# Cardiac microstructure and the immune-inflammatory response to SARS-CoV-2

> **NIH NIH R01** · CEDARS-SINAI MEDICAL CENTER · 2023 · $741,942

## Abstract

PROJECT SUMMARY
Amidst the rapidly growing body of evidence regarding risks and outcomes associated with coronavirus disease
2019 (COVID-19), many knowledge gaps persist. We and others have reported on how certain comorbidities,
including cardiovascular risk factors, predispose some individuals more than others to the severest forms of
COVID-19 illness. The natural history, diversity, and determinants of end-organ sequelae following COVID-19
illness remain unknown. Extending beyond lung injury, accumulating data have highlighted not only short-term
but also potentially long-term adverse effects involving the heart. In fact, multiple reports have indicated a high
prevalence of subclinical as well as clinical abnormalities in cardiac structure and function seen among patients
recovering from even mild cases of COVID-19 illness. Based on the emerging evidence and our own clinical
experience to date, we hypothesize that SARS-Cov-2 provokes a systemic immune-inflammatory response that
leads to under-recognized myocardial disease in a large proportion of infected individuals – in a manner that
persists over time and represents elevated risk for the longer-term post-acute sequelae of COVID-19. Thus, we
propose to expand the application of novel cardiac imaging methods to comprehensively characterize the post-
infectious cardiac effects of COVID-19. Our specific aims are: (1) to identify and characterize the longitudinal
trajectories of cardiac disease and associated outcomes following the post-acute phase of COVID-19 illness;
and, (2) to characterize the longitudinal trajectories of immune-inflammatory response to COVID-19 illness, and
their relations with post-infectious cardiac disease and associated outcomes. From our growing source sample
of >12,500 hospitalized treated since 3/8/2020 for rt-PCR confirmed positive or negative COVID-19 status, we
will prospectively enroll COVID-19 positive patients (cases) representing the spectrum of COVID-19 illness
severity; we will simultaneously enroll hospitalized COVID-19 negative patients (controls) matched on age, sex,
ethnicity/race, comorbidities, and illness severity. We will use serial multi-modality imaging to characterize
trajectories of persistent cardiac disease versus functional and structural recovery over time. We will also use
advanced high-throughput mass spectrometry methods to serially profile bioactive lipid eicosanoids, which are
recognized as upstream molecular mediators of the systemic immune-inflammatory response to stress (including
COVID-19). We will relate eicosanoid measures with trajectories of post-infectious cardiac disease persistence
versus recovery. For significant associations, will examine heterogeneity in trajectories by sex, age,
race/ethnicity, socioeconomic status, and host-environment modifiers.

## Key facts

- **NIH application ID:** 10580600
- **Project number:** 5R01HL131532-07
- **Recipient organization:** CEDARS-SINAI MEDICAL CENTER
- **Principal Investigator:** Susan Cheng
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $741,942
- **Award type:** 5
- **Project period:** 2016-04-01 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10580600

## Citation

> US National Institutes of Health, RePORTER application 10580600, Cardiac microstructure and the immune-inflammatory response to SARS-CoV-2 (5R01HL131532-07). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10580600. Licensed CC0.

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