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St. Louis researchers mobilize on new coronavirus, seeking treatments, answers
CORONAVIRUS PUZZLE

St. Louis researchers mobilize on new coronavirus, seeking treatments, answers

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ST. LOUIS — Scientists at St. Louis’ top research institutions have set aside work on parasites, antibiotics and bacterial diseases to join the urgent, global pursuit of treatments and a vaccine for the new coronavirus.

“We have a big problem. People are sick and people are dying. And it’s a global pandemic,” said Dr. Michael Diamond, a professor of medicine at Washington University. “Multiple groups across multiple regions are taking parallel approaches … with enough investigations ongoing, we hope that some come through with success.”

At St. Louis University, 36 researchers have trained their efforts to focus on the new coronavirus. At Washington U., 29 principal investigators have turned their labs over to COVID-19 research.

Their pursuits range from seeking basic knowledge about the behavior of the coronavirus to using antibodies, vaccines and drugs to treat and prevent COVID-19, the disease the virus causes.

“We hope that one of our groups makes such a significant discovery that it could be implemented very quickly to either mitigate the disease or disrupt transmission,” Diamond said.

Missouri had seen more than 2,100 positive cases of COVID-19 as of Friday afternoon and 19 deaths related to the virus. Illinois had counted more than 8,900 positive cases and 210 deaths.

“It’s a monumental challenge that requires a monumental research response,” said Josh Michaud, associate director of global health policy at the Kaiser Family Foundation. “It makes sense that so many places have turned their attention to this because it is the most important research and development question the world is facing right now.”

Until about a month ago, Dr. Jeffrey Henderson directed a laboratory at Washington U. studying antibiotic-resistant bacteria. Now he is working on methods to treat COVID-19 patients using antibodies from the blood of people who have recovered from the virus.

“Inside where I am, this is regarded as a big course shift,” said Henderson, an infectious diseases specialist. “This is like a career switch that began a month ago.”

Amelia Pinto, an assistant professor of molecular microbiology and immunology at St. Louis University, said recent weeks also have brought a 180-degree change for the majority of the people working in her lab, who previously were working on different viruses, such as Zika.

Other SLU researchers at the university’s College for Public Health and Social Justice have been working on new coronavirus-related projects, such as analyzing risk for nursing homes based on their proximity to airports and their inspection scores, and surveying infected individuals’ willingness to share their location data with the government.

Another project involves a smartphone app that would notify users when they go to a community with COVID-19 cases, as a reminder to follow health precautions, and would track the spread of the virus through users’ self-reported symptoms, according to Enbal Shacham, a professor at St. Louis University’s College for Public Health and Social Justice.

Experimental drug

SLU recently announced it would take part in a study of remdesivir, a drug that was previously tested on the Ebola virus. The study is supported by the National Institutes of Health and will take place across roughly 75 locations worldwide.

“I think this is probably going to be the pivotal trial,” said Dr. Sarah George, associate professor of infectious diseases and the principal investigator of the St. Louis trial.

The drug, a broad-spectrum antiviral developed by Gilead Sciences Inc., is experimental at this point. It is not FDA-approved to use as treatment for any particular illness — but George said some early research has looked promising.

“Of all of the potential therapies out there, this one has, at this time at least, the most and best data behind it,” George said.

The researchers aim to enroll adults at SSM Health St. Louis University Hospital who have been lab-diagnosed with COVID-19. It is uncertain how many patients will ultimately participate from the St. Louis area.

George said researchers could have some answers within a couple of months, give or take, as to whether remdesivir was effective.

If the answer is yes, further research will be needed on the correct dosage, said Dr. Daniel Hoft, director for SLU’s Center for Vaccine Development and director of division of infectious diseases, allergy and immunology.

And if the data show otherwise, Hoft added: “Then we would know not to study remdesivir anymore.”

Hoft and other SLU researchers are working to develop tests to identify people who are in the very early stages of infection, as well as people who have recovered from COVID-19.

Century-old treatment

Meanwhile, researchers at Washington University are looking at a century-old treatment, using plasma from patients who have recovered from the virus.

The method also was used experimentally on a small number of people during an outbreak of severe acute respiratory syndrome, or SARS, in 2002 and 2003. SARS is caused by a coronavirus related to the one that causes COVID-19.

So far, the method has been used on patients with the new coronavirus in Houston and in New York, Henderson said.

“We regard this method as something of a stopgap,” he said. “Hopefully, over time, we’ll have a vaccine. We’ll have manufactured and standardized antibodies that we might be able to use in place of this.”

But it may be difficult to find plasma donors for the research.

Eligible donors must have tested positive for COVID-19 and recovered for at least two weeks past their last symptoms. Because of a lag in testing, there may be individuals who don’t know they had the virus and could donate plasma.

Still, Henderson is enthusiastic. “I think it has a decent chance of working,” he said. “And it’s also a place where the public can help.”

Washington University researchers began mobilizing in January, he said.

Like many places, Diamond said, the labs that aren’t working on COVID-19 have mostly closed and are just maintaining essential operations.

“We got thrust into this right away,” Diamond said.

A difficult path

Researchers from both universities said COVID-19 is different from diseases they have studied in the past.

“It’s hard to think of a good parallel to something this large in scale and this urgent,” Henderson said.

COVID-19 is so new that there is not a well of scientific literature to learn from.

“We’re dealing with a brand-new virus that wasn’t known to humanity until December,” George, of SLU, said.

And while some research paths appear promising, the work is also challenging. Researchers are talking with patients and their families about participating in research trials in the midst of difficult circumstances.

“The family may be very, very distraught. The patient may be anxious,” George said. “People have a lot on their plates. Not just illness, but worrying about childcare and their job, and lots and lots of things.”

Added Hoft, “This is the biggest challenge we’ve faced in my lifetime. It’s scary to all of us.”

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Related to this story

St. Louis University was one of 68 sites around the world that participated in the trial, said Dr. Sarah George, associate professor of infectious diseases and the principal investigator of the St. Louis trial. "It's exciting news," George said. "There's been a lot of hype. But this is the first time we can say, solidly, this drug reduces the time people are ill with this disease."

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