Deploying the Right Stuff to Battle COVID
Along with providing excellent medical care during the outbreak, UMMS hospitals benefit from an affiliation with the University of Maryland School of Medicine (UMSOM), where faculty are pioneers in battling infectious disease.
Potential COVID-19 Antibody Treatment
Matthew Frieman, PhD, associate professor of microbiology and immunology, has researched coronaviruses for the past 17 years. He has closely studied SARS-CoV-2 (the virus that causes COVID-19) in his laboratory since the beginning of the outbreak, serving as a key researcher in several benchmark studies.
Frieman and his team evaluated several human antibodies – proteins that the immune system makes to destroy invading viruses and bacteria – to use as a promising therapy against coronavirus.
Monoclonal antibodies are developed in a laboratory and used to treat harmful viruses by mimicking the immune system's reaction to them. For these antibody therapies to work, developers must create a precise "cocktail" of antibodies that most effectively fight a type of virus. Frieman and his colleagues identified two powerful antibodies that may effectively treat COVID-19.
The antibody cocktail he tested, which is made by Regeneron, is currently being offered at the Baltimore Convention Center Field Hospital as an early COVID-19 treatment to prevent hospitalizations in high-risk patients.
Funding for Accelerated Drug Testing
Researchers at UMSOM have partnered on an agreement funded by the Federal Defense Advanced Research Projects Agency to test drugs currently on the market that can prevent or treat COVID-19. Through a unique antiviral testing system in Frieman's laboratory, the team rapidly tests drugs meant for other conditions to find out how they interact with the novel coronavirus.
In a preliminary study reported in the summer of 2020, Frieman (pictured) and his colleagues tested 20 FDA-approved drugs and found that 17 showed promise against the virus that causes COVID-19. In Frieman's own earlier research, he found these drugs also had antiviral effects against two other deadly coronaviruses: SARS-CoV-1, which emerged in 2003 in China; and MERS-CoV, which emerged in 2012 in the Middle East.
With new innovative Organ Chip technologies installed in his laboratory, Frieman and his team can determine how a drug interacts with the virus that causes COVID-19. Organ Chips are microdevices that contain human organ cells in sophisticated cell cultures; the cells replicate the function of full-size organs with tiny vasculature for fluid flow and mechanical forces to mimic the breathing motions of lungs, for example, or the filtration of kidneys.
Serology Testing for Community Prevalence
Because so many people were asymptomatic carriers of the virus, in the summer of 2020, the UMSOM offered serology testing to all team members at UMMS and the University of Maryland, Baltimore. Thousands of UMMS team members volunteered to give a blood sample to the study to help determine the prevalence of the novel coronavirus in the community. Ongoing testing can also help to determine, in the long term, how long after infection antibodies remain.
"What the serology test tells you is whether you've had COVID-19 in the past. It detects whether an antibody against the virus is present [in the blood sample]," said Anthony Harris, MD, MPH, professor of epidemiology and public health.
To increase the accuracy and validity of results, the UMSOM laboratories conducted two different tests on each sample. One test was from the US Centers for Disease Control and Prevention, and the other was produced by a commercial laboratory.
Technology That Helps Patients Heal
The University of Maryland Medical Center (UMMC) boasts one of the highest volume extracorporeal membrane oxygenation (ECMO) programs in the country.
ECMO technology takes over the work of the lungs, allowing them to heal and recover. UMMC implemented ECMO in its first COVID-19 dedicated unit and has watched the technology save some of the sickest patients. The medical team trained intensively to be one of only two hospitals in Maryland to use the technology.
Learn more about UMMC's dedicated COVID-19 ECMO Unit.
Other innovations in treating COVID-19 include:
Designated proning team: COVID-19 patients benefit from being placed on their stomachs to get enough oxygen. The process is called "proning." UM Baltimore Washington Medical Center (UM BWMC) created a proning team to assemble at scheduled times to go from room to room to reposition sick patients.
Reducing risk: Several of the hospitals found ways to reduce nurses' exposure to the virus, such as by moving IV poles into hallways, thereby reducing the number of times nurses needed to enter a patient room to replace fluid bags.
Survivorship programs: UMMC and UM BWMC instituted survivorship programs to support patients with lingering physical and emotional effects of COVID-19.
UM BWMC created an intensive care recovery program. The outpatient clinic is a collaboration among the medical center's Transitional Care Center, pulmonologists, critical care physicians and primary care providers.
"Our recovery program fills the gap for some of our sickest patients recovering from COVID-19," said Sara Viola, MD, pulmonary and critical care physician at UM BWMC.
"We now recognize the importance of following up with our patients after they have survived the critical phase of the illness. Oftentimes, they have left the ICU, but the ICU has not left them – both physical and emotional challenges may follow them, and we want to be there to care for these needs."