A COVID-19 testing update from Drs. Hochman and Heath

In the era of the coronavirus (COVID-19), we’re all expanding our vocabulary. Antibody testing, DNA and RNA-based vaccines, hydroxychloroquine and cytokine storms: Until recently, these clinical terms were largely unfamiliar to those not in the medical field. But now they’re becoming a part of our daily lexicon as they take center stage in the global search to find a viable vaccine for COVID-19.

In a Facebook Live event on April 21, 2020,  Dr. Rod Hochman,  president and CEO of Providence and Dr. Jim Heath, president and professor at Seattle-based Institute for Systems Biology (ISB)*, discussed these terms and more in a conversation focused on current research to find a vaccine for COVID-19.  During their 30-minute discussion, we’re given insights into the different types of testing being done and what it will take to develop a vaccine.

Read on for highlights from the doctors’ discussion. You can also watch the video below.

Learnings from cancer research

The human body is rife with many mysteries, but years of scientific research, specifically cancer research, has made clear that the immune system is the workhorse to protect us from and combat viruses, bacteria and parasites that invade our bodies.

Cancer researchers have amassed a vast amount of knowledge and data on how to target cells and organs to destroy the tiny invaders called pathogens. This is why many cancer institutes across the world are at the center of searching for a vaccine for COVID-19.

The Providence Cancer Institute in Oregon has refocused many of its efforts to search for a vaccine for the coronavirus. This video provides a snapshot of the work the Cancer Institute is focusing on.

Our immune system and COVID-19

Noting that the manifestations of COVID-19 are so varied, Dr. Hochman asked, “What are we learning about how the immune system reacts to this virus?”

Dr. Heath explained that the immune system ranges from first defenders through a set of protections that give you long-term immunity. These first defenders include a specific type of white blood cell, called neutrophils,  that attack foreign invaders. Over time, neutrophils teach T cells to recognize and hold off disease long enough for B cells, or antibodies, to step in and give longer-term immunity. To understand the interplay between COVID-19 and the immune system, Dr. Heath noted that his team is doing deep-dive analysis to track the evolution of the impact the virus is having on first and long-term protectors.

“We’ve been able to identify exactly what the T-Cells see with the coronavirus, this allows us to see the evolution. In some patients, the T-Cells ramp up. Sometimes they disappear, which can lead to negative outcomes,” said Dr. Heath. “This is the type of specificity we need to know so we can find the right treatments for different individuals.”

Swedish and ISB team to study COVID-19

In March, ISB and Swedish Medical Center launched a study to look at hundreds of patients who have COVID-19 in order to better understand the differing outcomes. To learn about the spectrum of outcomes – from death to recovery – the ISB researchers and Swedish health workers collect blood from consenting patients at three different times. This approach provides rich insights into the patients’ genomes, their evolving blood protein and details about their immune cell populations.

“Each of the COVID-19 patients has a unique lesson to teach us about how the medical and scientific community can respond most effectively to this pandemic,” said Dr. Heath. “We are taking extremely deep dives with patients to see what trajectory the virus is taking.”

Dr. Heath likened ISB-Swedish research study to a disjointed track race, saying, “Basically, we have people that are starting at all positions on the track – we don’t really know where – all we know is that they all cross the finish line at some point, and we’re trying to figure out exactly which ones did better and which ones didn’t.”

Learn more about the ISB and Swedish study here.

A snapshot of the drugs being tested

At the center of the various studies underway are the types of drugs being tested. Dr. Hochman asked: “It’s hard to understand which drug works where and how to test it. When designing tests, what are the types of drugs being considered, and how are they different?”

Dr. Heath offered some insights on some of the most prominent drugs currently being tested to develop a vaccine for COVID-19.

Remdesivir: This is an antiviral drug that was originally developed to eat Ebola over a decade ago, and is known to be generally safe in humans. However, relating to COVID-19, Dr. Heath said, “It’s not clear why they work in some patients and not others.” 

Hydroxychloroquine: This medication is used to prevent or treat malaria. It has also been used to treat auto-immune diseases such as lupus and rheumatoid arthritis. Dr. Heath said: “If it works at all it’s not clear how it works with COVID-19. With malaria the red blood cells lose iron."

On antibody tests, Dr. Heath said: “The long-term promise here is to look at patients who got COIVD-19 early and look at their antibodies and identify which antibodies protected the patients who have recovered. Some of them will be specific to the patient and some will be broadly relevant across people.”

Dr. Hochman asked: “There’s some discussion about plasma as a way to find a vaccine for COVID-19. What is the technique of plasma testing?”

“The idea with plasma testing is to take advantage of patients who have antibodies and lend them to a patient that doesn’t have them but could benefit from them,” said Dr. Heath. “They could help boost the B cells. Basically, the potential is to give the patient with deficient B-Cells a reprieve to allow your immune system to catch up. It’s a little early to know yet.”

Silver lining

Trying to solve the coronavirus conundrum is a very complex puzzle, but leaders like Drs. Hochman and Heath are stepping up to the call. They and many other organizations around the world are committed to putting together the pieces of the COVID-19 puzzle in the safest and most efficient way possible. While it will take time, there is unprecedented collaboration across medical and scientific disciplines for finding treatments and developing vaccines. 

In Dr. Heath’s words: “One thing this pandemic has done is brought the scientific and bio tech communities together.”

Stay safe. Stay well. Keep hope alive.

*Providence and ISB began an affiliated partnership in 2016.