COVID-19 is a global pandemic that disproportionately affects minority older adults with cardiac disease and multiple chronic conditions. Densely populated urban centers with a high proportion of socioeconomically disadvantaged persons, including New York City (NYC) and Boston, are most impacted by COVID-19. SCAN- MP (Screening for Cardiac Amyloidosis with Nuclear Imaging in Minority Populations, R01HL139671) is a NHLBI funded, prospective cohort study that enrolled 123 of a target 800 Black or Caribbean Hispanic participants over the age of 60 years with heart failure prior to the mandatory recruitment pause for the pandemic. The profile of the SCAN-MP participant matches those known to be at highest risk from COVID- 19. In this application, we propose to leverage the successful recruitment and retention techniques of the SCAN-MP infrastructure to advance our understanding of the prevalence of SARS CoV-2 infection and disentangle the demographic, social, and environmental factors known to be associated with infection. While mitigation is the primary public health strategy to address the spread of COVID-19, it may be particularly challenging for those with resource limitations or those who live in close physical proximity to others to comply with CDC recommendations, perhaps accounting for the observed increase in infection rates. Successful emergence from the pandemic will depend upon evidence of prior SARS CoV-2 infection in the population. Given that asymptomatic infection is common, serologic testing will likely play a critical role in the next phase of recovery. Serologic testing has been validated at Columbia University with a highly sensitive and specific, quantitative ELISA-based assay to detect antibodies to SARS-CoV-2 that we propose to leverage in this study. Our objectives are to (1) define the proportion of SCAN-MP participants with evidence of prior COVID- 19 infection by antibody testing, (2) determine the capacity of SCAN-MP participants to comply with CDC mitigation recommendations. We will then explore how infection rate and mitigation compliance interact with socio-economic factors such as income and living conditions, as well as measures of health literacy, trust/engagement in the health system, and perceived discrimination. We will explore whether the presence and/or titer of antibodies specific for SARS CoV-2 virus will be associated with future COVID-19 infection as well as adverse outcomes (hospitalizations and mortality) over a one-year time period. We are uniquely positioned to perform these studies quickly given our ability to recruit an urban, minority cohort with cardiac disease at high risk for COVID-19 morbidity/mortality, expertise in the performance of serologic testing for antibodies to SARS CoV-2, and established expertise in community engaged research. Successful completion of these Aims has the potential to inform implementation of mitigation strategies in high-risk populations and contribute important data useful for the resolution of the COVID-19 pandemic.
COVID-19, caused by infection with the SARS CoV-2 virus, is a global pandemic that disproportionately affects urban, minority, older adults with cardiovascular disease, centered in the US in New York and Boston. We will leverage the infrastructure of the SCAN-MP study, a NHLBI funded cohort study of Blacks and Caribbean Hispanics in these cities who are > 60 years of age with congestive heart failure to test for prior COVID-19 infection and assess social factors that may influence the capacity to effectively follow public health recommendations. These data will inform future mitigation strategies in high-risk populations and contribute important data useful for resolution of the COVID-19 pandemic.
