Researchers in the Rady Faculty of Health Sciences have taken rapid action to address the COVID-19 crisis.
Their findings are shedding important light on potential preventive strategies, disease-tracking methods, therapies and vaccines, and on COVID-19’s effects on specific populations.
“Our University of Manitoba researchers are on the cutting edge of battling this pandemic,” said Brian Postl [MD/76], dean of the Rady Faculty. “Our expertise in infectious disease, public health and clinical trials is bolstered by the speed at which our researchers have come together to combat COVID-19.”
Dr. Ryan Zarychanski [B.Sc./95, B.Sc.Med./00], associate professor of internal medicine in the Max Rady College of Medicine and senior scientist at the Research Institute in Oncology and Hematology, is a leading UM researcher contributing to the pandemic fight.
The hematologist, critical-care physician and clinician-scientist leads a large UM team that is conducting, or has completed, a number of COVID-19 clinical trials. Because of the urgent need for viable treatments, the trials have been planned, approved and put into action at high speed.
“All members of the team have been working flat-out so that Manitobans can have access to treatments in the context of high-quality, appropriately monitored clinical trials,” Zarychanski told Research Today.
Funding for the trials has included $25,000 from the Manitoba Medical Service Foundation, about $1.2 million from Research Manitoba and the Manitoba government, and $5.8 million from the Canadian Institutes of Health Research.
In March, it was announced that Zarychanski would lead Manitoba’s first COVID-19 trial. It aimed to evaluate the effect of hydroxychloroquine, a drug used for malaria and other diseases, on adults who had recently been exposed to someone with COVID-19, but did not yet have symptoms.
The double-blind, randomized, placebo-controlled trial was conducted with scientists at the Research Institute of the McGill University Health Centre, the University of Alberta and the University of Minnesota. Trial participants, who enrolled online, received the drug or a placebo by courier and took it for five days.
On June 3, the physician-researchers made international headlines with the result: hydroxychloroquine was not effective in preventing COVID-19 when taken post-exposure. The findings were published in the prestigious New England Journal of Medicine.
In May, the team started a clinical trial in collaboration with the University of Minnesota and McGill University to see whether hydroxychloroquine taken before exposure could protect front-line health-care workers. This trial was stopped prematurely. “As a consequence of political messaging, primarily from the United States, recruitment into this trial ground to a halt,” Zarychanski said.
A junior faculty member, Dr. Lauren MacKenzie, assistant professor of internal medicine, said she gained valuable experience by leading the Canadian arm of the pre-exposure trial.
In another project announced in May, Zarychanski and investigators from the University of Toronto launched two international clinical trials to assess whether heparin, an anticoagulant (blood thinner), could help to improve survival for COVID-19 patients.
There has been a high incidence of blood clots causing death in patients with the virus. Heparin may hold promise, Zarychanski said, because in addition to preventing clotting, it can reduce inflammation and may have antiviral effects.
One anticoagulant trial focuses on patients who are hospitalized on medical wards, the other on critically ill patients in intensive care units. These randomized trials are being recognized around the world, Zarychanski said, as the foremost studies to measure heparin’s potential in COVID-19.
Hospitals in Canada, the U.S., Brazil, Mexico, the U.K., Europe and Australia are participating. Zarychanski’s protocols have also been adopted by the National Institutes of Health as the exclusive anticoagulant trial protocols for hospitalized patients in the U.S.
“These collaborative trials have literally gone viral and gone global, and we’re leading them from Manitoba,” he said.
Yet another study sees the research team participating in a global trial by the World Health Organization to gauge the effects of several medications in hospitalized COVID-19 patients.
This trial is evaluating remdesivir (an antiviral medication) and interferon beta 1a (an immunomodulatory drug).
Its UM leaders are Yoav Keynan [PhD/14], associate professor of medical microbiology and infectious diseases, and Dr. Lauren Kelly, assistant professor of pediatrics/child health and community health sciences and researcher with the Children’s Hospital Research Institute of Manitoba.
Zarychanski is also co-leading a cross-Canada clinical trial to test the effects of giving blood plasma from people who have recovered from COVID-19 to critically ill patients, with the goal of introducing protective antibodies.
The physician-researcher describes the flurry of trials as “clinical science at warp speed.”
“We’re bringing science to the bedside to rapidly inform clinical decision-making,” Zarychanski said. “In addition to generating new knowledge, the trials are providing many opportunities for trainees and junior faculty to participate in, or help lead, randomized trials.
