Four UHN researchers—Drs. Donald Weaver, Ewan Goligher, Patrick Lawler and Steven Chan—have received funding to test existing drugs for their potential to treat COVID-19. The funding is provided by LifeArc, an independent medical research charity based in the UK that aims to turn promising science into benefits for patients. The charity is providing a total of £10m for 15 projects that involve clinical trials to find effective therapies for COVID-19.
The three UHN projects selected by LifeArc all focus on existing and widely used drugs. If these drugs are shown to work as treatments for COVID-19, they could be made available to patients much faster than newly developed drugs. More details about the three projects can be found below:
FaST for COVID
Furosemide as Supportive Therapy for COVID-19
Dr. Donald Weaver’s research aims to rapidly translate an anti-inflammatory drug, known as furosemide, into a therapy for patients with COVID-19. Treatment with the drug is expected to decrease the deadly levels of inflammation—often referred to as the ‘cytokine storm’—that is sometimes seen in severe cases of COVID-19. Find out more.
ATTACC Randomized Trial
Antithrombotic Therapy to Ameliorate Complications of COVID-19
Drs. Ewan Goligher and Patrick Lawler will conduct a multi-site clinical trial to determine if heparin, which is commonly used to prevent the formation of blood clots, can improve outcomes for patients who are at high risk of developing blood clots in the lungs. The clinical trial will take place at health centres across Canada, USA and Brazil. Find out more.
RUX-COVID
Clinical Study to Investigate the Efficacy and Safety of Ruxolitinib for the Treatment of COVID-19 Pneumonia
Dr. Steven Chan’s project will determine whether an established blood cancer drug, known as ruxolitinib, can reduce the need for ventilation in patients with severe COVID-19 (i.e., those at risk of developing complications such as pneumonia). Find out more.
LifeArc will provide ongoing support to all three projects. The support goes beyond funding alone and includes access to key research resources and expertise. This will ensure that the studies deliver new therapies to tackle the virus and its impact.
Mark Taylor, PEng MSc MBA is UHN's new Director, Technology Development and Commercialization (TDC), effective immediately. Mr. Taylor has been with TDC since 2008; he was promoted to Associate Director in 2019 and has been Interim Director since February of this year.
Mr. Taylor brings a wealth of business and commercialization experience, with previous roles in industry as well as several years developing research innovations within the health sciences sector. An engineer by training, his initial focus at TDC was on the development of medical technologies; he was also instrumental in the creation of the original plans for the launch of the Techna Institute. Over the years, he has helped translate many UHN inventions into products on the market that have improved patient experiences and outcomes, and his expertise in this area is evidenced by regular speaking engagements locally and at international conferences on commercialization and entrepreneurial best practices.
In 2014, Mr. Taylor began leading TDC’s dedicated licensing and commercialization team; under his direction, UHN spin-offs have attracted in excess of $930 million in cumulative risk capital investment, and experienced four major acquisitions/exits totaling more than $2.3 billion—among the highest across all Canadian research institutions.
Mr. Taylor has also helped lead some of the biggest deals in the Canadian and international biotech ecosystem, including those involving UHN spin-off companies AVROBIO and BlueRock Therapeutics, among others. Owing largely to the success of the transactions in which he was directly involved, UHN generated a record $37 million in licensing revenue over the last fiscal year alone—placing the institution in the top tier among North American peers in terms of revenue generation.
As Director of TDC, Mr. Taylor will continue to work closely with Dr. Brad Wouters, Executive Vice Presdient, Science and Research, to help grow UHN's Toronto biotech commercialization ecosystem; build upong the strong relationships with UHN’s invaluable Foundations and industry partners; and attract the best teams and risk capital sources for UHN startups. These goals will be accomplished in a way that provides fair value to UHN for its investments in people, infrastructure and funding—and will deliver excellence in support to UHN’s world-class research community, and fuel a perpetual cycle of discovery, translation and commercialization for the benefit of patients.
