AHA Rapid Response Grant COVID-19 and its Cardiovascular Impact

Selected to serve as the COVID-19 Coordinating Center, this team will collect results from the research projects and coordinate the dissemination of all study findings.

AHA Rapid Response COVID19 Research - What's Hot - Nov. 11, 2020

Columbia University Irving Medical Center, led by Sanjum S. Sethi, M.D., M.P.H.

Working with New York-Presbyterian and the Cardiovascular Research Foundation, this team will evaluate the clotting complications of COVID-19 in hospitalized patients, develop a risk score to aid in bedside decision-making and conduct a clinical trial to determine optimal medical treatment to prevent clotting complications in future COVID-19 patients.

Sethi Thrombotic Complications in COVID 19 Slides 10 16 20 (PDF)

Harvard Medical School, led by Joseph Loscalzo, M.D., Ph.D.

Working with the Center for Complex Network Research of Northeastern University, Lawrence Livermore National Laboratory and the National Emerging Infectious Diseases Laboratory at Boston University, this team will look at repurposing already approved drugs for faster applications in treating COVID-19 patients.

Repurposing Drugs for Treatment of Cardiovascular Disease Caused by SARS-CoV-2_ Joseph Loscalzo, MD, PhD_11.13.20

Covidome_in_different_tissues_Loscalzo.xlsx

Kaiser Permanente Southern California, led by Jaejin An, Ph.D.

This team will evaluate antihypertensive medication treatment in patients with confirmed COVID-19 infection and high blood pressure and their results could have an immediate impact on clinical guidance for patient care.

Poster, AHA Scientific Sessions 2020 (PDF)

Massachusetts General Hospital, led by Michael T. Lu, M.D., M.P.H.

Working with the Mass General Brigham hospitals, this team will use deep learning techniques and the initial chest x-ray of patients admitted for treatment to develop a new way to predict COVID-19 cardiopulmonary collapse and death.

Mayo Clinic, led by Ognjen Gajic, M.D.

This team will expand its current SMART randomized clinical trial to add the evaluation of biomarker-titrated corticosteroids dosing compared to usual care for treating COVID-19 patients.

Stanford University, led by Paul Heidenreich, M.D.

Working with the VA Palo Alto Health Care System, Stanford Health Care and Northern California Kaiser, this team will study the use of ACE and ARBs on patients with high blood pressure or diabetes during the COVID-19 pandemic to determine trends in the rates of COVID-19 infection, influenza, medication adherence, hospitalizations and deaths to improve patient management practices.

University of California, Los Angeles, led by Tzung K. Hsiai, M.D., Ph.D.

Working with the UCLA Cancer Virology Program, California Nanosystems Institute, Statistics and Epidemiology, Data Science, Behavioral Sciences, UCLA Medical Center and West Los Angeles VA Healthcare System, this team will set out to develop the first-of-its-kind COVID-19-on-a-chip, targeting the heart for now, but adaptable to other organ systems impacted by the infection, including the lung, gut, kidney and brain.

University of California, San Francisco, led by Michelle A. Albert, M.D., M.P.H.

Working with the UCSF NURTURE Center and the Slone Epidemiology Center at Boston University, this team will use the Black Women’s Health Study cohort to understand the experiences and cardiovascular effects of COVID-19 on African-American women, a population historically at the intersection of the worst health and economic disparities in the United States.

University of Colorado, led by Michael R. Bristow, M.D., Ph.D.

This team will study the specific mechanisms for how COVID-19 impacts the cardiovascular system either due to a robust inflammatory response and direct myocardial injury because that distinction can define therapeutic treatment.

University of Massachusetts, led by Jane E. Freedman, M.D.

This team will study the mechanisms of the platelet-mediated immune response of the COVID-19 virus on the cardiovascular system collecting fundamental molecular knowledge about the disease course of infection that will enable development of novel tools and strategies for clinical management that will lead to improved outcomes.

University of Nebraska Medical Center, led by Rebekah L. Gundry, Ph.D.

This group will be exploring specific pathways and biomarkers to identify those most at risk for COVID-19 infection and cardiovascular complications from the virus, and ultimately will look to develop the means for personalized medicine and future genomic testing and treatment.

Cleveland Clinic, led by Mina Chung, M.D.

This team will use a multidisciplinary approach to 1) study the interaction of SARS-CoV-2 spike protein in cardiac and brain cells, 2) screen possible candidate drugs targeting mechanisms of viral infection in these cells, and 3) assess these drugs using AHA’s COVID-19 registry. Expected outcomes include identification of drugs that can be repurposed and advanced toward clinical trials for treatment of COVID-19.

Johns Hopkins University, led by Daniela Cihakova M.D., Ph.D.

This team will seek to identify a potential peripheral biomarker of cardiac inflammation in COVID-19 and address possible mechanisms that lead to cardiac infection and subsequent injury. The results of these studies will also significantly contribute to the knowledge of the immune response in COVID-19 patients.

Cedars-Sinai Medical Center, co-led by Clive Svendsen, Ph.D. and by Arun Sharma, Ph.D.

This team will investigate whether SARS-CoV-2 can directly infect human cardiomyocytes, assess resulting effects and seek to establish a cardiomyocyte-specific antiviral drug screening platform against SARS-CoV-2. The findings potentially may lead to development of novel therapeutics for the cardiac-specific effects of COVID-19.

