Sunnybrook researchers awarded funding for COVID-19 response

Five Sunnybrook research projects have been awarded grants by the COVID-19 Research Initiative, an internal funding opportunity created by Sunnybrook Research Institute and funded by Sunnybrook Foundation through the generosity of donors who supported the COVID-19 response fund.

The competition, which provides grants of up to $100K for COVID-related research, was established in response to the significant research response to COVID-19 at Sunnybrook and the extraordinary generosity of our community. In total, more than 60 COVID-related research projects have been initiated at Sunnybrook since March. The projects supported through this fund aim to make a quick and substantive impact in better understanding the virus or proposing solutions to the challenges posed by the pandemic.

Congratulations to all the recipients. Learn more about their projects below.

How does COVID-19 affect the brain?

A team of researchers led by Dr. Simon Graham, Interim Director of Physical Sciences at Sunnybrook Research Institute, has launched a study to investigate how COVID-19 impacts the brain.

“We know from early case reports in China that about 30 to 40 per cent of hospitalized patients had neurological symptoms,” says Dr. Graham, the study’s principal investigator. “Symptoms included headaches, confusion, and stroke. Loss of smell was also common, which in the absence of any nasal congestion suggests that the virus may affect brain regions that control our sense of smell.

Dr. Graham, alongside his research team at Sunnybrook and collaborators at Baycrest, will study the neurological impact of COVID-19 through the use of clinical assessments and magnetic resonance imaging (MRI) of the brain in recovered COVID-19 patients. "In addition to raising awareness of this issue among doctors and in the public,” says Dr. Graham, “the study will also allow us to direct patients in need towards neurointerventions and treatments as early as possible.” Learn more about the study here.

Can blood thinners reduce the burden of disease in COVID-19?

Dr. Clare Atzema, Program Research Director of the Integrated Community Program and an emergency medicine physician at Sunnybrook, has launched a new study to determine whether patients who are already taking anticoagulation therapy (blood thinners) while diagnosed with COVID-19 fare better than similar patients not on the medication.

“There is emerging evidence that, in addition to inflammation in the body, the SARS-Cov-2 virus also causes clotting – large clots, like a deep vein thrombosis in the leg, and small clots in the tiny blood vessels in the lungs, says Dr. Atzema. “The goal of the study is to determine whether being on a therapeutic dose of a blood thinner when diagnosed with COVID-19 leads to a milder course of the disease.”

Dr Atzema’s team will use Ontario Health databases to measure outcomes such as blood clots, pneumonia, intensive care unit admissions and mortality in patients who were on a blood thinner at the time of diagnosis and those who weren’t. “If it turns out that people on a blood thinner at the time of a COVID-19 diagnosis fare better than similar patients who were not on a blood thinner, it provides evidence that we may want to start patients with a COVID positive result on a blood thinner, at least for a short time.”

How does COVID-19 damage the heart?

A pilot study, led by Dr. Idan Roifman, scientist in the Schulich Heart Research Program, will aim to better understand the prevalence and predictors of myocardial injury (heart damage) in recovered COVID-19 patients.

“Initial case reports from China and Washington have reported that 20-30 percent of hospitalized COVID-19 patients have some sort of myocardial injury,” says Dr. Roifman. “Elevated troponins (or proteins that signal heart damage) have been detected in the blood of many hospitalized patients with COVID-19.”

Using cardiac magnetic resonance imaging (MRI), the researchers will investigate the mechanism of injury causing heart damage — such as myocardial infarction (heart attack), myocarditis (inflammation of the heart) or cardiomyopathy (disease of the heart muscle). The study will also look at who is at risk for developing each form of heart damage by examining associated risk factors, such as diabetes or high blood pressure. “With a better understanding of the mechanisms and predictors of myocardial injury, we can better treat affected patients and screen patients who are most at risk for developing heart damage,” says Dr. Roifman.

Can changing the order of treatments help cancer patients with delayed surgical interventions due to COVID-19?

To prepare for the expected surge in COVID-19 cases, hospitals postponed thousands of elective or non-emergency operations – including many cancer surgeries. Although surgery is typically the first-line treatment for many of these patients, oncologists like Dr. Kelvin Chan, looked to cancer therapies, such as chemotherapy, as a possible bridge to surgery in cases where surgical interventions were put on hold. Dr. Chan and his research team are launching a population-based study to investigate whether drug treatments typically meant to follow the primary treatment (in this case surgery) are safe and effective when given before surgery.

“In some cancer types, neoadjuvant therapies or therapies given before the primary treatment are well established and effective. They can help shrink tumours, making them easier to remove. However, in many other cancers, surgery is still the first-line treatment, and we don’t have much experience with neoadjuvant therapies,” says Dr. Chan, principal investigator of the study and associate scientist in the Odette Cancer Research Program.

Using Ontario Health databases, Dr. Chan and his team, will analyze the outcomes of patients whose treatment plans were adapted to receive drug therapy before surgery. “We hope the lessons from this study will help inform our teams with interim decision making and also help cancer patients in Ontario and beyond.”

A virtual care program for outpatients diagnosed with COVID-19

A new research program – a collaborative effort of the entire Sunnybrook Infectious Diseases division – is helping Sunnybrook patients with COVID-19 who have mild to moderate symptoms manage their recoveries at home, providing support and a care plan by phone or video.

“We created COVIDEO because we didn’t want to notify our patients at home that they’ve tested positive for COVID-19, and then abandon them. It’s important that they still have access to a support system, therapeutic presence, close clinical monitoring, and a system for safe transfer to hospital when needed” says Dr. Nick Daneman, the study’s principal investigator.

The COVIDEO team has already cared for nearly 400 patients and is planning a province-wide study to measure the effectiveness of COVIDEO and other virtual care programs in improving outcomes for patients with COVID-19. Appreciating that the virus is new and poorly understood, the Sunnybrook Infectious Diseases division has designed COVIDEO to enable real-time rapid response research to solve urgent questions during the pandemic and address the pressing need to understand physical and mental health features of COVID syndrome in survivors. COVIDEO is uniquely poised to conduct research across the full spectrum of COVID-19.