Drs. Patrick Nicholson, Laila Alshafai and Timo Krings, neuroradiologists at UHN’s Toronto Western Hospital, recently revealed new details on how COVID-19 may affect the brains of certain individuals.
In a short preliminary case series, the research team observed evidence of internal bleeding and clotting in the blood vessels of the brain of four individuals with severe COVID-19.
All four individuals were unable to breath on their own. One was on a mechanical ventilator, and three were on an extracorporeal membrane oxygenation (ECMO) machine—a device that delivers oxygen directly to the blood.
All of the patients displayed new symptoms such as weakness or drowsiness—this was the initial reason why brain imaging was carried out. Images of the brains of patients were taken using advanced techniques to reveal the detailed structure of blood vessels and soft tissues. These techniques included computerized tomography and magnetic resonance imaging (MRI).
The team identified a number of abnormal features in the brain scans, including small areas of localized bleeding. In other areas, they found evidence of clotting in small blood vessels in the brain. The researchers note that these abnormalities could point to a condition known as thrombotic microangiopathy. Other case studies have suggested that COVID-19 can infect and damage cells that line blood vessels, which may help explain the bleeding that was observed.
Certain limitations exist in this study. For example, the number of patients is very limited and the use of ECMO may also contribute to bleeding in the brain, which could confound results.
In summarizing the implications, the team urges for clinicians to be extra vigilant when screening individuals with COVID-19. Dr. Nicholson says, “Use of medical imaging, such as MRI, for those with changes in behaviour or consciousness, may be key to the early detection and treatment of brain bleeds in those with COVID-19.”
Nicholson P, Alshafai L, Krings T. Neuroimaging Findings in Patients with COVID-19. American Journal of Neuroradiology. 2020 May. doi: 10.3174/ajnr.A6630.
In June 2020, the Krembil research community will welcome its newest member: Dr. Karun Singh, a mid-career researcher with extensive expertise in neuroscience and stem cell biology.
Dr. Singh’s research has led to a better understanding of how genes affect neurological development by identifying those that put individuals at higher risk of developing neurodevelopmental disorders (NDDs). In his research, he uses a variety of experimental models of NDDs—including lab-engineered brain cells from patients—and cutting-edge techniques such as CRISPR gene editing.
He received the 2018 Young Investigator Award from the Canadian Association for Neuroscience for identifying two novel risk genes for NDDs: TAOK2 in autism and OTUD7A in 15q13.3 microdeletion syndrome.
Dr. Singh’s expertise and experience are highly complementary to those of Krembil’s vision researchers. Through collaborations and scientific exchanges, he will help the vision researchers model disease in human and patient-derived material. Developing more humanized models of disease can lead to new insights into disease mechanisms.
“I am very excited to join Krembil’s large neuroscience community, where basic and clinical science are so highly integrated. I look forward to establishing new projects and collaborations—particularly with the vision and neurodegenerative disease groups—to mutually expand and enrich our research programs,” says Dr. Singh.
Before joining Krembil, Dr. Singh was a Scientist in the Stem Cell and Cancer Research Institute and an Associate Professor in the Department of Biochemistry & Biomedical Sciences at McMaster University, where he held the endowed David Braley Chair in Human Stem Cell Research. He completed his PhD at the University of Toronto and his postdoctoral fellowship at the Massachusetts Institute of Technology in the United States.
Dr. Singh’s recruitment was made possible by the generous support of Donald K. Johnson and Anna McCowan-Johnson through the Toronto General & Western Hospital Foundation.
Welcome to the Krembil Dr. Singh!
Welcome to the latest issue of The Krembil.
The Krembil is the official newsletter of the Krembil Research Institute. Research at Krembil is focused on finding innovative treatments and cures for chronic debilitating disorders, including arthritis and diseases of the brain and eyes.
Stories in this month’s issue include:
● STAYING CONNECTED: A message from Dr. Donald Weaver, Director of the Krembil Research Institute.
● MAPPING OUT MEMORY: Study combines experimental and computational research to link a type of brain cell to memory.
● OVER THE LONG HAUL: A drug for the long-term management of psoriatic arthritis.
● HITTING A BULL’S-EYE: Krembil researchers identify a therapeutic target to stop vision loss and prevent blindness.
● HELPING HAND: A strategy to restore movement after spinal cord injury shows promise in experimental model.
Welcome to the latest issue of Research Spotlight.
As Canada’s largest research hospital, UHN is a national and international source for discovery, education and patient care. This newsletter highlights top research advancements across UHN and from over 1000 researchers appointed at our institutes.
Stories in this month’s issue:
● Research to Protect Frontline Staff: New study will support the testing of health care workers for COVID-19 infections.
● A Potential Treatment for COVID-19: Interferon-α2b treatment shows promise for promoting recovery from COVID-19.
● The Need for Speed: Research projects at UHN awarded funding to quickly address COVID-19 pandemic.
● Research in Action: New COVID-19 studies to shed light on disease, treatments and fostering mental health.
An international team of researchers led by Dr. Eleanor Fish, emerita scientist at UHN’s Toronto General Hospital Research Institute, has shown that the antiviral drug interferon(IFN)-α2b can help speed up the recovery of COVID-19 patients.
Published today in Frontiers in Immunology, the study found that treatment with IFN-α2b significantly reduced the duration of detectable virus in the upper respiratory tract by about seven days on average. The treatment also reduced blood levels of two inflammatory proteins found in COVID-19 patients.
Interferons are a group of signaling proteins released by the human body in response to all viruses. Interferons prevent viruses from multiplying and also activate immune cells to help clear an infection. Some viruses can evade this defense mechanism by blocking the production of interferons. By raising interferon levels, the treatment helps to counter this evasive maneuver and restores the ability of the immune system to clear the virus.
Dr. Fish worked with researchers at the Tongii Medical College’s Union Hospital in Wuhan to evaluate the potential of interferon as a treatment for COVID-19. The study recruited 77 patients with moderate symptoms that were admitted between mid-January and late February.
IFN-α treatment has been approved for many years to treat cancers as well as viral infections. The research team considered IFN-α therapy for COVID-19 after Dr. Fish had demonstrated its therapeutic benefit during the SARS outbreak of 2002 and 2003.
“Rather than developing a virus-specific antiviral for each new virus outbreak, I would argue that we should consider interferons as the ‘first responders’ in terms of treatment,” says Dr. Fish. “Interferons have been approved for clinical use for many years, so the strategy would be to ‘repurpose’ them for severe acute virus infections.”
The study’s findings demonstrate the promise of IFN-α as a treatment strategy. A randomized clinical trial with a larger group of infected patients is a crucial next step to establish the efficacy and safety of this treatment for COVID-19. Dr. Fish is also part of an effort to evaluate interferons for prophylactic use against COVID-19.
Zhou Q, Chen V, Shannon CP, Wei X-S, Xiang X, Wang X, Wang Z-H, Tebbutt SJ, Kollmann TR, Fish EN. Interferon-alpha2b treatment for COVID-19. Front Immunol. 2020 May 15. doi: 10.3389/fimmu.2020.01061.
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