In particular, Mr. Taylor will help to advance the UHN Strategic Research Plan 2019–23 and its “Accelerate the translation of discovery to practice” priority—with its goal to elevate the position of UHN, Toronto and Canada on the world stage as a leading destination for commercialization and discovery. Congratulations to Mr. Taylor on this new position.
Congratulations to the UHN researchers who were awarded funding through the Canadian Institutes of Health Research (CIHR) COVID-19 Rapid Research Funding Opportunity.
In this round, a total of $8.25M will be provided for seven projects that are led or co-led by UHN researchers.
The projects use diverse strategies to fight COVID-19. Examples include Dr. Douglas Lee’s project, which will use artificial intelligence and statistical techniques to analyze large sets of health data from patients in Ontario and Alberta. By looking at health outcomes of those who are at risk or have developed COVID-19, the research team will be able to identify medications that affect the severity and outcomes of the disease, as well as help gauge whether changes in health care, in response to the pandemic, have impacted those living with chronic cardiovascular conditions.
Other projects will look at the effects of COVID-19 on patients up to one year after infection (Drs. Angela Cheung and Margaret Herridge); reveal how the pandemic has affected the use of the health care system by Canadians (Dr. Murray Krahn); explore whether severe symptoms are caused by certain patients’ own immune systems (Dr. Robert Rottapel); and determine whether severe symptoms can be averted through the use of nutritional supplements such as vitamin D and zinc (Dr. Kevin Kain), or medications including the blood thinner heparin (Drs. Ewan Goligher and Patrick Lawler) or a diabetes drug semaglutide (Dr. Vladimir Dzavik).
This current round of funding will provide a total of $109.7M to support 139 research teams across Canada. These projects include clinical trials, observational studies, implementation science or other relevant study designs to address COVID-19-related vaccines, diagnostics, or therapeutics; clinical management and health system interventions; and social, policy and public health responses and consequences. This current round complements the first round, which was announced in March and provided $55.3M to support 100 research teams.
For more information, see the press release.
The federal government’s New Frontiers in Research Fund – Exploration Stream program has awarded 12 projects that are led or co-led by UHN researchers. Each team will receive up to $250,000 to explore new research directions that bring together disciplines in non-traditional ways.
The projects, which are listed below, represent some of the most original and potentially transformative research into developing health solutions in Canada. The approaches to be taken include the use of polarized light to diagnose disease, the development of smart clothing to support rehabilitation, and material science approaches to fight multidrug resistant bacteria.
• Drs. Suze Berkhout (TGHRI) and Kelly Fritsch (Carleton University) will explore central challenges across the organ transplant process and how they can be radically transformed through critical disability studies, feminist science and technology studies
• Dr. John Byrne (TGHRI) will use an advanced imaging technique to detect immune cells called macrophages in abdominal aortic aneurysms to determine the risk of aneurysm growth
• Drs. Frances Skinner and Aylin Reid (Krembil) will merge mathematical models and experimental data of brain rhythms to identify cell-specific pathways that are modified by brain injury
• Drs. Alex Vitkin (PM) and Sharon Nofech-Mozes (Sunnybrook) will use novel polarized light technologies to develop image-based prognostic tools for cancer
• Dr. Azadeh Yadollahi (KITE) will develop customized treatments for people with sleep disorders to minimize damage to the heart and lungs and to prevent long-term disability
• Drs. Jane Batt (Unity Health Toronto) and Sunita Mathur (KITE) will develop smart textiles to deliver neuromuscular electrical stimulation to overcome acquired weakness in people recovering from intensive care
• Drs. Katherine Duncan (University of Toronto) and Taufik Valiante (Krembil) will use precisely-timed deep brain stimulation to better understand brain memory
• Drs. Benjamin Hatton (University of Toronto) and Allison McGeer (TGHRI) will attempt to stop the spread of antibiotic-resistant microbes in hospital plumbing networks using an engineered silicone material that minimizes bacterial colonization
• Drs. Hossein Kassiri (York University) and Georg Zoidl (Krembil) will design, develop and validate a wireless, battery-free and digitally-programmable optical device to precisely control the stimulation of brain cells
• Drs. Naomi Matsuura (University of Toronto) and James Drake (Techna) will use ultrasound-activated materials for the diagnosis and treatment of childhood brain cancers
• Drs. Joshua Milstein (University of Toronto) and Jonathan Rocheleau (TGHRI) will use microfluidics, time-lapse microscopy and genetically-encoded biosensors to uncover the role of metabolism in the persistence of infectious bacteria
• Drs. Andrei Yudin (University of Toronto) and Cheryl Arrowsmith (PM) will leverage the novel concept of ‘dark chemistry space’ to develop an entirely new approach for the rational design of cell-permeable drugs for childhood developmental diseases
Dr. Eddy Fan, Scientist at Toronto General Hospital Research Institute, recently led a study on the neurological outcomes of patients who receive life support for lung failure. The researchers found that complications such as seizures are more likely when the level of carbon dioxide in the blood changes quickly after starting life support.
