COVID-19 Infection and Diabetes Incidence in Native Americans

美洲原住民的 COVID-19 感染和糖尿病发病率

• 批准号: 10630755
• 负责人: Mary E. Lacy
• 金额: $ 21.61万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10630755
• 关键词: Address; Age; Alaska; Alaska Native; American Indians; Body mass index; COVID-19; COVID-19 mortality; COVID-19 pandemic; COVID-19 pandemic effects; COVID-19 patient; Clinical; Clinical Data; Code; Cohort Studies; Communities; Comprehensive Health Care; Data; Data Set; Data Sources; Database Management Systems; Databases; Death Rate; Diabetes Mellitus; Diagnosis; Electronic Health Record; Enrollment; Epidemiology; Ethnic group; Face; Glycosylated hemoglobin A; Health Insurance; Health system; Healthcare Systems; Hospitalization; Incidence; Individual; Infection; Insulin; Knowledge; Laboratories; Link; Matched Group; Measures; Medical; Morbidity - disease rate; Native Americans; Native-Born; Not Hispanic or Latino; Patients; Persons; Population; Population Heterogeneity; Prevalence; Race; Registries; Reporting; Retrospective cohort; Retrospective cohort study; Risk; SARS-CoV-2 infection; Series; Severities; Severity of illness; Site; System; Time; United States Indian Health Service; Vaccination; Variant; Veterans; Virus; clinical database; clinical diagnostics; cohort; comorbidity; coronavirus disease; diabetes risk; hazard; health disparity; health organization; high risk population; hospitalization rates; infection rate; infection risk; insight; mortality; pandemic disease; post SARS-CoV-2 infection; secondary analysis; trend; tribal health

PROJECT ABSTRACT American Indians and Alaska Natives (Native Americans) have suffered disproportionately during the COVID- 19 pandemic with higher rates of infection, hospitalization and mortality from COVID-19 compared to Non- Hispanic Whites. Native Americans also suffer disproportionately from diabetes with nearly 3 times the prevalence and 2.3 times the diabetes-related death rate of Non-Hispanic Whites. Growing evidence suggests that COVID-19 infection increases the risk of developing diabetes. Large cohort studies have reported a ~50% increased risk of developing diabetes following COVID-19 infection compared to matched or historic controls without known COVID-19 infection. While these studies offer important insight into the magnitude of risk of new onset diabetes following COVID-19 infection, existing studies were not inclusive of some of the highest risk populations because they studied US veterans, commercially insured patients enrolled in large US health insurance plans, and communities outside the US. Little is known how this risk varies across diverse populations within the US. Understanding the epidemiologic links between COVID-19 infection and diabetes in Native Americans is critical to address health disparities in a population that faces a disproportionate burden of both COVID-19 and diabetes. To measure the association between COVID-19 infection and diabetes risk in Native Americans we will conduct a series of analyses using two distinct data sources: 1) a large, nationally representative clinical database available through Indian Health Service and 2) the Alaska Diabetes Registry with linked electronic health record data from the Alaska Tribal Health System. Aim 1 will measure the association between COVID-19 infection and risk of incident diabetes in Native Americans via a matched, retrospective cohort study using national data from the Indian Health Service. Aim 2 will compare the clinical presentation of incident diabetes cases at diabetes onset and compare clinical progression over the 6 months following diagnosis by antecedent COVID-19 infection status in a retrospective cohort of individuals using nationwide data from Indian Health Service as well as the comprehensive Alaska Diabetes Registry maintained by the Alaska Native Tribal Health Consortium. The proposed studies will provide a comprehensive epidemiologic assessment of the COVID-19-diabetes association in Native Americans, including a nationwide description of COVID-19 infection-related diabetes risk and a deep dive into the clinical presentation of incident diabetes cases. This knowledge will support the continued efforts of Tribal, Federal, State, and community entities to mitigate the impacts of the COVID-19 pandemic in Native Americans and further efforts to address the COVID-19 and diabetes health disparities faced by this population.

项目摘要 美国印第安人和阿拉斯加原住民（美洲原住民）在联盟期间遭受了不成比例的 19大流行，与非 - 相比 西班牙裔白人。美洲原住民也因糖尿病而遭受不成比例的痛苦，近三倍 患病率是非西班牙裔白人的糖尿病相关死亡率的2.3倍。越来越多的证据表明 这种联想19的感染增加了患糖尿病的风险。大型队列研究报告了约50％ 与匹配或历史控制相比 没有已知的Covid-19感染。尽管这些研究为新的风险大小提供了重要的见解 19009年感染后的糖尿病发作，现有研究并不包括一些最高风险 人口是因为他们研究了美国退伍军人，商业保险的患者参加了大型美国健康 保险计划和美国以外的社区。几乎不知道这种风险在不同的不同 美国境内的人口。了解Covid-19感染与糖尿病之间的流行病学联系 美洲原住民对于解决面临不成比例负担的人口中的健康差异至关重要 COVID-19和糖尿病均两者。衡量199年感染与糖尿病风险之间的关联 美洲原住民，我们将使用两个不同的数据来源进行一系列分析：1）一个大型，全国性的 可通过印度卫生服务和2）阿拉斯加糖尿病注册表提供的代表性临床数据库 通过来自阿拉斯加部落卫生系统的链接电子健康记录数据。 AIM 1将测量 通过匹配的，美国原住民的糖尿病感染与糖尿病的风险之间的关联 回顾性队列研究使用来自印度卫生服务的国家数据。 AIM 2将比较临床 在糖尿病发作中介绍入射糖尿病病例并在6个月内比较临床进展 通过先前的共同covid-19诊断后，在回顾性人群中使用 印度卫生服务部的全国数据以及综合的阿拉斯加糖尿病登记处 由阿拉斯加土著部落卫生财团。拟议的研究将提供全面的 美洲原住民的共同生产评估，包括全国性的美国原住民协会 COVID-19的描述与感染相关的糖尿病风险和深入研究的临床表现 糖尿病病例。这些知识将支持部落，联邦，州和社区的持续努力 减轻199日大流行对美洲原住民的影响的实体，并进一步解决 该人群面临的COVID-19和糖尿病的健康差异。