RCMI@Morgan: Center for Urban Health Disparities Research and Innovation

项目总结 与艾滋病毒和丙型肝炎病毒类似，导致新冠肺炎的SARS-CoV-2对 健康差距人口(HDP)。然而，我们假设新冠肺炎可能会导致健康差距 在不同的HDP之间(即“内部的差距”)以及某些情况和决定因素可能有助于 并预测“内部差距”。我们与多医院医疗保健系统和 多点社区卫生中心为研究艾滋病毒/丙型肝炎病毒相关的健康差异提供了一个即时、 研究新冠肺炎对健康结果和医疗服务可获得性影响的实用、中肯的平台 以及在不同HDP人群中的利用情况。医疗保健系统的医院和医院的诊所 社区卫生中心位于健康差距较大的城市、郊区和农村地区。这个 医疗系统提供了SARS-CoV-2检测服务，治疗了许多住院的新冠肺炎 病人。社区卫生中心为种族/民族和性/性别少数群体提供艾滋病毒护理。 和其他弱势群体。我们将利用正在进行的合作伙伴关系，使用回顾 采用队列研究设计，结合病历资料，剖析新冠肺炎引起的“内部差异”。 首先，我们将描述住院患者中新冠肺炎的临床特点和自然病史，以及 确定与新冠肺炎发病机制、疾病严重程度和治疗效果相关的因素。 我们还致力于建立新的、独特的、量身定做的临床“评分”系统/模型，用于预测 不同羟色胺患者新冠肺炎的转归和严重程度。第二，我们将分析和 SARS-CoV-2检测的特点，并评估HDP的人在 测试。我们还将分析与SARS-CoV-2阳性相关的因素。对于那些 对于检测呈阳性的患者，我们将评估他们对新冠肺炎系列护理和服务的参与度 确定与参加或错过护理级联中的每个阶段相关的因素。接下来，我们将 评估新冠肺炎封锁期间艾滋病毒持续护理的情况，分析趋势和相关因素 缺少预约、实验室和/或处方以及远程医疗的使用。我们还将检查 在封锁期间继续护理的人中与艾滋病毒相关的健康结果。最后，我们将表演 问卷调查或访谈，以评估(1)新冠肺炎患者护理的经验和看法 来自一线医护人员和(2)来自HIV患者的远程保健在HIV护理中的利弊 和护理提供者。我们还将评估新冠肺炎疫情如何改变/塑造人们的看法和 实习医生、实习生和学生的职业/专业选择。这个项目的结果将会有所帮助 缩小新冠肺炎在惠民中造成的健康差距。 项目总结

PROJECT SUMMARY Similar to HIV and hepatitis C virus, SARS-CoV-2, the cause of COVID-19, is most devastating to people of health disparity populations (HDP). However, we hypothesize that COVID-19 could cause health disparities among different HDP (i.e. “disparities within”) and certain circumstances and determinants could contribute to and predict the “disparities within”. Our ongoing partnerships with a multi-hospital healthcare system and a multisite community health center for the study of HIV/HCV-related health disparities provide an immediate, practical, and pertinent platform to study the impacts of COVID-19 on health outcomes and healthcare access and utilization among people of various HDP. The hospitals of the healthcare system and the clinics of the community health center are situated in urban, suburban, and rural areas with major health disparities. The healthcare system has provided SARS-CoV-2 testing services and treated many hospitalized COVID-19 patients. The community health center provides HIV care to people of racial/ethnic and sexual/gender minorities and other vulnerable populations. We will take advantage of the ongoing partnerships, using a retrospective cohort study design with data from the medical records, to dissect the “disparities within” caused by COVID-19. First, we will delineate the clinical features and natural history of COVID-19 among the hospitalized patients, and determine the factors associated with COVID-19 pathogenesis, disease severity, and treatment effectiveness. We also aim to establish novel, unique, and tailored clinical “scoring” systems/models that can be used to predict COVID-19 outcomes and severity in patients of different HDP. Second, we will analyze the trends in and characteristics of the SARS-CoV-2 testing and assess whether people of the HDP were underrepresented in the testing. We will also analyze the factors associated with SARS-CoV-2 positivity among those tested. For those who tested positive, we will assess their participation/engagement in the COVID-19 cascade of care and determine the factors associated with attending or missing each of the stages in the care cascade. Next, we will assess the HIV continuum of care during the COVID-19 lockdown, analyzing the trends and factors associated with missing appointments, labs, and/or prescriptions as well as the utilization of telehealth. We will also examine the HIV-related health outcomes among those who continued care during the lockdown. Finally, we will perform questionnaire surveys or interviews to assess the experiences and perceptions of (1) COVID-19 patient care from the frontline healthcare workforce and (2) the pros and cons of telehealth in HIV care from the HIV patients and care providers. We will also evaluate how the COVID-19 pandemic has changed/shaped the perception and career/specialty choice of the medical residents, interns, and students. The results from this project will help reduce the health disparities caused by COVID-19 among the HDP. PROJECT SUMMARY