{"id":37395,"date":"2021-01-28T13:04:02","date_gmt":"2021-01-28T20:04:02","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=37395"},"modified":"2022-02-22T09:57:24","modified_gmt":"2022-02-22T16:57:24","slug":"why-does-covid-affect-people-differently-researchers-ask","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/why-does-covid-affect-people-differently-researchers-ask\/","title":{"rendered":"Researchers ask: Why does COVID-19 affect people differently?"},"content":{"rendered":"<div style=\"margin-top: 0px; margin-bottom: 0px;\" class=\"sharethis-inline-share-buttons\" ><\/div><figure id=\"attachment_38261\" aria-describedby=\"caption-attachment-38261\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-38261\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/05140911\/Blackmanmask.jpgtiny.webp\" alt=\"A man wearing a mask is out hiking.\" width=\"640\" height=\"427\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/05140911\/Blackmanmask.jpgtiny.webp 1200w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/05140911\/Blackmanmask.jpgtiny-300x200.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/05140911\/Blackmanmask.jpgtiny-1024x683.webp 1024w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/05140911\/Blackmanmask.jpgtiny-768x512.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/05140911\/Blackmanmask.jpgtiny-150x100.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/05140911\/Blackmanmask.jpgtiny-200x133.webp 200w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><figcaption id=\"caption-attachment-38261\" class=\"wp-caption-text\">Researchers are trying to determine why COVID-19 affects individuals differently. Photo: Getty Images.<\/figcaption><\/figure>\n<p>A major research initiative on the <a href=\"https:\/\/www.cuanschutz.edu\/research\" target=\"_blank\" rel=\"noopener noreferrer\">University of Colorado Anschutz Medical Campus<\/a> is making the fight against the novel coronavirus personal.<\/p>\n<p>The effort, which aims to accelerate research into the roots of COVID-19, launched a major data set called <a href=\"https:\/\/medschool.cuanschutz.edu\/covidome\" target=\"_blank\" rel=\"noopener noreferrer\">COVIDome<\/a> in a matter of months. Its source material is blood samples from patients who tested positive for COVID-19 and controls whose tests were negative. Through the <a href=\"https:\/\/medschool.cuanschutz.edu\/covidome\/data\" target=\"_blank\" rel=\"noopener noreferrer\">COVIDome Explorer<\/a> portal, researchers can analyze <em>(see box below) <\/em>the samples from a broad variety of biological perspectives.<\/p>\n<p>The goal: identify specific patterns \u2013 changes in proteins, red blood cells or immune response, for example \u2013 that can illuminate the mechanisms underlying the diverse ways COVID-19 affects people. Why does COVID-19 affect people differently? With that information and the ability to compare it to patients untouched by the disease, researchers and clinicians aim to design targeted treatments to patients, based on their unique characteristics.<\/p>\n<p>The motto of the COVIDome Project sums up that approach: \u201cNothing in the study of COVID-19 makes sense except under the light of precision personalized medicine.\u201d<\/p>\n<h2><strong>Why does COVID-19 affect people differently?<\/strong><\/h2>\n<p>\u201cCOVID-19 is not one entity,\u201d said <a href=\"https:\/\/medschool.cuanschutz.edu\/pharmacology\/faculty\/primary-faculty\/joaquin-espinosa-phd\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. Joaquin Espinosa<\/a>, <a href=\"https:\/\/medschool.cuanschutz.edu\/pharmacology\" target=\"_blank\" rel=\"noopener noreferrer\">Professor of Pharmacology<\/a> and executive director of the <a href=\"https:\/\/medschool.cuanschutz.edu\/linda-crnic-institute\" target=\"_blank\" rel=\"noopener noreferrer\">Linda Crnic Institute for Down Syndrome<\/a> at the <a href=\"https:\/\/medschool.cuanschutz.edu\/\" target=\"_blank\" rel=\"noopener noreferrer\">University of Colorado School of Medicine<\/a>. Espinosa is a COVIDome principal investigator and project leader. \u201cIt manifests itself in very different ways in every individual. In order for us to make a difference in care, we need to understand how COVID-19 affects different people.\u201d<\/p>\n<p>It\u2019s a question that has been one of the great puzzles of the disease, Espinosa noted.<\/p>\n<p>\u201cIf you have 100 people infected with the same virus, you have a wide range of outcomes,\u201d he said. \u201cEvery person is different. Some will not get sick at all, some will die, and everything in between. What are the mechanisms driving this massive diversity?