Disparities in COVID Disease Severity and Outcomes in New York City

项目摘要 本申请是根据通知编号：NOT-TR-20-011提交的，以强调 需要对2019年新型冠状病毒（COVID-19）进行研究，这是对我们母公司的管理补充 格兰特. 2019冠状病毒病的爆发和由该病毒引起的危及生命的急性呼吸道综合征 （SARS-CoV-2/2019-nCoV）导致了严重的全球公共卫生危机和经济中断。人伤心的是在 在这场流行病中，纽约市是震中中的震中。纽约市的一些社区受到的影响比 其他人对COVID，似乎有明确的相关性，与COVID的流行和其严重程度之间 某些民族和种族。重要的是，人们认识到，生物因素本身并不完全 导致新冠肺炎疫情的原因。社会决定因素对以下方面有重大影响： 各种健康相关的结果，如高血压、糖尿病、肥胖、肾脏和肺部疾病（1，2）。 证据还表明，无数的社会风险因素--如低收入、教育水平低、少数民族 或种族背景-加上社区住房和资源不足， 保健机会和保健利用率下降，导致健康结果不佳，易感性增加， 严重程度为Covid-19（3-14）。在这项研究中，我们组建了一个来自威尔康奈尔医学的多学科团队， 临床转化科学中心（CTSC）;英格兰德精密医学研究所（EIPM），威尔 康奈尔健康公平中心。初步研究将与纽约长老会（NYP）进行 医院医疗保健系统数据库涉及纽约市新冠肺炎“热点”地区。NYP网络是 最大的医疗保健系统的床位数在纽约市，是在前线的斗争， 新冠疫情。通过辨别生物学与健康的社会决定因素的相互作用/关系 （SDoH），我们将进一步了解为什么某些种族和民族群体更容易感染新冠肺炎， 以及为什么他们会发展出更严重的病毒此外，如果我们能够识别出 脆弱，并在疾病过程中提供充分的隔离和早期医疗干预-然后我们可以 拯救生命保护弱势群体并为他们提供预防和早期护理， 在日常活动中相互作用，防止经济大崩溃。那些不那么脆弱的人 在社会上的人平均会患上轻微的冠状病毒感染。因此，一旦更大的和 受轻度影响的较不脆弱人群恢复并获得自然免疫力， 会急剧下降，国家会稳定下来。

PROJECT SUMMARY This application is being submitted in response to Notice Number: NOT-TR-20-011 to highlight the urgent need for research on the 2019 novel Coronavirus (COVID-19), and is an administration supplement to our parent grant. The outbreak of COVID-19 and the life-threatening acute respiratory syndrome caused by the virus (SARS-CoV-2/2019-nCoV) have led to a severe, global public health crisis, and economic disruption. Sadly, in this epidemic, NYC is the epicenter of epicenters. Some neighborhoods in NYC have been more exposed than others to COVID, and there seems to be clear correlation with the prevalence of COVID and its severity between certain ethnic and racial populations. Importantly, it is recognized that biology factors alone do not exclusively account for disease outcomes in those stricken with Covid-19. Social determinants have a significant impact on various health-related outcomes such as hypertension, diabetes, obesity, kidney and lung disease (1,2). Evidence also indicates that a myriad of social risk factors- such as low income, poor education, minority race or ethnic background- coupled with inadequate community housing and resources, together with limited health care access and decreased health utilization, results in poor health outcomes and increased susceptibility and severity to Covid-19 (3-14). For this study, we assembled a multidisciplinary team from Weill Cornell Medicine's Clinical Translational Science Center (CTSC); Englander Institute for Precision Medicine (EIPM), the Weill Cornell's Center for Health Equity. The initial study will be conducted with the New York Presbyterian (NYP) Hospital health care system database involving “hotspot” areas in NYC with COVID. The NYP network is the largest healthcare system by bed counts in New York City and is on the frontlines of the struggle against the COVID pandemic. By discerning the interaction/relationship of the biology with the Social Determinants of Health (SDoH), we will gain further insight into why certain racial and ethnic groups are more susceptible to Covid -19, and why they develop the more severe forms of the virus. Furthermore, if we are able to identify the especially vulnerable, and provide adequate isolation and early medical intervention in the disease process- then we can save lives. Protecting and providing preventive and early care for the vulnerable would also allow the remainder of society to interact in daily activities and prevent the economy from a major collapse. The less vulnerable who are out in society would on average develop mild coronavirus infections. Consequently, once the larger and mildly affected less vulnerable population recover and gain natural immunity, the risk to the most vulnerable would fall dramatically and the country would stabilize.