Title: CRST COVID-19 Wayakta He? (Are you on guard against COVID?) PI: E. Erdei Project Summary Ongoing concurrent pandemics of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infections and toxic exposures originated from electronic cigarette (e-cig) and secondhand smoke had taken devastating tolls on minority communities in the U.S. Rather than being “the great equalizer” due to universal lack of immunity, evidence has shown that the burden of COVID-19 disease has been disproportionately felt by racial/ethnic minority and low-income communities. This stark and most current health disparity is likely due to a variety of psychosocial stressors stemming from structural inequalities that place individuals of color and/or low socioeconomic status, including American Indian/Alaska Native communities at greater risk for the contraction of SARS-CoV-2 infection and severity of COVID-19 disease. A recent literature showed that overall COVID-19 diagnosis was associated with youth use of e-cigarettes. However, that study did not look specifically at younger generation of American Indian and Alaskan Native (AI/AN), and how other factors within tribal communities affect disease susceptibility. This proposal is submitted in response to "Mechanism for Time-Sensitive Research Opportunities in Environmental Health Sciences ", RFA-ES-19-011. Aim 1 will employ a community-based data collection of socioeconomic and environmental stressors in the Cheyenne River Sioux Tribal (CRST) communities in South Dakota by administering a tribal-specific survey, which will constitute the CRST SARS-CoV-2 infection prevalence collected in 300 participating CRST households with 600 distinct participants representing a wide-range of ages (18-89 yrs). The development of novel and time - sensitive data during the ongoing CRSRT pandemic on social factors and environmental toxicants will expand under Aim 2 by capturing detailed personal behaviors (i.e. vaping), stressors, Tribal housing, and by measuring environmental health factors that may impact COVID-19 disease susceptibility, severity and immune response. Detailed immunological assessment (total IgA, viral-specific IgG & IgM positivities and cortisol) will be carried out by using non-invasive saliva sampling. These measures will help us to assess the association between risk factors from Aim 1 survey data and RT-PCR confirmed SARS-CoV-2 viral infection prevalence. Based on passive air monitoring we will be able to evaluate the association between airborne exposures to nitrogen dioxide and airborne nicotine in the homes with increased susceptibility for SARS-CoV-2 infections and increased viral-specific IgM and decreased protective IgG response. We will assist CRST COVID-19 Command Center by generating a community-driven, COVID-19 targeted, public health literacy, and by capturing population-based infection susceptibility risks and specific immune response data. Our hypothesis is that increased SARS-CoV-2 infections a...