COVID-19 Research
Stanford Medicine scientists have launched hundreds of research projects as part of the global response to COVID-19. Some aim to prevent, diagnose and treat the disease; others to understand how it spreads and how people’s immune systems respond to it; and finally, many seek to educate the public or to assess and help mitigate the social impact of the disease on populations.
Below is a curated selection, including summaries, of just a few of the projects underway.
The list is not comprehensive and instead represents a sampling of Stanford Medicine research on COVID-19 in a variety of areas. This page is frequently updated.
Candidate Vaccines and Treatments
A global, online challenge to develop safe mRNA vaccines for fighting COVID-19
Messenger RNA (mRNA) vaccines are currently the most promising approach for rapidly defeating the COVID-19 pandemic. While more quickly deployable than protein vaccines, mRNA vaccines still require numerous rounds of trial-and-error design to optimize the expression of proteins the body’s adaptive immune system can use to create protective antibodies, and the poor chemical stability of these vaccines precludes worldwide delivery in preloaded syringes. Dr. Das and his team aim to accelerate the design of stabilized, high-expression mRNA vaccines through a worldwide, open competition. The OpenVaccine challenge will be uniquely powerful in marshalling the world’s scientific potential toward solving the COVID-19 vaccine design problem.
Two novel COVID-19 drugs poised to begin clinical trials
Dr. Glenn’s team has prepared a small molecule therapeutic agent that is ready to go through the Investigational New Drug (IND) enabling process to enter clinical trials, with an expected trajectory of approximately 12 months before getting it to patients. It is a lipid kinase inhibitor developed within the ViRx@Stanford Center, which could not only be used against COVID-19, but also to combat other viruses such as enterovirus, rhinovirus, Ebola, and SARS. In addition, Dr. Glenn’s team has produced a locked nucleic acid (LNA) that can be used on every known strain of the flu and could be applicable to any flu pandemic—proactively instead of reactively—and which is also pending human clinical trials.
Coronavirus vaccine, particularly effective for the elderly
Dr. Wang is investigating a coronavirus vaccine that will protect people of all ages from COVID-19 but is designed to provide enhanced protection in the elderly. In the last year, Dr. Wang’s team developed a vaccine platform that can be used for many infectious diseases. To date their studies have been focused on the development of a universal influenza virus vaccine for the elderly. The team is now expanding this work to the novel coronavirus, with the goal of performing pre-clinical testing as soon as possible, and ideally, evaluating its efficacy in humans during the outbreak.
Prevention, Diagnostics, and Monitoring
APEX-based tests for COVID-19
Dr. Ting is developing a novel testing method for COVID-19, not based on traditional RT-PCR but on viral RNA-templated reconstitution of split APEX, whose reconstituted activity can be easily read out by colorimetry (as HRP’s activity is commonly read out in ELISAs and test strips). In principle this test would be highly sensitive due to signal amplification (by APEX enzymatic activity), cost-effective, and scalable with the possibility to do at home with immediate results—similar to an at-home pregnancy test.
Using human organoids to understand COVID-19 infection
The Kuo laboratory has helped pioneer methods to grow human mini-organs (or “organoids”) of lungs and intestines, which are two target tissues of SARS-CoV2 infection. Recreating SARS-CoV2 infection in three-dimensional organoid cultures—which can be grown in incubators instead of requiring infection of patients—allows infection of human tissue to be initiated in a controlled fashion and the sequence of virus-induced pathogenic events to be observed and delineated in detail.
Epidemiology, Transmission, and Tracing
Californians Fighting Against Coronavirus Together Study (CA-FACTS)
The CA-FACTS study is a population-based, longitudinal sampling to forecast the future trajectory of the epidemic, monitor the burden in vulnerable populations, direct health-care resource allocations, and interpret efficacy of intervention strategies. The study will leverage a new serologic test with high sensitivity and specificity developed at Stanford Medicine to determine whether or not people have been infected with the virus that causes COVID-19. CA-FACTS will capitalize on this new tool to understand the true burden of COVID-19 infection in Bay Area counties initially, and ultimately more broadly. The results of CA-FACTS can be rapidly provided to individuals, communities, and public health departments leading the response to the crisis.
Stanford coronavirus study to understand behavioral and societal impacts
Eleni Linos, MD, MPH, DrPH with Melissa Bondy, PhD
This online study is designed to collect information from individuals in the United States and around the world about the social and behavioral impact of the evolving COVID-19 pandemic and to rapidly learn about the factors affecting the world population currently and over time. An online survey tool will include reliable information about COVID-19 that will be continuously updated with new surveys (“waves”) and study results as the COVID-19 pandemic evolves, creating a reliable public health information source to directly inform public health practitioners, health-care systems, clinicians, and policy makers.
Artificial Intelligence (AI), Big data, and Modeling
Using wearables and smart devices to detect populations at risk
COVID-19 has an incubation period of up to 13 days and the virus that causes it can be transmitted by asymptomatic individuals. By detecting the disease early before symptoms appear, we can empower individuals to help slow the spread of the virus. With limited test kits and slow turnaround times for results, there is an immediate need for alternative methods to warn individuals they might be infected and estimate the likely severity of their illness. Many physiological changes, including increased temperature, elevated heart rate, increased respiration rate, increased sweating, and changes in blood oxygenation and blood pressure, can be detected using popular consumer wearable devices days in advance of symptoms.
