COVID-19 treatments and research

COVID-19 pandemic treatments and research refers to local efforts to study and develop public health responses to the 2020 Coronavirus pandemic.

Because the SARS-CoV-2 virus was entirely new, no immunity or specific antidotes were available before it caused a worldwide pandemic. Because of the ease of transmission, the first priority in hospitals was to seal off wards where COVID-19 could be treated and to establish protocols for the use of protective equipment by healthcare workers, in the context of local, national and global shortages.

UAB developed a "COVID-19 Symptom Tracker" which encouraged members of the general public to report any changes in possible symptoms over time, helping the university identify "hot spots" for public health intervention and to conduct research on the early indicators of the disease. Mohanraj Thirumalai led the development of the tool with assistance from citizen-science advocate Sarah Parcak and health informatics specialist Sue Feldman, along with several university departments and research centers.

The UAB School of Medicine's Division of Infectious Diseases opened a COVID Respiratory Clinic in the former Regions Bank branch in the Kirklin Clinic Parking Deck at 539 Richard Arrington Jr Boulevard South. The clinic conducted telephone or video consultations with UAB Health patients who have tested positive but are convalescing at home. In-person appointments could be made when warranted to determine if hospital treatment was required, without burdening emergency room capacity.

On April 24 UAB began administering antibody tests, blood tests which can determine if an individual has been exposed to SARS-CoV-2. The antibody test can not determine if an infection is active or if the individual is immune to re-infection. The major use of the test was expected to be in identifying candidates who could donate convalescent plasma, and as part of larger-scale epidemiological studies. That clinical study, in collaboration with Johns Hopkins University and the Mayo Clinic, was led at UAB by Sonya Heath.

In early May the Alabama Department of Public Health broadened the criteria for processing COVID-19 tests in its laboratory to better address the need to test front-line healthcare workers and residents of long-term care facilities, whether or not they have symptoms of illness.

One of the drugs used on a trial basis for the treatment of COVID-19 patients was remdesivir, a drug under development at the Antiviral Drug Discovery and Development Center under UAB's Richard Whitley. During the 2020 pandemic, UAB Hospital participated in a clinical trials with remdesivir, as well as a separate clinical trial of the use of nitric oxide in ventilators for those whose lung function was severely compromised. Nitric oxide had earlier shown some promise with SARS patients. Cardiologists Pankaj Arora and Vibhu Parcha led that study.

The Hugh Kaul Precision Medicine Institute at UAB contributed to development of trials at VA Medical Centers in West Los Angeles and elsewhere to measure the effectiveness in male patients of the androgen deprivation drug Firmagon (degarelix), which may suppress production of a certain protein in the lungs that COVID-19 utilizes.

Researchers in the UAB Division of Infectious Diseases and the UAB Department of Microbiology, led by James Kobie and Mark Walter, worked with the Texas Biomedical Research Institute to develop a therapeutic treatment based on the delivery of a "highly potent monoclonal antibody" (AR-711) nasally to non-hospitalized COVID-19 patients. A global study of the candidate treatment is planned for early 2021.

Robert Kennedy of UAB's Center for Clinical and Translational Science, Eric Ford of the UAB School of Public Health, and Jennifer Croker of the UAB School of Medicine led a national serological study of blood samples for the National Institutes of Health to help shed light on the percentage of Americans who may have been infected with SARS-CoV-2 without knowing it.

In November 2020 UAB launched a "Post COVID Treatment Program" to better manage health care for individuals suffering lengthy recoveries from COVID-19. Turner Overton directed the program.

In January 2021 a more easily transmissible strain of SARS-CoV-2, designated B.1.1.7, was reportedly present in states bordering Alabama. The strain was first identified in the United Kingdom. Limited use of genetic sequencing made it difficult to trace the spread of the newer variant in the U.S.

A study conducted by the UAB Comprehensive Diabetes Center and the Hugh Kaul Precision Medicine Institute found that use of Metformin to treat diabetes significantly reduced mortality from COVID-19.

UAB Department of Radiology researcher Benjamin Larimer announced the development of a new type of at-home test for COVID-19 neutralizing antibodies. The test will be further developed through the startup P3 Diagnostics, which Larimer co-founded with Joe Gay and Chris Paule in 2020.

