Winnipeg docs working to whip COVID-19

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This article was published 20/04/2020 (2151 days ago), so information in it may no longer be current.

A little more than a decade ago, a new influenza virus emerged in California and spread across the United States; it travelled across the globe and became a pandemic, with children and young adults suffering the most.

In 2009, the H1N1 influenza virus hit the world in waves, pediatric emergency physician Terry Klassen said, and not unlike the current coronavirus pandemic, researchers around the globe mobilized to study the outbreak.

That year, Klassen — on sabbatical from the University of Alberta — had founded the Pediatric Emergency Research Networks (PERN) to create a framework for national pediatric research organizations to collaborate on international issues.

The networks rapidly developed a study to collect data on risk factors for kids with severe cases of H1N1 at sites across the world.

“We had no research funding at the time; people just went back and did it on their volunteer time, and the next thing we had this study that was really important,” Klassen said. “It provided the research networks a chance to work together and to start to form those types of relationships that are important for research collaboration.”

Klassen, who had received his medical degree from the University of Manitoba, later returned to Manitoba. He has spent the last 10 years with the Children’s Hospital Research Institute of Manitoba (CHRIM) as chief executive officer and scientific director.

The grandfather of four is now a co-investigator for a multinational study that’s examining COVID-19 infections in children. The research is happening in 19 countries using the PERN framework Klassen built in 2009. It will look at risk factors for the disease, long-term outcomes for children infected with SARS-CoV-2, potential chronic conditions and the effect of regional policies on children’s health.

PERN was already in the midst of a worldwide pneumonia study when an opportunity for COVID-19 research funding was offered by the Canadian Institutes of Health Research, Klassen explained.

“We rapidly pivoted and used that other study as the backbone for the data-sharing and research ethics, and then made the application to study SARS-CoV-2,” Klassen said. “This is a particular virus that when it comes to children, there simply wouldn’t be enough at any one site to really get a large enough sample that would give you meaningful results. So you need an international entity that can recruit the number of children in meaningful numbers.”

The study is led by Dr. Stephen Freedman of the Alberta Children’s Hospital Research Institute. Its steering committee is composed of experts connected to PERN, including Klassen.

The participant pool will include 12,500 children and data will be collected on children’s experiences for 90 days, travel history, exposures and symptoms, lab tests, X-rays, treatment and outcomes. Children in Manitoba are not part of the study, Klassen said, but that could change as it progresses.

The findings of the study will be shared through Translating Emergency Knowledge for Kids — a Manitoba-based research resource portal — to health care providers and clinicians, Klassen said.

“With this, especially an entity that we know so little about, our learning curve has been so steep, and I would say painful. I think it’s really important that Manitoba can be right in there and have access to the best knowledge,” he said.

Local researchers with CHRIM are on the frontline of developing treatments for the novel coronavirus in the short term, in both pediatric and acute-care settings.

Dr. Lauren Kelly is one of the principal investigators with the Manitoba-arm of the World Health Organization’s Solidarity study. The Solidarity study will be the largest adult clinical trial in the world, Kelly said, with 83 countries participating and three participant sites in Winnipeg: Grace Hospital, Health Sciences Centre and St. Boniface Hospital.

“We need fast answers about a lot of questions, and I think that’s where this global platform– we’re looking to recruit more than 10,000 patients globally — is really an exciting opportunity for Manitoba to be a player in a global effort.” — Dr. Lauren Kelly

“Every single day in the news, there’s someone suggesting that something is working better than something else. So we need to be flexible in how we look at trials,” said Kelly, who is a clinical trials expert at CHRIM. The Solidarity study is still waiting for approval in Manitoba but is expected to begin recruiting participants in three weeks, she said.

“We need fast answers about a lot of questions, and I think that’s where this global platform — we’re looking to recruit more than 10,000 patients globally — is really an exciting opportunity for Manitoba to be a player in a global effort,” she said.

Kelly is also contributing to the suite of adult clinical trials led by Dr. Ryan Zarychanski of the U of M, where she is an assistant professor in the department of pediatrics and child health. Seven trials are in various stages, Kelly said, with the first clinical trial for those hospitalized with COVID-19 expected to begin shortly.

While she’s happy to step in to offer her expertise on clinical trial research to advance potential therapeutics for adults, Kelly continues to focus on testing treatment options for children infected with COVID-19.

CHRIM is considering two additional pediatric trials to be run through the research support unit, Kelly said. Both trials are in the design phase and one will look at a variety of therapeutics for COVID-19 while the other is a convalescent plasma study.

“Of course we’re all hoping we don’t have a lot of hospitalized children with COVID. We still feel from an equitable perspective we want to be able to have trials to offer them,” she said.

“You hope the trials aren’t going to be needed, but you also hope you have answers for next time.”

danielle.dasilva@freepress.mb.ca