Using AI and computer-vision technology to fight COVID-19
Arnold Milstein, MD, MPH; Fei-Fei Li, PhD; and Kevin Schulman, MD
Together, Stanford Medicine’s Clinical Excellence Research Center and the Engineering School’s Department of Computer Science have been developing two economical applications of computer-vision technology to demonstrate discrepancies in the ability of hospital staff to practice infection-prevention protocols. This wall-mounted technology will help ICU staff instantly detect and correct flaws in their adherence to the hand-hygiene protocol that is essential to preventing inadvertent infection of themselves and their critically ill COVID patients. The technology can also be used in homes to help monitor the health trajectories of COVID-infected and suspected patients who are not severely ill, and aid in preserving hospital resources for patients who are severely ill.
Genomics
Who’s at risk for the ICU? COVID-19 RNA sequencing study to determine susceptibility factors
Euan Ashley, MD, PhD; Manuel Rivas, PhD; and Carlos Bustamante, PhD
This study will look at one thousand patients of diverse backgrounds and disease severity categories, and will be coordinated across multiple departments and schools at Stanford and in the Bay Area. In coordination with the Chan Zuckerberg Biohub, the study aims to sequence the virus (RNA) and host (DNA) of patients to determine susceptibility factors. Only by understanding how the virus mutates by collecting genomics and immune profiles of infected patients can we understand susceptibility. The results of this anonymized study would immediately enhance our planning for COVID-19 in the Bay Area and will also be made available worldwide to aid researchers fighting against this virus.
Coronavirus proteins for clinical immunology assay development and implementation
This collaborative project involves multiple campus laboratories and researchers to produce SARS-CoV-2 proteins to assist with clinical and research needs associated with the current pandemic. This effort includes the isolation of novel neutralizing antibodies and nanobodies to block SARS-CoV2 entry and the screening for novel small molecule inhibitors of the SARS-CoV2 polymerase.
Vulnerable and Minority Populations, Mental Health, and Community Education
Medical and social impact of COVID-19 in the Bay Area
Dr. Forrester is conducting two projects in conjunction with Santa Clara Valley Medical Center to further understand the medical and social impact of COVID-19 on the Bay Area Peninsula. The first project aims to understand how the shelter-in-place order affects the epidemiology of traumatic injury and analyze rates of interpersonal violence, domestic violence, and alcohol-or drug-related injury. In a second study, the team will evaluate whether the pandemic and shelter-in-place orders have caused patients to delay seeking care for common general surgical conditions and analyze the impacts of those decisions. Findings from both studies will be used to improve and target public health messaging for other cities nationally and internationally.
Examining the effects of COVID-19 in underserved communities
Juno Obedin-Maliver, MD, MPH, MAS and Mitchell Lunn, MD, MAS
This team will investigate the impact that COVID-19 has among lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) communities by utilizing The PRIDE Study—a first-of-its-kind national, longitudinal study of the health of LGBTQ+ people, to determine how participants’ mental and physical health has changed over time and as a result of COVID-19. Additionally, the cohort nature of The PRIDE Study enables the team to repeatedly survey participants and reach out to them for additional clinical and research studies.
Impact of rapid transition from face-to-face patient care to remote virtual options in the age of COVID-19
In a very short period of time, Stanford clinical providers in the Department of Psychiatry and Behavioral Sciences rapidly transitioned their standard face-to-face patient care practices to remote, virtual options in an effort to promote safety while continuing to provide ongoing quality care. Dr. Lock is leading a clinical-improvement initiative to assess the feasibility and acceptability of adapting and delivering evidence-based treatments via tele-health from both patient and provider perspectives. The study will collect information related to treatment modality, diagnosis, number of sessions, attendance, cost/time savings, and frequency of late cancellations/no-shows across different patient and clinician groups. The resulting data could help identify important differences between providers and patients and be used to change the delivery of mental health care beyond this current crisis.
Home sweet office: An online platform for stress and productivity management in the era of COVID-19
As we face the current COVID-19 pandemic, millions of workers were challenged with the immediate need to move their work from the office to home. Unaccustomed to this new workplace dynamic, many will require support to maintain an adequate rhythm of work and productivity while managing the stress associated with this lifestyle change and the constant barrage of news about the pandemic. Dr. Paredes and his team have been studying stress-management technology tools and are in the process of rapidly generating an initial, broad “occupational precision mental health” research tool and platform. The platform’s solutions would initially focus on productivity and individual stress management before expanding to include interventions aimed at feelings of isolation and healthy family interactions.
Support for Care Providers
Supporting health-care professionals through the COVID-19 pandemic
In 2017, Tait Shanafelt, MD, joined Stanford Medicine as the nation’s first Chief Wellness Officer. Under his leadership, the WellMD Center has pioneered innovative ways to prevent burnout among physicians, nurses, and other health-care professionals by supporting their health and well-being. Many suffering from the extreme physical, intellectual, and emotional stress of being on the front lines of this unprecedented and dangerous battle against COVID-19 need help to protect both their short- and long-term health and emotional well-being. In the aftermath of this crisis, there will be an enormous unmet need to provide tools to help providers address the effects from their experiences fighting the pandemic—exhaustion, intense exposure to human suffering, moral dilemmas and ethical challenges, loss of colleagues, and potential post-traumatic stress disorder (PTSD). Developing these resources will serve Stanford Health Care professionals and benefit individuals and health-care organizations around the world.
The above projects are examples of COVID-19 related research underway at Stanford. If you would like to support Stanford's COVID-19 efforts, we encourage giving to the general clinical and research funds through the link above.
Original article appeared here.