Covid-19: Humanitas researchers, the hope to win the virus

The spread of the new Coronavirus has raised several questions that research is trying to answer, ranging from finding a vaccine to the most effective therapies to combat the epidemic. Doctors, professors and researchers at Humanitas and Humanitas University are working on numerous studies ranging from genetics, immunology and microbiology, addressing the critical issues and questions raised by the infection.

Covid-19, new diagnostics and new drugs

Alberto Mantovani, Scientific Director of Humanitas and lecturer at Humanitas University, underlined the researchers’ current efforts to identify drugs for a targeted therapy and to draft clinical protocols. An important part of their work is devoted to developing a new antibody-based diagnostics, supported by the use of Artificial Intelligence.

“Next to our core research in immunology and genetics – explained the professor – we have several on-going translational and clinical studies. Numerous trials are underway to evaluate both the use new drugs, such as Tocilizumab or Remdesivir, and antibody-based diagnostics. We are currently involved in an important project which aims to quickly identify potentially infected patients by developing a new diagnostics capable of providing highly sensitive information within an hour. In the diagnostic field, we also have an on-going study focused on using Artificial Intelligence for thoracic CT evaluations to capture aspects that can support identifying the patients most at risk for developing serious respiratory complications. We are also developing and applying clinical protocols, even in the intensive care area, for the management of Covid-19 patients. Such protocols are closely followed by observational studies focused on the correlations between clinical and biochemical factors and the prognosis of patients, to understand whether the severity of the course of disease is due to the immune system, to the gene pool, or to both “.

A report against fake news

Knowledge-sharing is crucial during social and health emergencies like the one we are experiencing. For this reason, Professor Maurizio Cecconi, professor at Humanitas University and head of the Anesthesia and Intensive Care unit at Humanitas, together with Professor Mantovani and Professor Guido Forni, both from Turin University, signed a report on Covid-19 to shed light on the current pandemic and correct any false information. The report was prepared by the Accademia Nazionale dei Lincei, one of the most prestigious Italian scientific societies.

Covid-19 and genetics

On the genetic research front, Professor Stefano Duga, lecturer at Humanitas University, with the collaboration of Professors Rosanna Asselta and Elvezia Maria Paraboschi, carried out a study, published on medRxiv, aimed at identifying factors pre-disposing to the risk of contracting the Coronavirus infection.

“This is the first genetics study of the Italian population in relation to Covid-19” – explained the Professor  – “It intends to investigate and understand the factors that influence the susceptibility to the infection, the severity of the clinical course of the disease and the greater symptoms severity that are observed in men compared to women. The results obtained through this study provide a basis for improving assistance to Covid-19 patients and for identifying more effective therapeutic strategies to face this difficult health emergency. Early identification of risk factors is essential to provide patients with an adequate support, including the ability to identify individuals who require closer clinical monitoring. ”

Covid-19 and the use of biological drugs for inflammation

Professor Carlo Selmi, head of Rheumatology and Clinical Immunology and lecturer at Humanitas University, focused his research on the effectiveness of treating Covid-19 patients with some biological drugs which are already used for the treatment of patients suffering from rheumatoid arthritis and autoimmune diseases. Indeed, pneumonia caused by Covid-19 manifests very quickly after the first signs of fever, cough and shortness of breath which can often lead to severe respiratory failure. This seems to be due to a real inflammatory cascade-effect induced by the viral infection, for which no specific therapy or vaccine has still been found for.
“Our immunological and virological knowledge – explains the Professor – led to the use of certain drugs both directly against the virus (with an anti-viral function) and against the inflammatory cascade induced by the virus. Such drugs, so far, have been approved for the treatment of patients with rheumatic diseases. These include Tocilizumab, a biological drug used against the inflammatory molecule called interleukin 6, which is currently employed for the treatment of rheumatoid arthritis, and hydroxychloroquine, a drug that modulates the immune system and which is often used in the treatment of autoimmune diseases such as systemic lupus erythematosus “.

“The study published by the Journal of Autoimmunity – points out  Dr. Angela Ceribelli, rheumatologist in Humanitas and main author of the study – explains what is known so far about the disease, with a special focus on patients being treated with immunosuppressants, therefore at greater risk of developing a severe infection. For these patients it is essential to follow the authorities’ guidelines and measures regarding the prevention of the Covid-19 transmission, to follow the therapies indicated by the medical prescription in the event of pneumonia, and not to interrupt any on-going therapies for rheumatic diseases in fear of an increased susceptibility to the Covid-19 infection.

