CARDINNATE: Variation in innate immune activation and cardiovascular disease risk as drivers of COVID19 outcome in South Asians in UK and India

虽然COVID-19在大多数人中引起轻微疾病，但有些人会患上更严重的疾病，需要住院治疗，包括重症监护。在英国，患有严重COVID-19的南亚裔人的死亡率高于其他种族背景的人，即使在调整了他们的年龄或社会经济地位之后。然而，南亚人感染COVID-19的死亡率在印度似乎远低于英国。这是非常令人惊讶的，因为印度的卫生服务不如国家卫生服务全面，而且印度的平均社会经济条件明显低于英国。国家之间这种意想不到的差异表明，社会经济条件本身以外的因素在决定人们是否能在严重的COVID-19中幸存下来方面很重要。我们对免疫启动和激活的理解使我们提出，调节身体对感染反应的生物因素可能非常重要。人体的免疫系统在抵抗感染方面至关重要。我们知道，严重的COVID-19与免疫反应的严重异常有关。此外，严重的COVID-19伴随着危及生命的心脏和血管功能问题。我们认为，免疫反应的差异及其对心脏和血管功能的影响可能导致COVID-19对英国和印度南亚人的影响。一种可能性是，印度人的免疫系统受到了更好的训练，能够对感染做出反应，因为他们持续暴露于各种感染和环境因素，而这些因素在英国并不常见。在英国的南亚人对感染的免疫反应较差，加上他们糖尿病和心脏病的高潜在发病率，当他们感染COVID-19时，可能会导致疾病恶化和危及生命的并发症。因此，这些生物因素可能是COVID-19对英国南亚人造成不成比例影响的原因。我们组建了一支由英国和印度科学家和医生组成的跨学科专家团队，他们在传染病，免疫学，心脏和血管疾病以及重症监护方面拥有出色的经验。我们的团队将共同努力深入研究这个问题，并确切证明为什么COVID-19会以不同的方式影响不同国家的南亚人。我们的目标是快速识别信息，使我们能够制定新的预防措施，更有针对性的监测，并希望新的治疗方法，以改善印度和英国的COVID-19结果。

While COVID-19 causes minor illness in most people, some individuals develop more severe disease requiring admission to hospital including intensive care. People of South Asian heritage admitted with severe COVID-19 in the UK have a higher death rate than those of other ethnic backgrounds even after adjusting for their age or socioeconomic status. However, death rates for South Asians with COVID-19 appear to be much lower in India than the UK. This is very surprising given that the health service in India is less comprehensive than the national health service and in India the average socioeconomic conditions are significantly lower than the UK. This unexpected disparity between countries suggests that factors beyond socioeconomic conditions per se are important in determining whether people survive severe COVID-19. Our understanding of immune priming and activation leads us to propose that biological factors that regulate how the body responds to infection may be very important. The body's immune system is vital in fighting infection. We know that severe COVID-19 is associated with profound abnormalities of the immune response. Furthermore, severe COVID-19 is accompanied by life-threatening problems with heart and blood vessel function. We propose that differences in immune response and how this impacts on heart and blood vessel function may contribute to the effects of COVID-19 on South Asians in the UK and India. One possibility is that the immune system of people in India is better trained to respond to infection because of continued exposure to a variety of infections and environmental factors that are uncommon in the UK. A poorer immune response to infection in South Asians in the UK combined with their high underlying rates of diabetes and heart disease may result in worse disease and life threatening complications when they get COVID-19. Such biological factors may therefore account for the disproportionate effects of COVID-19 in South Asians in UK.We have put together an expert interdisciplinary team of scientists and medical doctors from the UK and India who have outstanding experience in infectious diseases, immunology, heart and blood vessel disorders, and intensive care. Our team will work together to drill down into the problem and prove exactly why COVID-19 affects South Asians in different countries in different ways. We aim to rapidly identify information that allows us to develop new prevention steps, more targeted monitoring, and hopefully new treatments to improve the outcome of COVID-19 in both India and the UK.