R01HL157530

A Multi-Dimensional Linked Registry to Identify Biological, Clinical, Health System, and Socioeconomic Risk Factors for COVID-19-Related Cardiovascular Events - Project Summary/Abstract

There is mounting concern that patients hospitalized with COVID-19 experience unexpectedly high rates of cardiac and vascular events. Identifying which patients are at highest risk for COVID-19-related cardiovascular events and delineating how these events affect short- and long-term outcomes may help support individualized patient care, illuminate underlying pathophysiologic mechanisms, and accelerate the development of effective therapies. However, little is known about how multi-dimensional risk factors, including prior medical conditions, socioeconomic indicators, and circulating levels of biomarkers, affect patient outcomes.

Building on our team's expertise in data linkage, prediction modeling, and biomarker discovery, we will create a unique and powerful linked data resource to characterize the biological, clinical, health system, and socioeconomic risk factors for the development of cardiovascular sequelae of COVID-19 and examine their impact on health outcomes.

To create this data resource, we have partnered with the American Heart Association, whose COVID-19 Cardiovascular Disease Registry is actively capturing high-quality, standardized information on all adults hospitalized with confirmed SARS-CoV-2 infection at >100 U.S. sites spanning 30 states. We will link this registry to comprehensive health care claims, a national socioeconomic deprivation index, and detailed health care system information.

In Aim 1, we will apply traditional and machine learning approaches to the linked multicenter registry in order to identify the clinical, health system, and socioeconomic factors that predict in-hospital major adverse cardiovascular events (MACE) among COVID-19 patients.

In Aim 2, we will characterize long-term MACE (i.e., at 1 and 2 years after discharge from the index COVID-19 hospitalization) among older adults in a large multicenter registry linked with longitudinal Medicare claims, and identify the clinical, health system, and socioeconomic factors that predict their occurrence. Based on this work, we will create clinically implementable risk scores which will estimate, at the time of admission for and discharge from an index COVID-19 hospitalization, a patient's risk of developing a major cardiovascular event.

In Aim 3, we will evaluate the proteomic profiles of a subset of patients in the linked registry with biobanked serial blood samples, and identify biochemical markers that predict the occurrence of MACE, both during index hospitalization for COVID-19 and after discharge.

This research will advance our collective understanding of the biological, clinical, and socioeconomic predictors of COVID-19-related cardiovascular morbidity and mortality. By identifying patients at greatest risk of cardiovascular events, our work will help frontline clinicians better individualize clinical management strategies and health systems improve care delivery during future waves of the pandemic.

Beth Israel Deaconess Medical Center

TO FOSTER HEART AND VASCULAR RESEARCH IN THE BASIC, TRANSLATIONAL, CLINICAL AND POPULATION SCIENCES, AND TO FOSTER TRAINING TO BUILD TALENTED YOUNG INVESTIGATORS IN THESE AREAS, FUNDED THROUGH COMPETITIVE RESEARCH TRAINING GRANTS. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO STIMULATE TECHNOLOGICAL INNOVATION, USE SMALL BUSINESS TO MEET FEDERAL RESEARCH AND DEVELOPMENT NEEDS, FOSTER AND ENCOURAGE PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY SOCIALLY AND ECONOMICALLY DISADVANTAGED PERSONS, AND INCREASE PRIVATE-SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE TECHNOLOGICAL INNOVATION, FOSTER TECHNOLOGY TRANSFER THROUGH COOPERATIVE R&D BETWEEN SMALL BUSINESSES AND RESEARCH INSTITUTIONS, AND INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL R&D.

93.837 - Cardiovascular Diseases Research

National Heart Lung and Blood Institute (NHLBI) [HHS - NIH]

Massachusetts United States

State-Wide

NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed) (PA-20-185)

Amendment Since initial award the End Date has been extended from 03/31/25 to 07/31/25 and the total obligations have increased 288% from $785,888 to $3,049,476.