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Study seeks to learn why Covid-19 ravages some, leaves others unscathed

It’s a question that has perplexed doctors and public health experts:

Why do some patients recover without ever showing symptoms of Covid-19 while others end up fighting for their lives on a ventilator or dying from the disease caused by the novel coronavirus?

Some local health care institutions think they can solve this riddle and, in doing so, create a simple blood test to predict how ill people will become if they are infected with the virus.

That’s the ambitious goal of a new clinical study launched by Roswell Park Comprehensive Cancer Center and several partners.

Officials say the Western New York Immunogenomic Covid-19 Study could begin as soon as next week with blood sample collection from patients and could take as little as six months to complete.

The study, expected to cost up to $1 million, is one of the first to try to bring cutting-edge precision medicine and gene-sequencing technologies to the fight against Covid-19.

Roswell Park, Catholic Health, the University at Buffalo and Thermo Fisher Scientific are working together on the clinical study, which was announced Thursday morning by the institutions.

“This is a huge undertaking, a huge question, that is going to be instructive for the entire world and we could not do this alone,” said Dr. Kunle Odunsi, Roswell Park’s deputy director.

As efforts to detect the presence of the novel coronavirus slowly ramp up nationally, the focus has been on two main types of tests, said Dr. Carl Morrison, senior vice president of scientific development and integrative medicine at the cancer center.

The first is a test, performed using a nasal swab or blood sample, to determine whether someone has Covid-19.

The second is an antibody test to find out if someone previously was infected with the virus and, possibly, has developed immunity to Covid-19.

Those tests are effective as far as they go at the time they’re given, Morrison said, but they don’t say anything about future susceptibility to the virus.

Most people who become infected recover without showing symptoms or, if they do, without having to seek care at a hospital.

But a small number of victims end up needing assistance from a ventilator to breathe and, unfortunately, some of them succumb to the disease.

Doctors and public health experts say the elderly and people who have a pre-existing health issue, such as a compromised immune system, are more likely to suffer serious symptoms or die from the new coronavirus.

Officials involved in this clinical study say it’s possible to use gene-sequencing to analyze cells in blood samples taken from patients to make more precise assessments.

Researchers seek to identify how the immune system changes as it responds to Covid-19 to help predict which patients are likely to develop a debilitating infection that could require intensive treatment, said Andy Felton, Thermo Fisher’s vice president of product development, clinical next generation sequencing and oncology.

That’s one reason for the involvement of Catholic Health, which has an entire hospital – St. Joseph Campus in Cheektowaga – devoted to Covid-19 treatment. Officials hope to collect samples from 250 patients.

“We need something that’s going to tell us who of those community members – family members, loved ones – actually will be walking out in a couple days and who’s going to literally be needing an intensive level of care,” said Dr. Hans P. Cassagnol, Catholic Health’s executive vice president, chief clinical officer and chief physician executive.

UB has considerable expertise in clinical trials and has worked with Roswell Park before. Thermo Fisher is supplying advanced testing materials.

Participants say the study could help health care providers better direct the use of scarce medical resources by triaging which patients would need the most intensive treatment for the coronavirus.

Also, as the country looks to reopen the economy and revive daily life, government planners and members of the public could get a better sense of who and how many would be waylaid by a future infection – perhaps via an individual Covid-19 “risk score” provided through a one-time blood test, Morrison said.

And, with the involvement of Roswell Park, the study could reveal more about the intersection between cancer and Covid-19 in patients.

“This is an opportunity we never had with any previous pandemic,” Odunsi said.

Roswell Park performs numerous clinical studies in cancer and genetics.

The institute also has taken the lead on some coronavirus-related studies.

For example, the federal Food and Drug Administration recently gave researchers at Roswell Park and UB permission to help lead a study of an arthritis drug, sarilumab, that has shown promise in preventing inflammation that chokes off breathing for critically ill Covid-19 patients on ventilators. Hospitals here are part of this international study.

That’s not the only study into experimental Covid-19 treatments underway in this region.

Roswell Park, Kaleida Health, Catholic Health, Erie County Medical Center and other providers are, to various degrees, also studying the effectiveness of the anti-malarial drug hydroxychloroquine; remdesivir, which was used to treat Ebola; and the transfusion of donated plasma from people who recovered from Covid-19 into people currently fighting off the virus.

The Roswell Park study will launch with a $150,000 donation from the 11-Day Power Play hockey tournament charity. The cancer center is seeking additional donations to further defray the $1 million estimated cost.

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