UAB Department of Psychology professors Edward Taub and Gitendra Uswatte-Aratchi researched the effectiveness of existing constraint-induced therapies on COVID patients experiencing memory loss and impaired cognition.

Immunization

UAB and Southern Research conducted early trials of vaccine candidates created by Altimmune of Gaithersburg, Maryland and Tonix Pharmaceuticals of Chatham, New Jersey. UAB also enrolled volunteers in a large-scale human trial of a vaccine candidate developed by Oxford University and Cambridge-based AstraZeneca.

With the FDA's first Emergency Use Authorizations for vaccines developed by Pfizer and Moderna in early December, the Alabama Department of Public Health prepared to implement its distribution plans, prioritizing first-line workers in healthcare settings.

By late January Alabama was receiving 50,000-60,000 doses per week. The restricted supply slowed the progress of vaccination beyond the initial group. UAB opened large-scale drive-through vaccination sites at the Hoover Met and at Parker High School in early February as the Biden administration ramped up allotments to states. A third vaccine from Johnson & Johnson was expected to become available during February, greatly expanding the rate of immunizations.

References

• Pillion, Dennis (April 8, 2020) "UAB testing new coronavirus treatment on its sickest patients." The Birmingham News
• Yurkanin, Amy (April 13, 2020) "Early, but promising results for coronavirus drug developed at UAB." The Birmingham News
• Patchen, Tyler (April 21, 2020) "UAB opens new clinic focused on COVID-19." Birmingham Business Journal
• Windsor, Matt (April 29, 2020) "Coronavirus antibody testing now is available at UAB. Here’s what that means — and what it doesn’t" UAB Reporter
• Gore, Leada (May 7, 2020) "ADPH expands criteria for coronavirus testing." The Birmingham News
• Patchen, Tyler (May 15, 2020) "UAB collaborating with Mayo Clinic, Johns Hopkins on plasma therapy research for Covid-19." Birmingham Business Journal
• Gainer, Holly (June 9, 2020) "Study aims to determine the number of undetected COVID-19 cases in the United States." UAB News
• Patchen, Tyler (June 11, 2020) "UAB finds possible drug candidate for Covid-19." Birmingham Business Journal
• Patchen, Tyler (September 2, 2020) "UAB launching another Covid-19 clinical trial." Birmingham Business Journal
• Patchen, Tyler (October 19, 2020) "UAB-discovered drug makes headway in Covid-19 treatment." Birmingham Business Journal
• Yurkanin, Amy (November 16, 2020) "COVID-19 vaccine in Alabama will be free, first doses could be available by December." The Birmingham News
• Yurkanin, Amy (November 18, 2020) "New program in Alabama for COVID ‘long-haulers’ with lingering symptoms." The Birmingham News
• Stanley-Becker, Isaac; Yasmeen Abutaleb; Lena H. Sun; & Josh Dawsey (December 17, 2020) "States report confusion as government reduces vaccine shipments, while Pfizer says it has ‘millions’ of unclaimed doses." The Washington Post
• Whites-Koditschek, Sarah (December 18, 2020) "Alabama shorted 20,000 vaccines in next week’s shipment, say feds cut allotment." The Birmingham News
• Vollers, Anna Claire (December 18, 2020) "At this COVID-19 unit, things were getting better. Now, its nurses fear a ‘tsunami’ is coming." Reckon / Al.com
• "'The vaccine is coming': Alabama health officials call for patience amid slow rollout." (January 6, 2021) Associated Press / The Birmingham News
• Whites-Koditschek, Sarah (January 6, 2021) "UAB housing cancer patients in hotels as COVID rises." The Birmingham News
• Whites-Koditschek, Sarah (January 7, 2021) "New COVID-19 strain now found in three states bordering Alabama." The Birmingham News
• Patchen, Tyler (January 19, 2021) "UAB-led study identifies drug that helps fight Covid-19." Birmingham Business Journal
• Patchen, Tyler (January 20, 2021) "UAB researcher develops Covid-19 antibody test." Birmingham Business Journal
• Pillion, Dennis (February 24, 2021) "UAB researchers take aim at COVID ‘brain fog’." The Birmingham News