Partners’ contribution to COVID-19 research

Despite the impact of the COVID-19 pandemic, CURE has managed to continue delivering on its planned projects and activities. Currently, CURE is at its peak.

In addition to documented CURE objectives, our partners also undertook efforts to understand the complexities of the SARS-CoV-2 infection in relation to respiratory diseases such as asthma and allergies.  

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The National and Kapodistrian University of Athens (N.K.U.A), clinical partner of CURE, participated in international efforts to manage allergy and asthma during the COVID-19 pandemic. By taking part in the ARIA and the European Academy of Allergology and Clinical Immunology (ARIA-EAACI) statements, a World Allergy Organization’s initiative on acute asthma management during COVID-19 and other projects, it has helped provide a greater understanding on the wider impact of COVID-19 on people with pre-existing health conditions, particularly allergies and asthma.

Furthermore, the Pediatric Asthma in Real Life (PeARL) think tank, led by Prof. Papadopoulos of N.K.U.A and coordinator of the CURE Project, has promoted practice adjustments and disease burden analysis for children with asthma and conducted a study evaluating asthma management in children before and during the pandemic.

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The Swiss Institute of Allergy and Asthma Research (SIAF) was involved in the publication of 30 articles related to COVID-19 infections, in collaboration with Zhongnan Hospital of Wuhan University and EAACI. The articles focused on immunopathological changes in COVID-19, including patients that already suffer from other pathologies and respiratory syndromes.

In one of the review articles, researchers explored the immune response and immunopathological changes in patients alongside deteriorating clinical conditions such as cytokine storm, acute respiratory distress syndrome, autopsy findings and changes in acute-phase reactants, and serum biochemistry in COVID-19. 

Another review article entitled “A compendium answering 150 questions on COVID-19 and SARS-CoV-2”, contains answers to several questions formulated by young clinicians and scientists on COVID-19 and allergy. It provides a comprehensive overview of COVID-19 and allergic diseases on topics like virology, immunology, diagnosis, management of patients with allergic disease and asthma, treatment, clinical trials, drug discovery, vaccine development, and epidemiology.

 

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The Biomedical Research Foundation, Academy of Athens (BRFAA), and particularly the Andreakos lab, in collaboration with the General Chest Diseases Hospital of Athens, Sotiria, conducted a study on the mechanisms underlying the severity of respiratory illness observed in patients infected with SARS-CoV-2, compared to other viral infections. They found that, in sharp contrast with how influenza works, SARS-CoV-2 infections do not induce timely and sufficient production of type I and III interferons (INF), the key mediators of antiviral immunity (Figure 1). This untuned response is often accompanied by the production of pro-inflammatory cytokines, linked to acute respiratory failures. The findings are very valuable, since type I and III IFN are currently in clinical protocols against COVID-19.

Currently, the Andreakos lab is conducting more research in the field, focusing on the importance of allergy and asthma in the susceptibility to SARS-CoV2 infections, the analysis of patients’ response to different therapeutic protocols, the follow-up of patients in convalescence, as well as the immune response induced after COVID-19 vaccination

 

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Figure 1: Analysis of blood serum levels of interferons and pro-inflammatory cytokines and chemokines revealed impaired production of both type I (IFN-α) and III (IFN-λ) interferons in COVID-19 patients when compared to influenza patients of various disease severity.

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The University of Manchester, led by Prof. R. Tucker Gilman, conducted research on the impact of COVID-19 in refugee camps. Using an agent-based model, they studied the effects of feasible interventions that could slow down SARS-CoV2 infections in the Moria refugee camp in Greece. First, they divided the camp into sectors which reduced peak infections by up to 70% and delayed the spread of the virus. Furthermore, the use of face masks, coupled with timely isolation of infected individuals, reduced the overall incidence of infections, even eradicating the epidemic at the beginning (Figure 2).

The research and its findings provide an evidence base for successful intervention strategies in similar camps. This in turn could help other camp managers plan for and mitigate the impacts of COVID-19 and future pandemics.

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Figure 2: The projected total number of people infected over time without interventions (blue), with transmission control (e.g., face masks; red), and with transmission control and movement restrictions together (orange). The purple line shows the result if movement restrictions are not imposed until after 1% of the population shows symptoms.