\u201d<\/p>\n<h2><strong>Playing under the dome<\/strong><\/h2>\n<p>Espinosa describes COVID-19 as a unique \u201cdata ecosystem\u201d that allows research on many fronts by specialists with a variety of skill sets. It\u2019s an open system that encourages researchers to collaborate and broaden their perspectives about the disease.<\/p>\n<p>The raw material for the COVIDome Project comes from the <a href=\"https:\/\/research.cuanschutz.edu\/university-research\/covid-19-clinical-research\/covid-19-biobank-specimen-repository\" target=\"_blank\" rel=\"noopener noreferrer\">University of Colorado COVID-19 Biobank<\/a>, launched in March 2020 as a repository of COVID-19-positive blood samples for research under the guidance of <a href=\"https:\/\/www.uchealth.org\/provider\/thomas-flaig-md-medical-oncology\/\">Dr. Thomas Flaig<\/a>, <a href=\"https:\/\/www.cuanschutz.edu\/about\/leadership\" target=\"_blank\" rel=\"noopener noreferrer\">Vice Chancellor for Research and Professor of Medicine<\/a>\u00a0at CU Anschutz. Flaig works alongside Espinosa as COVIDome principal investigator and project leader.<\/p>\n<p>\u201cIt is a remarkable effort and example of research collaboration,\u201d Flaig said. \u201cThe productive outcome of this work is especially noteworthy considering the challenging nature of interacting with COVID-positive study participants, and the cooperation between the clinical teams and laboratories in this time of the pandemic.\u201d<\/p>\n<p><strong><div class=\"su-callout-box col-xs-12 col-sm-6 right\" style=\"background-color:#dce4e7; color:#2e3b44;\"><\/strong><\/p>\n<p><strong>Inside the COVIDome<\/strong><\/p>\n<p>The COVIDome Explorer portal offers researchers access to a range of data sets they can use to analyze components of blood samples from the COVID-19 Biobank.<\/p>\n<ul>\n<li>Transcriptome: Data on messenger RNA \u201ctranscripts,\u201d or the process through which DNA makes messenger RNA, which carries the genetic information to make proteins.<\/li>\n<li>Proteome: Proteins in the sample.<\/li>\n<li>Cytokines: Substances that regulate immunity.<\/li>\n<li>Metabolomics: Substances that regulate metabolism.<\/li>\n<li>Immune maps: Immune cells, such as T-cells, B-cells and natural killer cells.<\/li>\n<li>Seroconversion: Antibodies against SARS-CoV-2.<\/li>\n<\/ul>\n<p><strong><\/div><\/strong><\/p>\n<p>From the Biobank source, Espinosa and Flaig assembled a <a href=\"https:\/\/medschool.cuanschutz.edu\/covidome\/team\" target=\"_blank\" rel=\"noopener noreferrer\">broad-based COVIDome Project team<\/a>. In just a few months, the collaborators had built the structure for processing and analyzing samples. The blood samples also link to <a href=\"https:\/\/www.healthdatacompass.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">Health Data Compass<\/a>, a warehouse of clinical data that is part of the <a id=\"\" href=\"https:\/\/medschool.cuanschutz.edu\/cobiobank\/home\" target=\"_blank\" rel=\"noopener\">Colorado Center for Personalized Medicine on the Anschutz Medical Campus<\/a>.<\/p>\n<p>The COVIDome was open for play, as Espinosa puts it, with researchers entering through the COVIDome Explorer online portal to analyze some 110 samples, a little over 70 of them COVID-19-positive.<\/p>\n<h2><strong>Down Syndrome research created a framework for success<\/strong><\/h2>\n<p>It was a quick timeline, but the team had a head start. Several years previously, Espinosa and colleagues at the Linda Crnic Institute for Down Syndrome had created the Crnic Institute\u2019s <a href=\"http:\/\/www.trisome.org\/\" target=\"_blank\" rel=\"noopener noreferrer\">Human Trisome Project<\/a>. They aimed to explore some longstanding mysteries of people born with an extra chromosome 21 \u2013 the genetic cause of Down syndrome, or trisomy 21.<\/p>\n<p>For example, <a href=\"https:\/\/www.globaldownsyndrome.org\/syndrome-research-provide-important-insights-cancer-treatments\/\" target=\"_blank\" rel=\"noopener noreferrer\">people with Down syndrome have unusual protection against solid tumor cancers but are also highly vulnerable to blood cancers<\/a>. They are also at <a href=\"https:\/\/www.nia.nih.gov\/health\/alzheimers-disease-people-down-syndrome\" target=\"_blank\" rel=\"noopener noreferrer\">greater risk for developing Alzheimer\u2019s disease and dementia<\/a> and <a href=\"https:\/\/library.down-syndrome.org\/en-us\/research-practice\/12\/2\/autoimmunity-puzzle-down-syndrome\/#:~:text=It%20is%20well%2Dknown%20that,vitiligo%2C%20hypoparathyroidism%20and%20coeliac%20disease.