While many of us are working from home during the coronavirus (SARS-CoV-2) pandemic, members of The University of New Mexico Center for Global Health (CGH) are busy in their campus laboratories seeking solutions.
Initiatives for decontaminating personal protective equipment for health care workers and using the virus’s genetic code to understand the infection’s origins and help with testing and laboratory experiments are already under way.
Teams of CGH faculty and other UNM Health Sciences Center researchers and medical staff are also tackling five other initiatives with the hands-on guidance of CGH director Douglas J. Perkins, PhD.
One initiative has taken a team into UNM Hospital to look for fomites: something in the environment that could carry infection. “And in this particular case, it would be SARS-CoV-2 which is in the environment,” explains Perkins, a professor in the UNM Department of Internal Medicine.
Team members are swabbing surfaces around the hospital that could be contaminated with the virus – including PPE and the exposed skin of health care workers. In the lab, Perkins and his team isolate RNA from the swabs to see if any of it is from SARS-CoV-2. If they find viral RNA, the team exposes cultured cells to that contaminated sample to see if the virus will grow.
At the same time, the team also consults collection information about the sample. "If one detects virus, then you want to figure out where it was at and why that happened – and then you need to implement either some additional PPE and/or more aggressive decontamination efforts within that particular environment," Perkins explains.
Another team is collecting nasopharyngeal swabs – in addition to blood samples – from COVID-19 patients hospitalized at UNMH to study their immune responses. They first categorize the samples as severe or non-severe based on the patients’ symptoms and survival, Perkins says. Then, the samples are subjected to next-generation sequencing to discover what gene networks differ between the two categories.
"Once you find emergent pathways that are good for discriminating between the groups, you go in and look specifically at that pathway and all the genes in it,” he explains. This helps researchers determine what drugs might block “severe disease genes” and test how they work in the severe patients’ blood cells. The team also hopes to find out whether any drugs can reduce a patient’s disease severity, says Perkins.
But COVID-19 doesn’t just affect the lungs – the digestive tract is also vulnerable.
One CGH team is studying how the virus develops in the gut and how it affects the cells lining the intestine. Though gastrointestinal symptoms from COVID-19 are one motivating factor for this initiative, another is the possibility that the virus could be shed from the body through stool.
“That shedding may take place at a longer, more protracted period of time,” says Perkins. “In other words, someone could be negative on their nasopharyngeal swab and still have virus that's shedding in stool." Fortunately, Perkins says, this concern can be slowed by hygienic practices like washing your hands.
Though many of us are heeding this wisdom, treating those patients who do become infected by the virus is difficult. That’s why a multidisciplinary team from the CGH and across the HSC are searching chemical databases to discover potential drug treatments and test them on cells in the laboratory.
“Essentially, (it’s) compound screening for different therapeutics that could prevent viral replication,” says Perkins. It’s not only an interesting part of what’s being done but important too, he adds.
The CGH is also working with Observational Health Data Sciences and Informatics, an international health informatics collaborative, to study how drugs being used to treat COVID-19 affect other diseases patients have.
"In general, we’re asking what do these medical and electronic health records across the globe say about outcomes when you're on different doses of hydroxychloroquine, for example,” Perkins says.
Other efforts include building new models to forecast the virus’s spread locally and statewide, as well as monitoring new information about the virus from across the globe. Center faculty are also working with other HSC faculty to create a summary COVID-19 briefing each day for the New Mexico Medical Advisory Team, HSC leadership and even the governor.
"That has become a very important source of information," he says.
Overall, Perkins says, the goal for the Center for Global Health and HSC teams is to help in the fight against SARS-CoV-2. “Our hope for the concerted activities is to improve clinical outcomes in patients with COVID-19 and to help keep our frontline health care personnel safe.”