Sharma 2020 - Cell Reports Medicine - Human iPSC-Derived Cardiomyocytes Are Susceptible to SARS-CoV-2 Infection (PDF)

Columbia University Vagelos College of Physicians & Surgeons, led by Emily J. Tsai

This team will compare single nuclei RNA sequences and histopathological findings between the hearts of COVID-19 non-survivors with and without suspected COVID-19 cardiac disease. Understanding the viral and host factors that drive cardiac injury in COVID-19 will help determine appropriate therapeutic strategies.

University of Texas Health Science Center at San Antonio, led by Anand Prasad, M.D.

Clinical Question: What is the incidence, degree, risk factors, and clinical outcomes of new-onset cardiac dysfunction in patients infected with the SARS-CoV-2 Virus defined by elevation in cardiac biomarkers and ventricular systolic and diastolic dysfunction on echocardiography?

Along with the new rapid response research grants above, the American Heart Association is also investing $800,000 in supplemental, short-term special projects at the four centers in its Health Technologies & Innovation Strategically Focused Research Network. This funding is in addition to their original grants and will focus on rapid technology solutions to address the COVID-19 pandemic crisis.

Cincinnati Children's Hospital, led by Andrea Z. Beaton, M.D.

Recently, automated intelligence, or computer learning, has become available to help non-expert users take better ultrasound pictures of the heart (echocardiogram) and even provide them with an automatic interpretation. One such software, Navigational Guidance, directs users to the correct position, automatically captures the best images, and provides an automatic value for the squeeze of the heart, known as the ejection fraction. Tools such as these, create the potential for more routine integration of heart imaging into clinical care.

This study takes a broad look at the value of integrating routine measurement of ejection fraction in the setting of COVID-19 from both the patient and provider perspective. Navigational guidance will be tested in the Emergency Department and Intensive Care Unit facing COVID-19. The experience and performance of frontline providers will be measured. Detailed clinical data, including ejection fraction, will be collected on a large group of patients with COVID-19. This data will be used to develop a risk prediction score, to improve the early identification of patients most likely to become critically ill.

Ejection Fraction as the Sixth Vital Sign for Patients with COVID (PPT)

Johns Hopkins University, led by David Newman-Toker, M.D.

Strokes can lead to obvious and crippling symptoms. These include paralysis on one side of the body or trouble speaking. Strokes can also have milder symptoms like dizziness or vertigo. This can be mistaken for common inner ear disorders. Prompt stroke diagnosis can lead to treatments that restore brain blood flow and prevent stroke worsening. This can limit or reverse disability. It can also decrease risk of future stroke and heart attack. However, during COVID-19, patients with early stroke symptoms may avoid in-person care.

Specialist doctors can tell the difference between brain and ear problems. They do this by looking at a patient’s eye movements. This is more accurate than brain imaging such as CT or MRI. Looking at eye movements remotely requires high-quality video. This cannot be done with routine streaming video used in telemedicine services. This American Heart Association funded project will create equitable access to specialists through mobile tele-diagnosis. Specialists will address possible stroke symptoms in patient homes using a smartphone application. Patients will use the app to record their eye movements and send them to specialists. Specialists will rapidly say if the patient needs urgent stroke care or in-home treatment for ear problems. For those at risk of stroke or other cardiovascular disease, we will use this “teachable moment” connect patients with preventive care.

University of Michigan, led by Brahmajee Nallamothu

The number of coronavirus disease 2019 (COVID-19) infections is rising rapidly in the US. Michigan has been one of the hardest hit states with more than 15,000 cases as of early April 2020. Infections most commonly target the lung, but heart-related consequences of COVID-19 are also important. For example, heart disease, hypertension and diabetes mellitus lead to more severe disease. And the COVID-19 pandemic may have negative effects even for those who evade infection. Stress, social distancing, and unemployment may disrupt non-COVID treatment and healthy lifestyles.

We will use data from 2 ongoing U-M mHealth studies to see how the COVID-19 pandemic is affecting communities. These studies include nearly 7,500 diverse participants in Ann Arbor and Flint. Including both groups is critical given early data on the racial differences with the infection. With study enrollment initiated before the COVID-19 pandemic, we will be able to understand how factors like blood pressure and heart are affected by the COVID-19 infection. We will also be able to track stress, anxiety and mood. Finally, we can follow patients to see how outcomes like hospitalization and ED visits change over time.

Our findings will be able to help patients and their physicians better tackle the COVID- 19 pandemic.

Stanford University, led by Paul Wang, M.D.

The novel coronavirus (SARS-CoV-2) rapidly became a global pandemic. To capture scientific information about the novel coronavirus, the American Heart Association has rapidly created the COVID-19 Get With The Guidelines® (GWTG) registry. Obtaining such data will be critical in advancing our knowledge about the novel coronavirus and developing effective strategies to combat it. Entering the data can be resource intensive and be a barrier for inclusion of centers that have particularly diverse and underserved populations. We, therefore, propose to develop a set of tools that will simplify data entry and have several benefits: 1) decrease burden of data capture, particularly during surges in hospital resource use; 2) permit analysis of data during the pandemic; 3) avoid bias of omitting entry of complicated long length of stay admissions; 4) encouraging low resource institutions to participate, reducing disparities in populations studied.