“The end result will be to increase our research capacity at U of M while putting Manitoba on the global map of centres that can develop and lead international randomized trials.”
BY RADYUM STAFF
Here are some other Rady Faculty research projects that are advancing knowledge about COVID-19:
Meghan Azad [PhD/10], assistant professor of pediatrics/child health and community health sciences, Canada Research Chair in developmental origins of chronic disease, and researcher with the Children’s Hospital Research Institute of Manitoba (CHRIM), received $1,639,795 from the Canadian Institutes of Health Research (CIHR) and $100,000 from Research Manitoba to study the direct effects of coronavirus infection and the indirect effects of the pandemic within the ongoing Canadian Healthy Infant Longitudinal Development (CHILD) Cohort Study.
Jared Bullard [B.Sc.(Med)/04, MD/04], associate professor of pediatrics/child health and medical microbiology/infectious diseases and researcher with CHRIM, led a collaborative study by Manitoba Health and the Public Health Agency of Canada, demonstrating that the infectious potential of COVID-19 drops to a low level as soon as eight days after symptoms appear.
Dr. Kevin Coombs, professor of medical microbiology and infectious diseases and researcher with CHRIM, was awarded $790,162 from the CIHR to lead a study using a novel tool called SOMAscan and next-generation sequencing to study how COVID-19 affects genes and proteins in lung cells.
Dr. Michelle Driedger, professor of community health sciences, received $499,731 from the CIHR for a study examining how members of the public, including populations such as the Métis, understand public health communication efforts about how to protect themselves from COVID-19.
Renee El-Gabalawy [B.Sc.(Hons.)/08, MA/10, PhD/15], assistant professor of anesthesiology, perioperative and pain medicine and clinical health psychology, leads a mental health study of what factors may predict or prevent stress during and following the COVID-19 pandemic.
Lawrence Gillman [B.Sc.(Med.)/02, MD/02], associate professor of surgery, and Faisal Siddiqui [B.Sc.(Med.)/01, MD/01], assistant professor of anesthesiology, perioperative and pain medicine, provided medical expertise to a UM team that developed a simple, inexpensive 3D-printed ventilator that could be produced and used in a pandemic emergency.
Dr. Jody Haigh, associate professor of pharmacology and therapeutics and senior scientist at the Research Institute in Oncology and Hematology, co-authored a study with postdoctoral researcher Dr. Carlos Farkas showing that the COVID-19 virus has many variants in different geographic regions, which may cause false-negative test results and hamper vaccine development.
Dr. Anand Kumar, professor of internal medicine, medical microbiology/infectious diseases and pharmacology/therapeutics, led a research team in demonstrating that some N95 masks can be sterilized in an autoclave for reuse up to 10 times in clinical settings.
Dr. Josée Lavoie, professor of community health sciences and director of Ongomiizwin – Research, received $475,836 from the CIHR to work in partnership with the First Nations Health and Social Secretariat of Manitoba to develop a platform for modelling the community impact of a pandemic.
Verena Menec [BA(Hons.)/89, MA/91, PhD/95], professor of community health sciences, is the Manitoba lead for a study within the Canadian Longitudinal Study on Aging to examine the pandemic experiences of older adults, including how they cope, the effects on their physical and mental health, and changes in how they access health services.
Dr. Nathan Nickel, assistant professor of community health sciences and researcher with CHRIM, received $317,917 from the CIHR to study, in partnership with the First Nations Health and Social Secretariat of Manitoba, Manitoba Metis Federation and Manitoba Inuit Association, who is being tested for COVID-19 among Indigenous populations in the province.
Brad Pickering [B.Sc./03, PhD/10], assistant professor of medical microbiology and infectious diseases, received $270,550 from Research Manitoba and $140,270 from the CIHR for research on the use of portable CRISPR-based diagnostics to detect COVID-19 at the point-of-need, such as in passenger screening.
Dr. Christen Rachul, director of research for the Rady Faculty’s Office of Educational and Faculty Development, is studying Internet claims about “immune boosting” to prevent COVID-19. The study is part of a larger CIHR-funded project looking at how misinformation and disinformation are spread through various forms of media.
Dr. Xiao-Jian Yao, professor of medical microbiology and infectious diseases and researcher with CHRIM, leads a team that received $326,578 from the CIHR and $270,550 from Research Manitoba to study the development of a vaccine that targets COVID-19 by using a technology platform patented by UM.