Center for Collaborative Research in Minority Health and Health Disparities

少数民族健康和健康差异合作研究中心

• 批准号: 10209376
• 负责人: Emma Fernandez-Repollet
• 金额: $ 18.75万
• 依托单位: UNIVERSITY OF PUERTO RICO MED SCIENCES
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-09-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10209376
• 关键词: 2019-nCoV; Acute; Acute-Phase Reaction; Address; Administrative Supplement; Admission activity; Adopted; Affect; Area; Aspirin; Biological; Blood Coagulation Disorders; COVID-19; COVID-19 pandemic; Candidate Disease Gene; Cardiovascular Diseases; Caribbean Hispanic; Caring; Cessation of life; Characteristics; Clinical; Clinical Research; Clinical Trials; Coagulation Process; Cohort Studies; Communities; Consensus; Coronary Arteriosclerosis; Critical Illness; Data; Development; Disease; Disease Outbreaks; Ethnic Origin; Exposure to; Faculty; Funding; Future; Genes; Genetic Predisposition to Disease; Goals; Grant; HLA-B Antigens; Health; Health Sciences; Health Services Accessibility; Healthy People 2020; High Prevalence; Hispanics; Hospitalization; Hospitals; Household; Immune; Individual; Infection; Infrastructure; Institute of Medicine (U.S.); Latino; Light; Measures; Mechanical Ventilators; Medical; Outcome; Parents; Participant; Pathogenesis; Pathway interactions; Patients; Peripheral arterial disease; Pharmaceutical Preparations; Pharmacogenetics; Phenotype; Pilot Projects; Population; Predisposition; Prevalence; Puerto Rican; Puerto Rico; Recording of previous events; Renin-Angiotensin-Aldosterone System; Reporting; Research; Research Activity; Research Infrastructure; Research Personnel; Research Project Grants; Resources; Risk; Risk Marker; Role; Science; Seeds; Serologic tests; Services; Severity of illness; Stroke; Symptoms; TMPRSS2 gene; Testing; Thrombosis; Time; Translational Research; Underrepresented Minority; Universities; Variant; Vascular Diseases; Virus; Work; base; biobank; career; clinical practice; clopidogrel; cohort; comorbidity; disparity reduction; ethnic diversity; experience; genome wide association study; genome-wide; genomic tools; health care disparity; health disparity; improved; instrumentation; interest; medically underserved; minority health; multidisciplinary; myocardial injury; parent grant; personalized intervention; personalized medicine; precision medicine; prevent; programs; racial and ethnic; response; sound; translational study; vascular endothelial dysfunction; whole genome

Project Summary/Abstract: Among patients with COVID19, there is a high prevalence of cardiovascular disease, and >7% of patients experience myocardial injury as a result of the infection (22% of critically ill patients). COVID19 may disproportionately affect people with cardiovascular disease. Previous observations suggest that underlying cardiovascular disease is associated with an increased risk of in-hospital death among patients hospitalized with COVID19. Furthermore, coagulopathy and vascular endothelial dysfunction have also been proposed as complications of COVID19. We propose a supplement to “Adopting a Precision Medicine Paradigm in Puerto Rico: leveraging ancestral diversity to identify predictors of clopidogrel response in Caribbean Hispanics” to describe and better understand how the COVID19 pandemic is affecting our established cohort of Caribbean Hispanics with cardiovascular disease. Our cohort is currently made up of 549 patients with coronary artery disease (CAD), peripheral artery disease (PAD), and/or a history of stroke (CVA) who are currently receiving treatment with the antithrombotic medication clopidogrel (with or without aspirin). Building on the personalized medicine approach we are already developing for this population, we will combine serologic testing to measure individual exposure to the SARS-CoV-2 virus with their health (symptoms, clinical outcomes, medical comorbidities), access to care (including SARS-CoV-2 testing), and household status during the COVID19 pandemic. This will allow us to evaluate the true prevalence of SARS-CoV-2 exposure in our cohort, as well as understand the phenotypic effects of the virus in our population. These data will shed light on the underlying biological pathways involved in COVID-19 pathogenesis. We will then combine data from our cohort with patients hospitalized for acute COVID19 to perform a targeted and untargeted exploratory genome-wide association study of poor clinical outcomes (e.g., hospitalizations, ICU admission, need of mechanical ventilators) in order to identify potential risk markers or protective genes among Caribbean Hispanics suffering from the disease.

项目摘要/摘要： 在新冠肺炎患者中，心血管疾病的患病率很高，>7%的患者 感染导致心肌损伤（22% 的重症患者可能）。 先前的观察表明，这对患有心血管疾病的人影响更大。 心血管疾病与住院患者院内死亡风险增加相关 此外，凝血病和血管内皮功能障碍也被提出。 我们建议对“在波多黎各采用精准医疗范式”进行补充。 Rico：利用祖先多样性来确定加勒比西班牙裔氯吡格雷反应的预测因素” 描述并更好地了解新冠病毒大流行如何影响我们已建立的加勒比地区群体 我们的队列目前有 549 名患有心血管疾病的西班牙裔患者。 目前正在接受治疗的疾病 (CAD)、外周动脉疾病 (PAD) 和/或中风病史 (CVA) 使用抗血栓药物氯吡格雷（加或不加阿司匹林）进行治疗。 我们已经为这一人群开发了医学方法，我们将结合血清学检测来测量 个人接触 SARS-CoV-2 病毒对其健康状况（症状、临床结果、医疗状况）的影响 合并症）、获得护理的机会（包括 SARS-CoV-2 检测）以及 COVID19 期间的家庭状况 这将使我们能够评估我们的队列中 SARS-CoV-2 暴露的真实流行率。 了解该病毒对我们人群的表型影响。这些数据将揭示其潜在的影响。 然后，我们将把我们的队列数据与患者的数据结合起来。 因急性新冠肺炎住院进行有针对性和无针对性的探索性全基因组关联 对不良临床结果（例如住院、入住 ICU、需要机械呼吸机）的研究，以便 识别患有该疾病的加勒比西班牙裔人中潜在的风险标记或保护基因。