Inflammatory and Metabolic Biomarkers in Cardiovascular Complications with SARS-CoV-2

One of the most poorly understood yet clinically important aspects of the novel COVID-19 SARS
CoV2 coronavirus is the marked heterogeneity that it displays with infection severity and with
development of end organ complications and mortality. SARS CoV-2 infection has a complex
epidemiologic interplay with cardiovascular (CVD) and highlights this complex heterogeneity.
The biology underlying this heterogeneity in CVD outcomes is poorly understood and
concomitantly, clinically useful biomarkers do not currently exist to identify the highest risk
patients in need of the most intense monitoring. Thus, we propose to use integrated omics and
EHR data in a diverse multi-center North Carolina cohort with existing biological specimens to
determine the role of inflammation, metabolism and novel molecular mechanisms, and identify
biomarkers of CVD outcomes in patients with COVID-19. We propose to (1) Determine the
clinical predictors of infection severity in a diverse population of individuals with CVD risk
factors and SARS-CoV2 infection including evaluation of racial differences; (2) Determine the
role of inflammatory, SARS-CoV-2 related, and other candidate proteins as biomarkers of
infection severity and CVD outcomes in patients with SARS CoV-2 infection; and (3) Evaluate
metabolic pathways in SARS Co-V-2 infection severity and CVD outcomes. The proposal has
high potential for dissecting the molecular mechanisms of the heterogeneity between CVD and
SARS CoV-2 outcomes. Importantly, it has great short-term potential for clinically important
results that will lead to earlier and better identification of high-risk patients for more intensive
monitoring; novel therapeutic interventions to prevent end organ complications and mortality;
and diagnostic and disease-progression biomarkers.