Our body maintains a delicate balance of oxygen and carbon dioxide in our bloodstream. The lungs deliver oxygen to the blood, and clear carbon dioxide from the blood. When the lungs cannot perform these functions, such as during lung transplant surgery or severe COVID-19 infection, a device known as an extracorporeal membrane oxygenation (ECMO) machine is needed to provide life support by serving as an artificial lung.
“Just before a patient receives ECMO support, there is typically too much carbon dioxide in the blood. Once ECMO is initiated, the machine is able to correct this fairly quickly.” says Dr. Fan.
The research team analyzed de-identified data from 11,792 adults receiving ECMO support between 2012 and 2017 worldwide. Neurological complications such as bleeding in the brain, stroke and seizures occurred in 6.9% of these individuals.
“Although neurological complications were uncommon, we found that when the carbon dioxide levels were corrected too quickly, neurological complications such as bleeding in the brain, stroke, or seizures were more likely to occur,” says Dr. Fan.
Important limitations of the study include incomplete data for some patients and several unaccounted confounding factors. Even though the current study does not prove a causal association between sudden changes in carbon dioxide levels in the blood and poorer outcomes of brain function, other studies have supported a causal association.
“Our findings suggest that on the first day of a patient starting ECMO support, clinicians should carefully moderate the correction of carbon dioxide levels in the blood,” cautions Dr. Fan.
This work was supported by the Extracorporeal Life Support Organization (ELSO) and the Toronto General & Western Hospital Foundation.
Cavayas YA, Munshi L, Del Sorbo L, Fan E. The Early Change in PaCO2 After Extracorporeal Membrane Oxygenation Initiation is Associated with Neurological Complications. Am J Respir Crit Care Med. 2020 Apr 6. doi:10.1164/rccm.202001-0023OC.
Is anxiety keeping you up at night? A team of international researchers, including UHN’s Dr. Frances Chung, are investigating how the COVID-19 pandemic may be impacting sleep quality for people around the world.
Participation in the study, which involves completion of a 20-minute online questionnaire, is voluntary and anonymous. Anyone over the age of 18 can participate.
Click here to participate in the study.
The study will gather data from participants in at least nine countries, across North America, Europe and Asia. The researchers hope to enroll at least 1,000 people in each country.
The fear of being infected with the virus, worrying about friends and family, job loss, financial problems, physical distancing and new work routines are all factors that can generate stress and anxiety, with consequences on sleep routine. "The pandemic is impacting all aspects of our lives and truthfully nobody knows when it will end," says Dr. Frances Chung, ResMed Research Chair of Anesthesiology, Sleep, and Perioperative Medicine in the Department of Anesthesia and Pain Management at UHN, and one of the principal investigators of the study.
Dr. Chung says the research will help gather data about people's sleep patterns to determine how they are affected by social confinement, risk of exposure to COVID-19, and any psychological conditions that may have been exacerbated during the pandemic, such as anxiety, depression or post-traumatic stress.
