Anschutz Medical Campus COVID-19 Research Consortium
Children's Hospital Colorado and University of Colorado Hospital are collaborating on a new protocol to collect patient electronic health record data and biological samples for analysis. The study is now active at both hospitals, and the first specimens have been collected.
A second collaborative effort is underway to develop a protocol specifically evaluating the risks our own team members face as frontline healthcare providers. The goals are to:
- Determine the incidence of COVID-19 among healthcare workers
- Identify risk factors for severe illness
- Evaluate the humoral and cellular response to SARS-CoV-2
- Characterize the effects of COVID-19 on healthcare workforce capacity
The results of this study will help us protect our team members and guide operational planning into the future. This collaborative approach to understand the clinical characteristics of COVID-19 disease in pediatric and adult populations, as well as the underlying characteristics of patients and their treatment responses, will help us comprehend why children seem better protected from COVID-19. Children are usually one of our most vulnerable populations to viral respiratory infections.
The goal of the HEROS (Human Epidemiology and Response to SARS-CoV-2) study is to learn more about the number of people who may have the coronavirus without knowing it, particularly children. The study will also help us learn how the virus spreads from person to person and the nasal response to the coronavirus. Sponsored by the NIH National Institute of Allergy and Infectious Diseases, the HEROS study is considered mission critical. Andrew Liu, MD, pediatric pulmonologist and Glenn Furuta, MD, pediatric gastroenterologist will lead our participation as one of 11 study sites. National Jewish Hospital is the lead lab for the study.
Airway Inflammation, Resilience and the Environment (AIRE) Research Program updates
Children's Colorado is the clinical performance site for the NHLBI-sponsored program project grant “Defining Molecular Phenotypes of Exacerbation Prone Asthmatics” and is now COMIRB-approved to convert to tele-research and add COVID-19 surveillance. We have long been interested in the determinants of airway inflammation versus resilience to common cold viruses. Molecular phenotyping and translational research can lead us to new therapies and prevention for severe respiratory viral illness, asthma exacerbations and perhaps the common cold.
Age-related airway host factors associated with COVID-19
Age is a primary determinant of COVID-19 disease severity, as are comorbidities including diabetes, obesity, pulmonary and cardiac disease. The receptor for angiotensin converting enzyme 2 (ACE2) expressed by epithelial cells throughout the respiratory tract is recognized as a dominant route for entry of SARS-CoV-2 viral particles into cells lining the airway. Children have lower expression of ACE2 receptors, which may result in age-related differential responses, yet no studies have investigated the expression of ACE2 receptors nor the host response specific to SARS-CoV-2 in children.
This study is among the first to investigate the differential response between asymptomatic carriers and patients with symptomatic COVID-19 in children, and to compare the virus-host interaction between children and adults, to identify potential targets for prevention and therapy.
Lilliam Ambroggio, PhD is the pediatric emergency medicine investigator of the study.
Healthcare worker COVID-19 seroprevalance
This research study is designed to investigate how frequently healthcare workers at Children’s Colorado have antibodies in response to being exposed to patients with SARS-CoV-2 infection. The goals of this research include studying the prevalence and incidence of COVID-19, documented by serology testing, correlated with epidemiologic characteristics in 400 Children’s Colorado healthcare workers. This research is led by pediatrics investigator Steve Berman, MD, FAAP.
COVID-19 prospective observational cohort study and biobank of healthcare workers and other populations
The goal of this research study is to evaluate rates of immunologic responses to SARS-CoV-2 across a variety of occupations, including healthcare workers, first responders, individuals with prior COVID-19 and other campus personnel. A biobank of clinical data and blood samples will be created for future research. Rheumatology investigator Kevin Deane, MD, and pediatric allergy and immunology investigator Elena Hsieh, MD, are leading the study.
National COVID Cohort Collaborative
The National COVID Cohort Collaborative, or N3C, is a secure data and computing environment designed to facilitate virtual access to clinical data provided by 72 clinical centers nationwide on more than 374,000 patients with COVID-19. Launched by the National Institutes of Health, it’s the single largest integrated collection of COVID-19 patient data in the nation. Its mission is threefold: make it easier for researchers across the country to access the large data set; expand the number of research studies using the data and analytical supports available to improve our understanding of COVID-19; and demonstrate that aggregating data across centers really does work.
The University of Colorado Anschutz Medical Campus is playing a key role in N3C in part by contributing data from both Children’s Hospital Colorado and neighboring UCHealth University of Colorado Hospital. Additionally, Children’s Colorado critical care physician and informaticist Tell Bennett, MD, MS, is co-leading the N3C’s clinical scenarios and analytics team. His team’s work includes writing code so that future database users will be able to efficiently run algorithms across the database without having to access any patient records.
“One of the reasons this resource is crucial is that each medical center may not have enough patients with different subtypes of the disease to conduct the necessary clinical science,” says Dr. Bennett. “By having a centralized, cloud-based data resource, researchers across the country can easily access the information they need in significant sample sizes.”
For example, in a retrospective cohort study of COVID-19 patients, N3C data and machine learning helped predict clinical severity and risk factors over time (1). “The N3C supports robust evidence-based development of predictive and diagnostic tools and informs critical care and policy,” Dr. Bennett says. Researchers interested in accessing N3C can learn more through covid.cd2h.org/n3c.