Role of SARS-CoV-2 virus in activating the complement immune system
Endothelial cells play a key role in activating complement. Kurt Stenmark, MD, and team are studying whether the SARS-CoV-2 virus, in conjunction with hypoxia, might be acting on endothelial cells to activate complement, and whether anti-complement therapies aimed at the pulmonary vascular endothelium might help. Dr. Stenmark’s team received a $200,000 grant from the American Lung Association to support this research.
“A lot of people who come in with COVID-19 are severely hypoxic,” Dr. Stenmark says. “We’re seeing evidence of vascular involvement, severe endothelial injury and cell death, inflammation and thrombosis. A lot of the same stuff we see in pulmonary hypertension.” Read related research.
Navajo Nation Community Asthma Program Research
We have added COVID-19 surveillance to our current NHLBI-sponsored grant focused on asthma management with a cohort of children from the Navajo Nation and their families. The prevalence of asthma in children from the Navajo Nation is nearly 20%, which is double the U.S. prevalence. National Jewish Hospital is also highly involved in this work, serving as the principal investigator for this study. Our goal is to improve resources to better manage asthma and coronaviruses for the Navajo Nation, where COVID-19 infection and death rates per capita are much higher than surrounding communities.
Defining Molecular Phenotypes of Exacerbation Prone Asthmatics (ENIGMA)
This twelve-month surveillance study was added to an existing study focused on the impact of rhinovirus on asthma severity. The study compares pre-pandemic, current and post-pandemic environmental exposures, lung mechanics and asthma severity among non-infected, symptomatic and symptomatic SARS-CoV-2 infections. Researchers analyze cellular and gene expression responses to SARS-CoV-2 and other common respiratory viruses, enabling the team to investigate factors contributing susceptibility or resilience to these viruses in children with asthma. The allergy and immunology investigator is Andrew Liu, MD.
COVID-19 in type 1 diabetes
The Centers for Disease Control and Prevention reports that individuals with diabetes are at high risk for severe illness and poorer health outcomes with COVID-19. Research suggests this might be due to poor glycemic control or chronic hyperglycemia, yet information on clinical outcomes specifically for patients with type 1 diabetes who have confirmed cases of COVID-19 is limited.
To learn more, the Barbara Davis Center for Childhood Diabetes at the University of Colorado, the primary type 1 diabetes service provider for Children’s Colorado, helped rapidly form a national COVID-19 registry. “In partnership with other U.S. pediatric and adult diabetes clinics, the registry helps pinpoint factors associated with poorer outcomes,” says pediatric endocrinologist Todd Alonso, MD.
An early publication from the registry last August demonstrated poor outcomes and symptoms in patients with type 1 diabetes. A third of patients in the study developed diabetic ketoacidosis, or DKA, a life-threatening illness often precipitated by other illnesses. Subsequent studies showed clear inequities in those who were hospitalized and developed DKA, particularly Black and Hispanic patients, mirroring observations in other patient populations. The registry has also studied new onset diabetes during the COVID-19 pandemic. It found that patients were very sick at onset, suggesting healthcare access has significantly suffered. “These papers show that DKA is a big risk for this patient population,” Dr. Alonso says. “It’s more important than ever to optimize blood sugar management.”