"This study will help us understand to what extent COVID-19 has impacted sleep health, and help guide strategies during this pandemic response period, and beyond," says Dr. Chung.
Even before the COVID-19 pandemic, sleep disorders were considered an overlooked public health issue. In Canada, an estimated 35 per cent of the population aged 15 or older had trouble going to sleep or staying asleep for the appropriate number of hours.
Sleep health can have a huge impact on mental health, wellbeing, and can also affect how our bodies function. Studies have shown that insufficient or poor quality of sleep is associated with obesity, diabetes, cardiovascular diseases, injuries, lower immunity and other health problems.
"Unfortunately, sleep health is an area of study still largely ignored," says Dr. Chung. "Collecting this kind of data is a critical first step to get a better picture and improve both, sleep and mental health."
Laboratories at UHN have partnered with medical programs to become hotbeds for the design, manufacturing and testing of medical grade personal protective equipment (PPE).
These initiatives are supporting frontline workers and the fight against COVID-19 by providing a locally manufactured and reliable supply of safety-tested protective equipment—including face shields, patient monitoring components and alternatives to disposable N95 masks.
The programs that are leading these efforts include Techna Institute’s Image Guided Discovery Lab (IGDL) and Tele-Monitoring Program; as well as UHN’s The Lynn & Arnold Irwin Advanced Perioperative Imaging Lab (APIL), and the departments of Anesthesia & Pain Management and Medical Engineering.
A key challenge of manufacturing medical equipment is the need for it to meet the highest safety standards. Tackling this issue requires multiple rounds of designing, prototyping and clinical validation. Being based as Canada’s largest research hospital is a key advantage and has enabled the vertical integration of these processes.
The following innovative projects are being led to meet the increased demand for scarce resources:
● The IGDL has helped to fast-track the manufacturing process by serving as a hub for multidisciplinary collaboration between engineers, scientists and clinicians.
● The APIL, led by Dr. Azad Mashari, is contributing an extensive collection of 3D printing equipment—which is key to manufacturing the various PPE components. Currently, the facility is producing the components required to assemble 100 face shields/day and supplying to hospitals throughout the Greater Toronto Area. 3D printing is also being employed to manufacture test swabs and new ventilator components to support ventilation for more than one patient on a single machine.
● The Tele-Monitoring team, led by Techna’s Manager of Engineering Jimmy Qiu, has been working closely with Medical Engineering to conduct rapid prototyping, 3D printing and assembling of camera mounts for medical vital sign monitors. These remote monitoring systems have been deployed to medical wards so that patients with severe COVID-19 symptoms can be continuously monitored for oxygen saturation levels.
● The APIL has also been working with the department of Anesthesia & Pain Management to develop and clinically validate a number of stop-gap solutions for the shortage of N95 masks, should the supply disruptions for masks and respirators continue. These solutions include a reusable, silicone N95-caliber mask and a positive pressure respirator to reduce risk of exposure for clinicians performing aerosolizing procedures. These devices have been prototyped and can be manufactured at a small to medium scale using 3D printing and molding techniques refined by APIL. For more information about this innovative N95-caliber mask, see the APIL website and this article.
The COVID-19 pandemic has ushered in a new set of challenges for safely delivering care to a critically ill patient population. By working towards a common goal, diverse experts at UHN are rising to the challenge to support frontline healthcare workers.
UHN and Toronto hospitals are seeking unopened and unexpired PPE, as well as medical gowns, gloves, masks and eye protection. If you or anyone you know would like to donate supplies or help in other ways, click here. All donated equipment are inspected and assessed by UHN’s Safety Services team and the Infection Prevention and Control team.
Research conducted at UHN's research institutes spans the full spectrum of diseases and disciplines, including cancer, cardiovascular sciences, transplantation, neural and sensory sciences, musculoskeletal health, rehabilitation sciences, and community and population health.
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