Disparities in COVID Disease Severity and Outcomes in New York City

项目总结 本申请是为回应通知编号：NOT-TR-20-011而提交的，以突出紧急情况 需要对2019年新的冠状病毒(新冠肺炎)进行研究，是对我们父母的行政补充 格兰特。新冠肺炎的爆发和由该病毒引起的危及生命的急性呼吸综合征 (SARS-CoV-2/2019-nCoV)导致了严重的全球公共卫生危机和经济中断。可悲的是，在 此次疫情，纽约市是震中。纽约市的一些社区受到的影响比 其他人与COVID有关，而且似乎与COVID的患病率及其严重程度之间存在明显的相关性 某些民族和种族人口。重要的是，人们认识到，生物因素本身并不是唯一 考虑那些感染新冠肺炎的人的疾病结果。社会决定因素对 各种与健康相关的结果，如高血压、糖尿病、肥胖、肾脏和肺病(1，2)。 证据还表明，无数的社会风险因素--如低收入、教育程度低、少数族裔 或种族背景--加上社区住房和资源不足，以及有限的健康 医疗服务的可获得性和卫生利用率的降低，导致健康状况不佳，增加了易感性和 严重到新冠肺炎(3-14)。在这项研究中，我们组建了一个来自威尔·康奈尔医学公司的多学科团队 临床转化科学中心(CTSC)；英格兰精密医学研究所(EIPM)，The Weill 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，涉及纽约的COVID热点地区。NYP电视网是 按床位计算是纽约市最大的医疗体系，并站在与 冠状病毒大流行。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)，我们将进一步深入了解为什么某些种族和民族更容易感染Covid-19， 以及为什么他们会发展出更严重的病毒形式。此外，如果我们能够识别出特别是 并在疾病过程中提供足够的隔离和早期医疗干预--那么我们就可以 拯救生命。保护和为弱势群体提供预防性和早期护理也将允许其余的人 在日常活动中与社会互动，防止经济出现重大崩溃。不那么脆弱的人 处于社会之外的人平均会患上轻微的冠状病毒感染。因此，一旦较大的和 受轻微影响的较不脆弱的人群恢复并获得自然免疫力，最脆弱的人群面临的风险 会急剧下降，这个国家会稳定下来。

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.