-threatening acute respiratory syndrome caused by the virus (SARS-CoV-2/2019-nCoV) have led to a severe, global public health crisis, and economic disruption. Sadly, in this epidemic, NYC is the epicenter of epicenters. Some neighborhoods in NYC have been more exposed than others to COVID, and there seems to be clear correlation with the prevalence of COVID and its severity between certain ethnic and racial populations. Importantly, it is recognized that biology factors alone do not exclusively account for disease outcomes in those stricken with Covid-19. Social determinants have a significant impact on various health-related outcomes such as hypertension, diabetes, obesity, kidney and lung disease (1,2). Evidence also indicates that a myriad of social risk factors- such as low income, poor education, minority race or ethnic background- coupled with inadequate community housing and resources, together with limited health care access and decreased health utilization, results in poor health outcomes and increased susceptibility and severity to Covid-19 (3-14). For this study, we assembled a multidisciplinary team from Weill Cornell Medicine's Clinical Translational Science Center (CTSC); Englander Institute for Precision Medicine (EIPM), the Weill Cornell's Center for Health Equity. The initial study will be conducted with the New York Presbyterian (NYP) Hospital health care system database involving “hotspot” areas in NYC with COVID. The NYP network is the largest healthcare system by bed counts in New York City and is on the frontlines of the struggle against the COVID pandemic. By discerning the interaction/relationship of the biology with the Social Determinants of Health (SDoH), we will gain further insight into why certain racial and ethnic groups are more susceptible to Covid -19, and why they develop the more severe forms of the virus. Furthermore, if we are able to identify the especially vulnerable, and provide adequate isolation and early medical intervention in the disease process- then we can save lives. Protecting and providing preventive and early care for the vulnerable would also allow the remainder of society to interact in daily activities and prevent the economy from a major collapse. The less vulnerable who are out in society would on average develop mild coronavirus infections. Consequently, once the larger and mildly affected less vulnerable population recover and gain natural immunity, the risk to the most vulnerable would fall dramatically and the country would stabilize.

项目概要提交此申请是为了响应通知编号：NOT-TR-20-011，以强调紧急情况需要对 2019 年新型冠状病毒（COVID-19）进行研究，并且是对我们家长的行政补充 COVID-19 综合征的爆发以及由该病毒引起的危及生命的急性呼吸道疾病。可悲的是，（SARS-CoV-2/2019-nCoV）导致了严重的全球公共卫生危机和经济混乱。这次疫情，纽约市是震中的震中，纽约市的一些社区的暴露程度比震中还要严重。其他人与新冠病毒之间的关系似乎与新冠病毒的流行率及其严重程度存在明显的相关性重要的是，人们认识到，生物学因素本身并不完全如此。考虑到 Covid-19 患者的疾病结果，社会决定因素对患者有重大影响。各种健康相关结果，如高血压、糖尿病、肥胖、肾病和肺病 (1,2)。有证据还表明，许多社会风险因素——例如低收入、教育程度低、少数族裔或种族背景——加上社区住房和资源不足，以及健康状况有限医疗服务的可及性和医疗利用率的降低，导致健康结果不佳并增加易感性和在这项研究中，我们组建了来自威尔康奈尔医学院的多学科团队。临床转化科学中心（CTSC）；英格兰精准医学研究所（EIPM）；康奈尔大学健康公平中心将与纽约长老会 (NYP) 一起进行初步研究。涉及纽约市新冠疫情“热点”地区的医院医疗保健系统数据库 NYP 网络。按床位计算，纽约市拥有最大的医疗保健系统，并且处于抗击疾病的最前线新冠疫情大流行。通过辨别生物学与健康社会决定因素的相互作用/关系。 (SDoH)，我们将进一步深入了解为什么某些种族和族裔群体更容易感染 Covid -19，以及为什么他们会发展出更严重的病毒形式。此外，如果我们能够识别出特别严重的病毒。脆弱，并在疾病过程中提供充分的隔离和早期医疗干预——那么我们就可以保护弱势群体并为其提供预防性和早期护理也能让其他人受益。社会在日常活动中互动并防止经济严重崩溃。一旦出现规模更大、规模更大的病例，在社会上平均会出现轻微的冠状病毒感染。受到轻微影响的弱势群体恢复并获得自然免疫力，这是最弱势群体面临的风险将会急剧下降，国家将会稳定。