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Principal Investigator: Emma Fernandez-Repollet
Organization: UNIVERSITY OF PUERTO RICO MED SCIENCES
Fiscal Year: 2020
Award: $187,497
Funding agency: National Institute on Minority Health and Health Disparities
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.
Terms: <2019 novel coronavirus><2019-nCoV><Access to Care><Acetylsalicylic Acid><Acute><Acute-Phase Reaction><Acute-Phase Response><Acute-Phase State><Address><Administrative Supplement><Admission><Admission activity><Adopted><Affect><Apoplexy><Area><Aspirin><Biological><Blood Coagulation Disorders><Brain Vascular Accident><COVID-19><COVID-19 epidemic><COVID-19 pandemic><COVID19><COVID19 epidemic><COVID19 pandemic><Candidate Disease Gene><Candidate Gene><Cardiovascular Diseases><Caribbean Hispanic><Caring><Cerebral Stroke><Cerebrovascular Apoplexy><Cerebrovascular Stroke><Cessation of life><Characteristics><Clinical><Clinical Research><Clinical Study><Clinical Trials><Clotting><Coagulation><Coagulation Disorder><Coagulation Process><Coagulopathy><Cohort Studies><Communities><Concurrent Studies><Consensus><Coronary Arteriosclerosis><Coronary Artery Disease><Coronary Artery Disorder><Coronary Atherosclerosis><Critical Illness><Critically Ill><Data><Death><Development><Disease><Disease Outbreaks><Disorder><Drugs><Epitheliasin Gene><Ethnic Origin><Ethnicity><Exposure to><Faculty><Funding><Future><GWA study><GWAS><Genes><Genetic Predisposition><Genetic Predisposition to Disease><Genetic Susceptibility><Goals><Grant><HLA-B><HLA-B Antigens><Health><Health Sciences><Health Services Accessibility><Healthy People 2020><High Prevalence><Hispanic Populations><Hispanics><History><Hospital Admission><Hospitalization><Hospitals><Household><Immune><Immunes><Individual><Infection><Infrastructure><Inherited Predisposition><Inherited Susceptibility><Institute of Medicine><Institute of Medicine (U.S.)><Investigators><Latino><Latino Population><Light><Measures><Mechanical Ventilators><Medical><Medication><NAS/IOM><Outbreaks><Outcome><PRSS10><Parents><Participant><Pathogenesis><Pathway interactions><Patients><Peripheral arterial disease><Pharmaceutic Preparations><Pharmaceutical Preparations><Pharmacogenetics><Phenotype><Photoradiation><Pilot Projects><Plant Embryos><Plant Zygotes><Population><Predisposition><Prevalence><Puerto Rican><Puerto Rico><Pulmonary Ventilators><R-Series Research Projects><R01 Mechanism><R01 Program><Recording of previous events><Renin-Angiotensin-Aldosterone System><Reporting><Research><Research Activity><Research Grants><Research Infrastructure><Research Personnel><Research Project Grants><Research Projects><Research Resources><Researchers><Resources><Respirators><Risk><Risk Marker><Role><SARS-CoV-2><SARS-CoV2><SARS-associated coronavirus 2><SARS-coronavirus-2><SARS-related coronavirus 2><Science><Seeds><Serologic tests><Serological Tests><Services><Severe acute respiratory syndrome coronavirus 2><Severity of illness><Spanish Origin><Stroke><Susceptibility><Symptoms><TMPRSS2><TMPRSS2 gene><Testing><Thrombosis><Time><Translational Research><Translational Science><Underrepresented Ethnic Minority><Underrepresented Minority><Universities><Variant><Variation><Vascular Diseases><Vascular Disorder><Virus><Work><Wuhan coronavirus><access to health services><access to services><access to treatment><accessibility to health services><atherosclerotic coronary disease><availability of services><base><biobank><biorepository><bleeding disorder><blood vessel disorder><brain attack><cardiovascular disorder><care access><career><cerebral vascular accident><cerebrovascular accident><clinical practice><clopidogrel><clotting disorder><co-morbid><co-morbidity><cohort><comorbidity><corona virus disease 2019><corona virus disease 2019 epidemic><corona virus disease 2019 pandemic><coronary arterial disease><coronavirus disease 2019><coronavirus disease 2019 epidemic><coronavirus disease 2019 pandemic><developmental><disease severity><disparity in care><disparity in health><disparity in healthcare><disparity reduction><drug/agent><entire genome><ethnic diversity><ethnically diverse><experience><full genome><genetic etiology><genetic mechanism of disease><genetic vulnerability><genetically predisposed><genome scale><genome wide association><genome wide association scan><genome wide association studies><genome wide association study><genome-wide><genomewide><genomewide association scan><genomewide association studies><genomewide association study><genomic tools><health care disparity><health disparity><health service access><health services availability><healthcare disparity><hispanic community><improved><injury to the myocardium><instrumentation><interest><medically underserved><minority health><multidisciplinary><myocardial injury><parent grant><pathway><peripheral artery disease><personalization of treatment><personalized intervention><personalized medicine><personalized therapy><personalized treatment><pilot study><precision interventions><precision medicine><precision-based medicine><prevent><preventing><programs><pulmonary respirator><racial and ethnic><reduce disparity><response><seed><serology><service availability><social role><sound><thrombotic disease><thrombotic disorder><translation research><translational study><treatment access><under-representation of minorities><underrepresentation of minorities><vascular dysfunction><vascular endothelial dysfunction><vasculopathy><whole genome><whole genome association analysis><whole genome association studies><whole genome association study>