\" target=\"_blank\" rel=\"noopener noreferrer\">for a variety of autoimmune disorders<\/a>. As it is for those studying COVID-19, the question for Down syndrome researchers is why the discrepancies, Espinosa said.<\/p>\n<p>The Human Trisome Project set out to build a framework for answering that: create a biobank with samples from blood draws and mouth swabs. That material forms the basis for the <a href=\"http:\/\/www.trisome.org\/explorer\" target=\"_blank\" rel=\"noopener noreferrer\">TrisomExplorer<\/a>, a portal for researchers to explore the biological pathways underlying Down syndrome. Thus far, the database has samples from some 700 patients and controls gathered across 43 states. It has spawned a <a href=\"http:\/\/www.trisome.org\/projects\" target=\"_blank\" rel=\"noopener noreferrer\">host of investigations<\/a>.<\/p>\n<p>Flaig immediately recognized the expertise Espinosa had at his fingertips for creating a database to study COVID-19. But Espinosa has an additional motivation. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7252041\/\" target=\"_blank\" rel=\"noopener noreferrer\">His own research<\/a> concludes that people with Down syndrome are at high risk for developing severe cases of COVID-19. That gave him \u201ca vested interest\u201d in developing the COVIDome Project, he said.<\/p>\n<figure id=\"attachment_37398\" aria-describedby=\"caption-attachment-37398\" style=\"width: 200px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-37398 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/28125018\/COVIDome-1-Joaquin-Espinosa.webp\" alt=\"Dr. Joaquin Espinosa created the framework for COVIDome helping to answer the questions as to why COVID-19 affects people differently.\" width=\"200\" height=\"300\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/28125018\/COVIDome-1-Joaquin-Espinosa.webp 426w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/28125018\/COVIDome-1-Joaquin-Espinosa-200x300.webp 200w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/28125018\/COVIDome-1-Joaquin-Espinosa-100x150.webp 100w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><figcaption id=\"caption-attachment-37398\" class=\"wp-caption-text\">Dr. Joaquin Espinosa created the framework for COVIDome and is helping to answer the questions as to why COVID-19 affects people differently. Photo by UCHealth.<\/figcaption><\/figure>\n<h2><strong>A collaborative effort focused on understanding COVID-19<\/strong><\/h2>\n<p>Difficult as it is to say anything good about COVID-19, the disease has helped to drive collaboration between researchers, clinicians, information specialists and others to a remarkable degree, said <a href=\"https:\/\/www.uchealth.org\/provider\/andrew-monte-md-msc-emergency-medicine\/\">Dr. Andrew Monte<\/a>, an <a href=\"https:\/\/www.uchealth.org\/services\/emergency-care\/\">emergency medicine<\/a> physician, medical toxicologist and researcher at CU who is a co-investigator and member of the clinical data team for the COVIDome Project.<\/p>\n<p>\u201cThe pandemic has brought scientists together to solve a single problem like no other instance in our history,\u201d Monte said. \u201cThe amount of scientific collaboration that has come together to solve this problem is in and of itself an incredible undertaking.\u201d<\/p>\n<p>Monte offers a good example of that collaboration. He is an investigator who runs a biorepository through the Emergency Department at <a href=\"https:\/\/www.uchealth.org\/locations\/uchealth-university-of-colorado-hospital-uch\/\">UCHealth University of Colorado Hospital<\/a>. With those samples, he\u2019s studied genetic variations in patients that predict the safety and effectiveness of various drugs.<\/p>\n<p>With the advent of the pandemic, Monte began getting consents to use blood samples from Emergency Department patients who test positive for COVID-19 and contributing them to the COVID-19 Biobank. As a clinical co-investigator with the COVIDome Project, he said he collaborates with basic scientists by providing feedback to them about the \u201cclinical variables\u201d that affect COVID-19 patients, such as oxygen levels and kidney and liver injury.<\/p>\n<p>With only a relative handful of treatment alternatives for COVID-19 patients, developing new medications is vital to improving their care, Monte said. The COVIDome offers the chance for researchers to isolate a change in a biologic pathway \u2013 a protein or immune cell, for example \u2013 and select or develop drugs that target the pathway, Monte said.