Among patients with COVID19, there is a high prevalence of cardiovascular disease, and >7% of patients experience myocardial injury as a result of the infection (22% of critically ill patients). COVID19 may disproportionately affect people with cardiovascular disease. Previous observations suggest that underlying cardiovascular disease is associated with an increased risk of in-hospital death among patients hospitalized with COVID19. Furthermore, coagulopathy and vascular endothelial dysfunction have also been proposed as complications of COVID19. We propose a supplement to ?Adopting a Precision Medicine Paradigm in Puerto Rico: leveraging ancestral diversity to identify predictors of clopidogrel response in Caribbean Hispanics? to describe and better understand how the COVID19 pandemic is affecting our established cohort of Caribbean Hispanics with cardiovascular disease. Our cohort is currently made up of 549 patients with coronary artery disease (CAD), peripheral artery disease (PAD), and/or a history of stroke (CVA) who are currently receiving treatment with the antithrombotic medication clopidogrel (with or without aspirin). Building on the personalized medicine approach we are already developing for this population, we will combine serologic testing to measure individual exposure to the SARS-CoV-2 virus with their health (symptoms, clinical outcomes, medical comorbidities), access to care (including SARS-CoV-2 testing), and household status during the COVID19 pandemic. This will allow us to evaluate the true prevalence of SARS-CoV-2 exposure in our cohort, as well as understand the phenotypic effects of the virus in our population. These data will shed light on the underlying biological pathways involved in COVID-19 pathogenesis. We will then combine data from our cohort with patients hospitalized for acute COVID19 to perform a targeted and untargeted exploratory genome-wide association study of poor clinical outcomes (e.g., hospitalizations, ICU admission, need of mechanical ventilators) in order to identify potential risk markers or protective genes among Caribbean Hispanics suffering from the disease.
The majority of clinical studies lack the racial/ethnic diversity of the US population, particularly our under- represented minority populations of Latinos (i.e., ~1% of participants in clinical trials). This proposal is aligned with the consensus report of the Institute of Medicine that recommends identifying patient characteristics and treatments that vary by ethnicity so that personalized interventions can be developed in Caribbean Hispanics to minimize differences in care and disparities in outcomes. It is also consistent with Healthy People 2020, which seeks to eliminate health disparities in Hispanics, as well as prevent harm through valid and useful genomic tools in clinical practices. OMB No. 0925-0001/0002 (Rev. 03/2020 Approved Through 02/28/2023) Page Continuation Format Page
| Lozada-Delgado, Eunice L; Grafals-Ruiz, Nilmary; Miranda-Román, Miguel A et al. (2018) Targeting MicroRNA-143 Leads to Inhibition of Glioblastoma Tumor Progression. Cancers (Basel) 10: |
| Montes-Rodríguez, Ingrid M; Rodríguez-Pou, Yesenia; González-Méndez, Ricardo R et al. (2018) Characterization of Histone Genes from the Bivalve Lucina Pectinata. Int J Environ Res Public Health 15: |
| Rosas-Vidal, Luis E; Lozada-Miranda, Valeria; Cantres-Rosario, Yisel et al. (2018) Alteration of BDNF in the medial prefrontal cortex and the ventral hippocampus impairs extinction of avoidance. Neuropsychopharmacology 43:2636-2644 |
| Ramírez, Maite; Santos, Saritza; Martínez, Osmarie et al. (2018) Characterization of the immune response elicited by the vaccinia virus L3 protein delivered as naked DNA. Vaccine 36:2049-2055 |
| Manfredi, Barbara; Morales-Ortíz, Jessica; Díaz-Díaz, Lymarie M et al. (2018) The Characterization of Monoclonal Antibodies to Mouse TLT-1 Suggests That TLT-1 Plays a Role in Wound Healing. Monoclon Antib Immunodiagn Immunother 37:78-86 |
| Hernandez-Suarez, Dagmar F; Tomassini-Fernandini, Jonnalie C; Cuevas, Angelica et al. (2018) Clinical Relevant Polymorphisms Affecting Clopidogrel Pharmacokinetics and Pharmacodynamics: Insights from the Puerto Rico Newborn Screening Program. Int J Environ Res Public Health 15: |
| González De León, Joenice; González Méndez, Ricardo; Cadilla, Carmen L et al. (2018) Identification of Immunoglobulin E-Binding Proteins of the Xerophilic Fungus Aspergillus penicillioides Crude Mycelial Mat Extract and Serological Reactivity Assessment in Subjects with Different Allergen Reactivity Profiles. Int Arch Allergy Immunol 175:147-159 |
| Joshipura, Kaumudi J; Muñoz-Torres, Francisco J; Dye, Bruce A et al. (2018) Longitudinal association between periodontitis and development of diabetes. Diabetes Res Clin Pract 141:284-293 |
| Chapa-Dubocq, Xavier; Makarov, Vladimir; Javadov, Sabzali (2018) Simple kinetic model of mitochondrial swelling in cardiac cells. J Cell Physiol 233:5310-5321 |
| Pérez-Pedrogo, Coralee; Martínez-Taboas, Alfonso; González, Rafael A et al. (2018) Sex differences in traumatic events and psychiatric morbidity associated to probable posttraumatic stress disorder among Latino prisoners. Psychiatry Res 265:208-214 |
Showing the most recent 10 out of 48 publications
