COVID-19 Collaboration Saves Lives of ICU Patients

In late March, Zee Rahiman spiked a fever and could barely talk because of non-stop coughing and vomiting. Once admitted to hospital, his condition rapidly deteriorated. Zee tested positive for COVID-19 and was transferred to the intensive care unit (ICU), where he was placed on a ventilator.

“I initially thought ‘I’m fit. This is going to be another flu for me,’” says Zee, 32. “But I found out that my immune system was not as talented as I thought.”

As Zee lay unconscious and intubated in ICU, a physician asked his mother for permission to treat him with an immunosuppressant as part of a new collaborative study led by the University of British Columbia (UBC) and Vancouver General Hospital (VGH).

Knowing Zee’s life was in the balance, his mother agreed. The results were remarkable, and after four days, Zee was moved out of ICU to recover.

The research collaboration, co-led by Dr. Myp Sekhon, clinical assistant professor in UBC’s department of medicine and intensive care physician in the ICU at VGH and Dr. Cheryl Wellington (pictured), a professor in UBC’s department of pathology and laboratory medicine, was examining how the immune system can overreact in the presence of COVID-19 and attack the lungs.

Quick work in the lab saved lives in hospital

Before the COVID-19 pandemic was declared, Drs. Sekhon and Wellington were working together on a study of the neurological complications of heart attacks. Thanks to the research techniques and technology that they were already using, they were quickly able to quickly pivot their work in response to the global emergency and quickly developed a new project within two days and received full Research Ethics BC and biosafety approvals within a week.

Initial tests performed in Dr. Wellington’s laboratory at the Djavad Mowafaghian Centre for Brain Health indicated COVID-19 patients had elevated presence of inflammatory and immune biomarkers—a substance in the blood that indicates specific biological processes—which led them to investigate the possibility of using existing immune suppressant medication.

The research team worked around the clock, completing analyses within 48 hours, where a patient study would usually take between four and six months.

“There was exhilaration, elation that we were really onto something as we saw the data unfold into a clear picture," says research associate Dr. Sophie Stukas.

“Jumping on this project was so exciting and fulfilling,” says Dr. Ryan Hoiland, another member of Dr. Sekhon’s team. “We’ve positioned ourselves to have some legitimate impact.”

So far, 58 patients have taken part in the study. Vancouver Coastal Health predicts 60 per cent of COVID patients in British Columbia will be treated at VGH and Surrey Memorial, which gives the team a significant opportunity to discover more about how the body’s immune system reacts to the disease.

“As a scientist, being able to help the clinicians and be a member of a large interdisciplinary team that is doing work to an exceptional standard has been the most meaningful period of my professional life,” says Dr. Wellington. “It’s a fantastic feeling to be able to contribute and bring in my team to be a part of this.”

The peer-reviewed study, titled Amelioration of COVID-19-related cytokine storm syndrome: parallels to chimeric antigen receptor-T cell cytokine release syndrome was published in the British Journal of Hematology in June 2020, with a total of six other papers featured in other prestigious publications including the Canadian Medical Journal Association, Blood Advances, Blood Reviews, Critical Care Explorations and the European Respiratory Journal. This body of work includes research into the connections between inflammation and lung function, neurological aspects of COVID-19, and how ABO blood group influences disease course.  The achievements of this team are truly remarkable, as only $20,000 was initially spent and the entire investigative team has personally contributed and leveraged other funding sources to support these studies.

A basis for a Canada-wide biobank

The study represents a unified collaboration between UBC and VGH that could prove to be a blueprint for future partnerships between clinicians and scientists, setting the stage for a British Columbia-wide biobank that now has over 700 specimens from approximately 58 COVID-19 patients. As a major collaborative effort between frontline healthcare and academia, a province-wide biobank would bring together the individual efforts of teams like Dr. Sekhon’s and Dr. Wellington’s who are racing to understand the effects of SARS-CoV-2 on the body to discover new treatments. Existing as a network of sites within major hospitals in BC, it will be a means to collect tissue samples and alleviate the burden on patients, frontline clinicians and researchers, accelerating work on effective therapies with a view to connecting with similar projects in other provinces.

“I don’t know of any other collection worldwide that has this depth,” Dr. Wellington says. “There are many collaborators that we’ve already begun to speak to who really understand immune response, so the biobank is critical in supporting other studies that will build on the work that Myp has already done within his intensive care unit. However, there are finite specimens that will eventually run out, and this is why we want to keep the study going.”

 

Tags: