Understanding the COVID-19 virus through health research

In the early months of the COVID-19 pandemic, there was little known about the virus that was causing the COVID-19 illness. Hospital researchers in London, Ontario, through Lawson Health Research Institute, quickly got to work to study and better understand the SARS-CoV-2 virus. Lawson is the research arm of London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London.

“When the pandemic hit, we were well prepared in London to start research studies. We had existing expertise, laboratories and teams through the hospitals, Lawson and Western University that could be mobilized quickly,” explains Dr. Douglas Fraser, Critical Care Physician at LHSC and Scientist at Lawson. “Patients started coming to hospital with COVID-19 and we began research that involved collecting human samples and bringing them to the lab for analysis.”

Dr. Fraser, who is also a Professor at Western’s Schulich School of Medicine & Dentistry, led the research team studying the samples from COVID-19 patients in hospital. “We learned very quickly that COVID-19 patients were experiencing a strong inflammatory response to the virus. We looked at the molecules involved because many of these are signaling molecules to the immune system.”

Dr. Douglas Fraser, Critical Care Physician (LHSC) and Lawson Scientist 

“By studying the molecules, we were able to determine the pathways. This is important because it also points to how we should be targeting our diagnostics and therapeutics,” adds Dr Fraser.

As a hospital research institute, Lawson is uniquely positioned to address the medical questions posed by a new virus. Its Clinical Research Services (LCRS) and Center for Clinical Investigation and Therapeutics (CCIT) teams responded rapidly when researchers initiated COVID-19 studies, including Dr. Fraser’s study to examine the immune response in patients with COVID-19.

“Starting a clinical trial usually takes a certain amount of time to put together, but the pandemic created a perfect storm,” explains Sue Tereschyn, Manager of LCRS at Lawson. “Clinical researchers had to develop studies at a speed they have never seen, and they needed implementation support at the same speed. In Dr. Fraser’s case, we needed samples from the Intensive Care Unit (ICU) and we were processing samples from COVID-19 patients seven days a week. A high level of skill was needed.”

 

Dr. Fraser and his team soon became the first in the world to understand the immune response and several pathophysiological features of the virus. This work led to a critical understanding of how the virus was impacting patients and potential avenues for therapy.

“It’s important to understand what’s happening in the body when someone has COVID-19 because that gives us information as to why some patients don’t do well and why others recover,” shares Dr. Fraser. “This helps us know who is vulnerable to COVID-19 and how to best offer treatments in the future.”

Read about Dr. Fraser's COVID-19 research: 

• Researchers team up with Diagnostics Biochem Canada to study COVID-19
• Study identifies biomarkers that could be used in a quick, inexpensive COVID-19 blood screening tool
• Researchers unravel two mysteries of COVID-19

Work is also underway to find the unique fingerprint that the COVID-19 virus can leave on the lungs. Hospital researchers at Lawson have developed and tested an artificial neural network for diagnosing COVID-19.

Dr. Robert Arntfield, Medical Director, Critical Care Trauma Centre (LHSC) and Lawson Researcher 

“The lung ultrasound techniques and the findings of COVID-19 by looking at the lungs didn’t initially look unique when compared to other conditions like pneumonia. Our group wanted to investigate whether or not there were differences that were possibly subvisible,” says Dr. Robert Arntfield, Medical Director of Critical Care Trauma Centre at LHSC and Lawson Researcher. “Through our work, we were able to show that in fact artificial intelligence could outperform a trained clinician in identifying a COVID-19 lung from a similar affected lung that was not due to COVID-19.”

This new technique just scratches the surface of the beneficial use of AI when it comes to medical imaging for patients. “It shone a light on the idea that there were hidden details within all the noise of the image,” adds. Dr. Arntfield. “When you can input that into a machine that is extremely portable the way ultrasounds are, you have a precise diagnostic machine that you can take anywhere a tablet can go.”

• Read more about the team's research findings. 

The team is now expanding on these findings with further research. Lawson has recently approved Dr. Arntfield’s “Project Deep Breath” which aims to go beyond COVID-19 and explore multiple conditions where lung ultrasounds and AI can be paired together.