One of the most confounding factors about COVID-19 is that no one seems able to predict who is most likely to contract the coronavirus, who will experience the worst symptoms, or who will die from it. More than 96 percent of COVID-19 cases and almost half of COVID-19 deaths in Colorado have occurred in people under the age of 80—many in people who were considered low risk.
Barbara Gould of Boulder is one of those and like many medical researchers, she is baffled by the question of why she not only contracted COVID-19 but nearly died from it.
In March, Gould, who was 64 at the time, contracted the coronavirus on a flight home from Atlanta. Within days of developing a cough, Gould was admitted to the hospital. Ultimately, she spent 65 days on a ventilator – nearly 10 times as long as the average COVID-19 patient.
Why Gould – who had no pre-existing conditions and was in good health – wound up with such a severe case while others who are far less healthy walk away with hardly a symptom is one of the mysteries of COVID-19. It’s also the reason so many people of all ages fear the diagnosis.
“I wonder all the time why it hits some people so hard but not others,” Gould says.
If public health professionals knew the answer to this question, the entire trajectory of a pandemic would change. Instead of needing to confine everyone to their homes during the worst outbreaks, only those who are most susceptible to severe symptoms would need to be isolated.
In the current pandemic, the elderly and people with pre-existing conditions, such as diabetes or heart disease, are thought to be the ones at highest risk. But that conclusion is based on previous coronaviruses and doesn’t explain why some healthy young people die from COVID-19 or why some 80-year-olds in nursing homes can contract the virus but remain asymptomatic.
“Nearly a year into this pandemic and we are still flying blind in many respects,” says Phyllis Wise, PhD, CEO of the Colorado Longitudinal Study, a Colorado biobank that is hoping to help researchers discover why some people develop disease while others don’t. “We know, for instance, that Black and Latino Americans are contracting COVID-19 and dying from it at much higher rates. However, we don’t know if that is due to comorbidities, air pollution, nutrition and vitamin levels, genetics, or something totally unthought of.”
Uncovering Real Risk Factors
COLS vision is to collect biological specimens along with in-depth, comprehensive health, sociological, and environmental data for hundreds of thousands of Coloradans and track them for a decade or longer. These specimens and data will provide researchers with the ability to examine a myriad of factors down to the neighborhood level to understand better who develops particular diseases and why.
Although COLS will not start recruiting participants until late 2021, the non-profit biobank could play a valuable role sooner in the quest to better understand COVID-19. COLS data or its biological sampling protocols could be put to almost immediate use in COVID-19 research, such as:
- Proteomic Biomarkers in Healthcare Workers: Using new technology developed by Boulder-based SomaLogic, researchers could analyze blood samples of healthcare workers to determine if there are recognizable differences in proteins that could enable hospitals to identify workers most at risk of contracting the coronavirus and adjust staffing to mitigate that risk. Likewise, this study could be conducted with other groups of essential workers to help decrease transmission and reduce morbidity and mortality rates in a community.
- Blood Type and COVID-19 Risk: Whether blood type makes a difference in infection risk or response severity is unknown, with some studies indicating a link and others showing no link. To understand whether there is a relationship, much larger studies that monitor people with various blood types before and after infection would help researchers confirm whether this is true and, if so, whether the biological dynamic that leads to improved response can somehow be replicated in people with other blood types.
- Risk Factors in Minorities: Are African Americans, Latinos, and Native Americans dying at a higher rate due to comorbidities such as diabetes and heart disease, environmental factors such as exposure to air pollution, or some combination? COLS has been working to develop partnerships in Fort Collins, Aurora, and Durango that could help public health and medical officials there expedite research into this issue.
Next Steps for COLS
For COLS to assist in COVID-19 research, it will need to partner with entities that conduct research through an established IRB protocol, Wise says. The COLS biobank will help these researchers in several ways, including instituting its protocols for blood collection and storage to preserve fragile molecules such as proteins – protocols that are not currently being used by most biobanks. COLS also is close to completing development of its surveys that collect comprehensive information about a person’s social determinants of health, such as housing, nutrition, and environment. This work could be expedite COVID-19 research, especially research to help understand the disparities that are putting communities of color at much higher risk of COVID-19, she says.
“We have been developing COLS protocols for two years and are in a position now that we could utilize our work to make an immediate difference in the health of Coloradans and the rest of the world,” Wise says.
Gould, who is still recovering from her fight against COVID-19, is hopeful that researchers will not only investigate who is at risk of contracting COVID-19 but what the long-term impacts to survivors will be.
“We’re only measuring statistics in terms of deaths and not people like me and others who will have long-term, if not lifetime, health effects,” Gould says.
If your organization is interested in learning more about partnering with COLS on current or proposed COVID-19 research, please contact us.
Photo by Katie Kerwin McCrimmon, courtesy of UCHealth. Read Barbara’s full story here.