Center for Collaborative Research in Minority Health and Health Disparities (2)

Project Summary/Abstract:Among patients with COVID19, there is a high prevalence of cardiovascular disease, and >7% of patientsexperience myocardial injury as a result of the infection (22% of critically ill patients). COVID19 maydisproportionately affect people with cardiovascular disease. Previous observations suggest that underlyingcardiovascular disease is associated with an increased risk of in-hospital death among patients hospitalized withCOVID19. Furthermore, coagulopathy and vascular endothelial dysfunction have also been proposed ascomplications of COVID19. We propose a supplement to "Adopting a Precision Medicine Paradigm in PuertoRico: leveraging ancestral diversity to identify predictors of clopidogrel response in Caribbean Hispanics" todescribe and better understand how the COVID19 pandemic is affecting our established cohort of CaribbeanHispanics with cardiovascular disease. Our cohort is currently made up of 549 patients with coronary arterydisease (CAD), peripheral artery disease (PAD), and/or a history of stroke (CVA) who are currently receivingtreatment with the antithrombotic medication clopidogrel (with or without aspirin). Building on the personalizedmedicine approach we are already developing for this population, we will combine serologic testing to measureindividual exposure to the SARS-CoV-2 virus with their health (symptoms, clinical outcomes, medicalcomorbidities), access to care (including SARS-CoV-2 testing), and household status during the COVID19pandemic. This will allow us to evaluate the true prevalence of SARS-CoV-2 exposure in our cohort, as well asunderstand the phenotypic effects of the virus in our population. These data will shed light on the underlyingbiological pathways involved in COVID-19 pathogenesis. We will then combine data from our cohort with patientshospitalized for acute COVID19 to perform a targeted and untargeted exploratory genome-wide associationstudy of poor clinical outcomes (e.g., hospitalizations, ICU admission, need of mechanical ventilators) in orderto identify potential risk markers or protective genes among Caribbean Hispanics suffering from the disease.