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

基本信息

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
项目类别：
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

项目摘要

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.

项目摘要美洲印第安人和阿拉斯加原住民（美洲原住民）在新冠疫情期间遭受了不成比例的苦难。与非流行病相比，19 大流行病的 COVID-19 感染率、住院率和死亡率更高西班牙裔白人。美洲原住民患糖尿病的比例也很高，几乎是美国原住民的三倍患病率和糖尿病相关死亡率是非西班牙裔白人的 2.3 倍。越来越多的证据表明 COVID-19 感染会增加患糖尿病的风险。大型队列研究报告约 50% 与匹配或历史对照相比，感染 COVID-19 后患糖尿病的风险增加没有已知的 COVID-19 感染。虽然这些研究为了解新的风险程度提供了重要的见解 COVID-19 感染后出现糖尿病，现有研究未包括一些最高风险的人群因为他们研究了美国退伍军人、加入美国大型医疗机构的商业保险患者保险计划以及美国以外的社区。很少有人知道这种风险在不同的国家之间有何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人口健康差异至关重要，因为他们面临着不成比例的负担 COVID-19 和糖尿病。衡量 COVID-19 感染与糖尿病风险之间的关联对于美洲原住民，我们将使用两个不同的数据源进行一系列分析：1）一个大型的全国性数据源可通过印度卫生服务中心和 2) 阿拉斯加糖尿病登记处获得代表性临床数据库与阿拉斯加部落卫生系统链接的电子健康记录数据。目标 1 将测量 COVID-19 感染与美洲原住民患糖尿病风险之间的关联通过匹配使用印度卫生服务局的国家数据进行回顾性队列研究。目标 2 将比较临床介绍糖尿病发病时的糖尿病病例并比较 6 个月内的临床进展在回顾性队列中根据先前的 COVID-19 感染状态进行诊断后，使用来自印度卫生服务中心和综合阿拉斯加糖尿病登记处的全国数据得到维护由阿拉斯加原住民部落健康联盟提供。拟议的研究将提供全面的对美洲原住民中 COVID-19-糖尿病协会的流行病学评估，包括全国范围内的对 COVID-19 感染相关糖尿病风险的描述以及对事件临床表现的深入研究糖尿病病例。这些知识将支持部落、联邦、州和社区的持续努力实体减轻 COVID-19 大流行对美洲原住民的影响，并进一步努力解决该人群面临的 COVID-19 和糖尿病健康差异。