SCAN-MP (Screening for Cardiac Amyloidosis with Nuclear imaging in Minority Populations) COVID-19 Suppplement

Project SummaryCOVID-19 is a global pandemic that disproportionately affects minority older adults with cardiac disease andmultiple chronic conditions. Densely populated urban centers with a high proportion of socioeconomicallydisadvantaged persons, including New York City (NYC) and Boston, are most impacted by COVID-19. SCAN-MP (Screening for Cardiac Amyloidosis with Nuclear Imaging in Minority Populations, R01HL139671) is aNHLBI funded, prospective cohort study that enrolled 123 of a target 800 Black or Caribbean Hispanicparticipants over the age of 60 years with heart failure prior to the mandatory recruitment pause for thepandemic. The profile of the SCAN-MP participant matches those known to be at highest risk from COVID-19. In this application, we propose to leverage the successful recruitment and retention techniques of theSCAN-MP infrastructure to advance our understanding of the prevalence of SARS CoV-2 infection anddisentangle the demographic, social, and environmental factors known to be associated with infection. Whilemitigation is the primary public health strategy to address the spread of COVID-19, it may be particularlychallenging for those with resource limitations or those who live in close physical proximity to others to complywith CDC recommendations, perhaps accounting for the observed increase in infection rates. Successfulemergence from the pandemic will depend upon evidence of prior SARS CoV-2 infection in the population.Given that asymptomatic infection is common, serologic testing will likely play a critical role in the next phaseof recovery. Serologic testing has been validated at Columbia University with a highly sensitive and specific,quantitative ELISA-based assay to detect antibodies to SARS-CoV-2 that we propose to leverage in thisstudy. Our objectives are to (1) define the proportion of SCAN-MP participants with evidence of prior COVID-19 infection by antibody testing, (2) determine the capacity of SCAN-MP participants to comply with CDCmitigation recommendations. We will then explore how infection rate and mitigation compliance interact withsocio-economic factors such as income and living conditions, as well as measures of health literacy,trust/engagement in the health system, and perceived discrimination. We will explore whether the presenceand/or titer of antibodies specific for SARS CoV-2 virus will be associated with future COVID-19 infection aswell as adverse outcomes (hospitalizations and mortality) over a one-year time period. We are uniquelypositioned to perform these studies quickly given our ability to recruit an urban, minority cohort with cardiacdisease at high risk for COVID-19 morbidity/mortality, expertise in the performance of serologic testing forantibodies to SARS CoV-2, and established expertise in community engaged research. Successfulcompletion of these Aims has the potential to inform implementation of mitigation strategies in high-riskpopulations and contribute important data useful for the resolution of the COVID-19 pandemic.