Inflammatory and Metabolic Biomarkers in Cardiovascular Complications with SARS-CoV-2

One of the most poorly understood yet clinically important aspects of the novel COVID-19 SARS CoV2 coronavirus is the marked heterogeneity that it displays with infection severity and with development of end organ complications and mortality. SARS CoV-2 infection has a complex epidemiologic interplay with cardiovascular (CVD) and highlights this complex heterogeneity. The biology underlying this heterogeneity in CVD outcomes is poorly understood and concomitantly, clinically useful biomarkers do not currently exist to identify the highest risk patients in need of the most intense monitoring. Thus, we propose to use integrated omics and EHR data in a diverse multi-center North Carolina cohort with existing biological specimens to determine the role of inflammation, metabolism and novel molecular mechanisms, and identify biomarkers of CVD outcomes in patients with COVID-19. We propose to (1) Determine the clinical predictors of infection severity in a diverse population of individuals with CVD risk factors and SARS-CoV2 infection including evaluation of racial differences; (2) Determine the role of inflammatory, SARS-CoV-2 related, and other candidate proteins as biomarkers of infection severity and CVD outcomes in patients with SARS CoV-2 infection; and (3) Evaluate metabolic pathways in SARS Co-V-2 infection severity and CVD outcomes. The proposal has high potential for dissecting the molecular mechanisms of the heterogeneity between CVD and SARS CoV-2 outcomes. Importantly, it has great short-term potential for clinically important results that will lead to earlier and better identification of high-risk patients for more intensive monitoring; novel therapeutic interventions to prevent end organ complications and mortality; and diagnostic and disease-progression biomarkers.