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The External Exposome and COVID-19 Severity

外部暴露组和 COVID-19 严重程度

基本信息

批准号：
10174270
负责人：
Jiang Bian
金额：
$ 22.19万
依托单位：
UNIVERSITY OF FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-08-20 至 2022-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10174270
关键词：
2019-nCoV Affect Age Air Pollution Asthma COVID-19 Cardiovascular Diseases Centers for Disease Control and Prevention (U.S.)Cessation of life Characteristics Chronic lung disease Clinical Clinical Research Consumption Data Data Sources Databases Diabetes Mellitus Diagnosis Disease Elderly Electronic Health Record Environment Environmental Exposure Environmental Risk Factor Ethnic group Exposure to Florida Future Geography Health Hospitalization Individual Joints Knowledge Laboratories Link Literature Mediation Medical Methods Neighborhoods Obesity Outcome Patients Physicians Prevention Measures Primary Prevention Process Public Health Recording of previous events Resolution Resources Review Literature Risk Factors Severities Structure Symptoms Testing Time Vital Statistics Work base cohort comorbidity coronavirus disease data resource demographics deprivation design electronic structure epidemiology study high risk improved mortality natural language novel pandemic disease patient oriented personalized intervention phenotyping algorithm predictive modeling racial and ethnic racial and ethnic disparities repository response scale up social social health determinants sociodemographics socioeconomics spatiotemporal success systematic review walkability young adult

项目摘要

PROJECT SUMMARY The 2019 novel coronavirus disease (COVID-19) is a global pandemic with severe medical and socioeconomic consequences. Young adults without any underlying health conditions can still develop severe COVID-19 disease, and there are racial and ethnic disparities in COVID-19 hospitalization and mortality rates which cannot be explained by age and underlying health conditions alone. Risk factors of severe COVID-19 beyond older age and underlying health conditions are large unknown. There are large overlaps between the currently known risk factors of severe COVID-19 and the health conditions that are affected by environmental exposures, and emerging evidence suggested that long-term environmental exposures may be important determinants of COVID-19 severity. Traditional environmental epidemiological studies usually examine environmental factors separately without considering “the totality of the external environment”. Such studies are not only time consuming as they examine individual exposures separately, but more importantly, cannot account for confounding by co-exposures. The external exposome is an ideal framework to identify novel exposures associated with severe COVID-19 as it can systematically and efficiently screen thousands of environmental exposures. In this project, we will leverage a unique real-world data (RWD) resource – OneFlorida – a large repository of linked electronic health records (EHR), claims and vital statistics data, covering more than 60% of Floridians, contributing to the national Patient-Centered Clinical Research Network (PCORnet). Building on our prior work on the external exposome, we will expand our existing external exposome database to include additional factors that may impact COVID-19 outcomes through a systematic analysis of literature and resources. We aim to (1) develop phenotyping algorithms for identifying a COVID-19 cohort and their severity and extracting associated individual-level risk factors from the OneFlorida real-world data, and (2) identify external exposome factors associated with severe COVID-19, examine how the external exposome contributes to racial and ethnic disparities in severe COVID-19, and build predictive models of severe COVID-19 with external exposome factors. This study will fill important knowledge gaps by providing timely information to understand how environmental exposures may impact COVID-19 severity that will improve identifications of high-risk COVID-19 patients and inform the design of future precision interventions. Our approach and initial results for Florida can (1) be readily scaled up to a multi-state study through PCORnet and (2) answer other novel questions such as the external exposome’s contribution to geographic disparities in COVID-19 outcomes.

项目总结