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Principal Investigator: HANA M EL SAHLY
Organization: BAYLOR COLLEGE OF MEDICINE
Fiscal Year: 2021
Award: $1,756,259
Funding agency: National Institute of Allergy and Infectious Diseases
Abstract
Currently, the United States (US) has far more confirmed COVID-19 cases than any other country. The US
epidemic is remarkably heterogeneous, with many cities and communities experiencing a disproportionately
high disease burden and mortality. For example, at present, Miami, Minneapolis, Houston, Atlanta, and
Durham NC, are projected to bear the brunt of the US epidemic and in the future, other communities may see
an increase in the number of COVID-19 cases.
The epidemic has also been marked by harsh disparities in COVID-19 rates and other health outcomes among
African American and Latino communities who have substantially higher attack rates and higher mortality
compared with any other racial or ethnic group across the US The communities surrounding several NIAID
CRSs have suffered from not only longstanding racial inequalities, but also socioeconomic disparities in
housing and employment, as well as varied access to health and other essential services. These populations
also have a high prevalence of co-morbidities associated with higher incidence of COVID-19, more severe
manifestations of COVID-19 disease , higher mortality from COVID-19, and have poorer health outcomes from
a variety of illnesses overall. As with the observations among the elderly, these racial and ethnic factors all
compel the need for the systematic collection of COVID-19-related data from populations at high risk for and
highly impacted by COVID-19 and from the general population in their communities to enable the successful
design and conduct of COVID-19 targeted prevention and treatment studies and provision of access to these
populations of promising prevention and treatment interventions.
The proposed research will provide comprehensive information on communities impacted by COVID-19
beyond surveillance studies currently in the field. It will directly contribute to preparedness for SARS-CoV-2
vaccine and other COVID-19 prevention and treatment studies by determining the prevalence of SARS-CoV-2
infection and seroprevalence among samples of individuals at elevated risk and of different ages who are
recruited from communities where NIAID CRSs are situated. All prevalence estimates will be weighted for
survey design, non-response and post-stratification population projections in order to generate estimates that
are representative of the NIAID CRS communities. This research will determine the extent to which children
and adults in these areas have SARS-CoV-2 infection or evidence of prior SARS-CoV-2 infection (based on
results of antibody tests, self-report, and medical records). Additionally, data captured through questionnaires
about participants' household members with COVID-like illness and deaths, combined with serologic data from
participants, may also provide information about transmission dynamics within households. Questionnaire data
will inform estimates of the percent of individuals of different age groups, including children, who may have had
an asymptomatic COVID-19 infection. The frequency of infection among children and whether infected children
play an important role in community transmission is poorly understood. The survey will also provide estimates
of the association of SARS-CoV-2 seroprevalence with medical co-morbidities that have been associated with
more severe disease outcomes and will also identify demographic and social risk factors associated with
infection. Finally, this research will provide important information about SARS-CoV-2 transmission, COVID-19
disease, attitudes about and uptake of containment and mitigation measures, racial and ethnic health
disparities, varied access to testing and public health resources by key demographic indicators, prospects for
new prevention and treatment strategies, and be used to inform mathematical models of disease progression
and projection of future COVID-19 risk.
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