<\/p>\n<figure id=\"attachment_37399\" aria-describedby=\"caption-attachment-37399\" style=\"width: 199px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-37399 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/28125155\/COVIDome-2-Thomas-Flaig.jpgtiny-scaled.webp\" alt=\"\" width=\"199\" height=\"300\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/28125155\/COVIDome-2-Thomas-Flaig.jpgtiny-scaled.webp 663w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/28125155\/COVIDome-2-Thomas-Flaig.jpgtiny-scaled-199x300.webp 199w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/28125155\/COVIDome-2-Thomas-Flaig.jpgtiny-scaled-99x150.webp 99w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/28125155\/COVIDome-2-Thomas-Flaig.jpgtiny-scaled-200x302.webp 200w\" sizes=\"auto, (max-width: 199px) 100vw, 199px\" \/><figcaption id=\"caption-attachment-37399\" class=\"wp-caption-text\">Dr. Thomas Flaig joins Espinosa as principal investigator and project leader of COVIDome. Photo by UCHealth.<\/figcaption><\/figure>\n<p>\u201cUnderstanding the underlying biology of the disease allows us to choose medications that are more likely to be effective and less likely to cause adverse drug effects,\u201d he said.<\/p>\n<h2><strong>More blood samples from COVID-19 patients provide more opportunities<\/strong><\/h2>\n<p>For now, when COVIDome researchers choose a data set they can also analyze by sex and age group (all or 21 and older). Espinosa said more samples could bring more choices, such as analyzing by comorbidities or race.<\/p>\n<p>The racial question is of particular interest to Monte, who noted that Hispanics make up a disproportionate percentage of the patient population in the intensive care units at University of Colorado Hospital.<\/p>\n<p>\u201cDiscrepancies like that suggest there are genetic and biologic reasons [for the difference],\u201d Monte said. \u201cThat is exactly the kind of thing I hope we can examine as we enroll more patients in the Biobank and improve their care.\u201d<\/p>\n<p>For his part, Espinosa believes the open-access, collaborative approach of the Human Trisome and COVIDome projects could change medical research and our understanding of many diseases fundamentally.<\/p>\n<figure id=\"attachment_37400\" aria-describedby=\"caption-attachment-37400\" style=\"width: 300px\" class=\"wp-caption alignleft\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-37400 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/28125342\/COVIDome-3-Andrew-Monte.webp\" alt=\"Emergency medicine physician Dr. Andrew Monte is a co-investigator and clinical data team member with COVIDome. Photo by UCHealth.\" width=\"300\" height=\"170\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/28125342\/COVIDome-3-Andrew-Monte.webp 1024w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/28125342\/COVIDome-3-Andrew-Monte-300x170.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/28125342\/COVIDome-3-Andrew-Monte-768x435.webp 768w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/28125342\/COVIDome-3-Andrew-Monte-150x85.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2021\/01\/28125342\/COVIDome-3-Andrew-Monte-200x113.webp 200w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-37400\" class=\"wp-caption-text\">Emergency medicine physician Dr. Andrew Monte is a co-investigator and clinical data team member with COVIDome. Photo by UCHealth.<\/figcaption><\/figure>\n<p>\u201cWe are bringing together people who understand different areas,\u201d Espinosa said. \u201cThe work keeps evolving. My hope is that it can be done relatively cheaply for all medical conditions.\u201d<\/p>\n<p><em>For a detailed discussion of the COVIDome Project, watch a <\/em><a href=\"https:\/\/www.youtube.com\/watch?v=2UfMz62lUWQ&amp;feature=youtu.be\"><em>YouTube video<\/em><\/a><em> of a November 19 townhall led by Drs. Espinosa and Flaig.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A major research initiative on the University of Colorado Anschutz Medical Campus is making the fight against the novel coronavirus personal. The effort, which aims to accelerate research into the roots of COVID-19, launched a major data set called COVIDome in a matter of months. Its source material is blood samples from patients who tested [&hellip;]<\/p>\n","protected":false},"author":2143,"featured_media":38261,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[9085,138,4860,9069,330,137,4781],"class_list":["post-37395","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-biobank","tag-center-for-personalized-medicine","tag-covid-19","tag-covid-19-vaccine","tag-infection-control","tag-personalized-medicine","tag-research-in-health-care"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Researchers: Why does COVID affect people differently? 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