CoV-Ind-UK: Prospective investigation of the determinants for COVID-19 outcomes amongst South Asians in India and the United Kingdom.

印度和英国的研究结果表明，南亚人患COVID-19的风险很高，或者感染导致这种疾病的SARS-CoV2病毒的风险很高。南亚人患病风险增加的原因尚不清楚。为了解决这一重要的知识差距，我们将利用我们已经建立的“人口队列”，包括印度和英国的南亚男性和女性，他们已经被监视了长达20年。所有参与者都是在COVID-19大流行发生之前招募的，并测量了与COVID-19相关的关键风险因素，包括体重、血压、糖尿病、心脏病和社会经济因素。此外，我们对许多参与者的新陈代谢、遗传变异和基因调控进行了综合评估，这些都是在以前的研究项目中产生的。这些已有的队列具有丰富的数据和样本，为确定南亚地区COVID-19的主要风险因素提供了有力和有效的机会。在这项新研究中，我们将邀请3万名南亚人（1万名在印度，2万名在英国）接受SARS-CoV2病毒感染证据的检测（抗体检测）。我们还将要求他们填写一份关于COVID-19症状、相关行为疾病、对疫苗接种的态度以及COVID-19大流行（及控制措施）对精神、身体和财务健康的影响的问卷。在可能的情况下，我们将与医疗记录和死亡率数据联系起来，以确定患有严重COVID-19的人。我们将使用收集的数据来确定印度和英国的南亚人感染SARS-CoV2或经历严重或长期的COVID-19的主要风险因素是什么。我们最初将把重点放在公认的风险因素上，如肥胖、血压升高和糖尿病、心血管疾病、健康行为（酒精、吸烟、缺乏体育活动）、社会经济指标和代谢健康措施。我们将把南亚人的结果与欧洲人的等效测量结果进行比较，并确定已知的风险因素是否可以解释亚洲人感染COVID-19的高风险。我们将利用这些结果开发简单的工具来预测南亚地区COVID-19的风险，这些工具可用于优先接种疫苗或进行行为干预，并保护他们免受COVID-19的侵害。我们还将报告南亚地区的疫苗犹豫（疫苗接种接受延迟或低）及其主要原因。这将有助于确定成功免疫规划的潜在障碍，以及开展公共卫生教育以建立理解、信任和信心的必要性。最后，我们将使用“所有数据”，包括现有的健康和遗传数据，调查以前未确定的可能导致南亚人感染COVID-19的风险因素或生物过程。这些发现将为南亚地区COVID-19高负担背后的原因提供急需的知识，并将为印度、英国和全球预防和控制该疾病的卫生政策和实践提供信息。我们将在头3个月内提供重要的初步产出，从而使工作产生早期影响。这项研究由来自印度和英国的团队领导，他们一直站在国家层面应对COVID-19的最前沿。该团队在了解南亚人口健康的研究方面也有成熟的专业知识和记录。因此，我们的研究解决了一项重大的公共卫生挑战，是及时、有效的，并且很有可能产生结果，从而降低占世界人口25%的南亚地区COVID-19的发病率和死亡率。

Results of studies from India and the UK show that South Asian people are at high risk for risk COVID-19, or to being infected with the SARS-CoV2 virus which causes this illness. The reasons for this increased risk in South Asians are not known. To address this important knowledge gap, we will take advantage of our established 'population cohorts' comprising South Asian men and women in India and the UK who have been under surveillance for up to 20 years. All participants were recruited before the onset of the COVID-19 pandemic, and have measures of key risk factors relevant to COVID-19, including weight, blood pressure, diabetes, heart disease and socio-economic factors. In addition, we have comprehensive assessment of metabolism, genetic variation, and of gene regulation for many of the participants, generated in previous research projects. These already available cohorts, with rich data and samples, provide a powerful and efficient opportunity to define the primary risk factors for COVID-19 in South Asians. In this new study, we will invite 30,000 of these South Asian people (10,000 in India, 20,000 in the UK) to be tested for evidence of infection with the SARS-CoV2 virus (antibody test). We will also ask them to complete a questionnaire about COVID-19 symptoms, relevant behaviours disease, attitudes to vaccination, and impact of the COVID-19 pandemic (and control measures) on mental, physical and financial wellbeing. We will link to medical records and mortality data where possible to identify people with severe COVID-19. We will use the data collected to determine what are the major risk factors in South Asians in India and the UK, for infection with SARS-CoV2, or experiencing severe or prolonged COVID-19. We will focus initially on recognised risk factors such as adiposity, raised blood pressure and diabetes, cardiovascular disease, health behaviours (alcohol, smoking, physical inactivity), socio-economic indicators, and measures of metabolic health. We will compare our results in South Asians with equivalent measures for Europeans, and determine whether known risk factors explain the high risk of COVID-19 in Asians. We will use the results to develop simple tools for predicting risk of COVID-19 in South Asians, that can be used to prioritise people for vaccination or behavioural interventions, and to protect them from COVID-19. We will also report on vaccine hesitancy in South Asians (delayed or low acceptance of vaccination) as well as the main reasons for this. This will help identify potential obstacles to successful immunisation programmes and the need for public health education to build understanding, trust and confidence. Finally, we will use 'all-of-the-data' including the available health and genetic data to investigate for previously unidentified risk factors or biological processes that might contribute to COVID-19 in South Asians. The findings will provide much needed knowledge into the reasons underlying the high burden of COVID-19 in South Asians, and will inform health policy and practice for prevention and control of the disease in India, the UK and globally. We will deliver significant initial outputs within the first 3 months, thus bringing early impact from the work. The research is led by teams from India and the UK who have been at the forefront of responses to COVID-19 at national level. The team also have established expertise, and track record in research to understand the health of South Asian populations. Our research thus addresses a major public health challenge, is timely, efficient and has a high probability of delivering results that will reduce morbidity and mortality from COVID-19 amongst South Asians, who represent 25% of the world's population.