A biobank of biological samples for the Covid-related  studies

The SARS-Cov-2 virus manifests itself through a broad spectrum of symptoms: from a simple cold to pneumonia. Luckily, in some individuals it occurs with very few symptoms (paucisymptomatic individuals), or even without any symptoms at all (asymptomatic). Through the comparison of categories of infected individuals it is possible to understand not only the basis of the pathology, but also its risk factors.

As a part of epidemiological studies, the research group coordinated by Professor Maria Rescigno, head of the Mucosal Immunology and Microbiota’ laboratory of Humanitas and professor of General Pathology at Humanitas University, created a biobank of biological samples (from peripheral blood to bronchial lavage) from subjects who contracted Coronavirus, in order to study all the different aspects of the pathology (symptoms, risk factors, role of comorbidities, common characteristics among individuals, adaptive immunity etc.) and and hope to be able to give precise answers about the disease as soon as possible.

Below is the list of the published or in press studies, to date:

• Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response
• Coronavirus (COVID-19) outbreak: what the department of endoscopy should know
• COVID-19 pandemic: perspectives on an unfolding crisis
• Inflammatory bowel disease care in the COVID-19 pandemic era: the Humanitas, Milan experience
• Football cannot restart soon during the COVID-19 emergency! A critical perspective from the Italian experience and a call for action
• Management of IBD during the COVID-19 outbreak: resetting clinical priorities
• How COVID-19 Outbreak Is Impacting Colorectal Cancer Patients in Italy: A Long Shadow Beyond Infection
• Critical Organizational Issues for Cardiologists in the COVID-19 Outbreak: A Frontline Experience From Milan, Italy
• Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19)
• Coronavirus pandemic and Colorectal surgery: practical advice based on the Italian experience
• Intranasal corticosteroids in allergic rhinitis in COVID-19 infected patients: An ARIA-EAACI statement
• Hospital surge capacity in a tertiary emergency referral centre during the COVID-19 outbreak in Italy.
• The Greek study in the Effects of Colchicine in COvid-19 complications prevention (GRECCO-19 study): rationale and study design.
• COVID-19 and liver disease.
• Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region
• Facing COVID-19 in Ophthalmology department
• Recommendations for coronavirus infection in rheumatic diseases treated with biologic therapy
• COVID-19 Outbreak in Northern Italy: viewpoint of the Milan area surgical community
• CORONA-steps for tracheotomy in COVID-19 patients: A staff-safe method for airway management
• May we deliver neuro-oncology in difficult times (e.g. COVID-19)?
• Highlights for management of patients with Autoimmune Liver Disease during COVID-19 pandemia
• Neurosurgery in the storm of COVID-19: suggestions from the Lombardy region, Italy (ex malo bonum)
• Diarrhea during COVID-19 infection: pathogenesis, epidemiology, prevention and management
• Endoscopy units and the COVID-19 Outbreak: A Multi-Center Experience from Italy
• Clinician Education and Adoption of Preventive Measures for COVID-19: A Survey of a Convenience Sample of General Practitioners in Lombardy, Italy
• COVID-19 pandemic: guidance for nuclear medicine departments
• The procoagulant pattern of patients with COVID-19 acute respiratory distress syndrome
• Gastroenterology department operational reorganisation at the time of covid-19 outbreak: an Italian and Chinese experience
• Maintaining the quality standards of care for inflammatory bowel disease patients during the COVID-19 pandemic
• European Society of Trauma and Emergency Surgery (ESTES) recommendations for trauma and emergency surgery preparation during times of COVID-19 infection
• Will COVID-19 infection be less severe in ulcerative colitis than in Crohn’s patients due to a lower rate of smokers?
• Advanced forecasting of SARS-CoV-2 related deaths in Italy, Germany, Spain, and New York State
• Covid-19 epidemic in Italy: evolution, projections and impact of government measures
• Inflammatory bowel diseases and COVID-19: the invisible enemy
• Endoscopy in inflammatory bowel diseases during the COVID-19 pandemic and post-pandemic period
• The Italian Outbreak of COVID-19: Conditions, Contributors, and Concerns
• Reorganize and survive-a recommendation for healthcare services affected by COVID-19-the ophthalmology experience
• Key elements of preparedness for pandemic coronavirus disease 2019 (COVID-19) in nuclear medicine units
• The Radiology Department during the COVID-19 pandemic: a challenging, radical change
• An academic allergy unit during COVID-19 pandemic in Italy
• Contribution of Interventional Radiology to the Management of COVID-19 patient
• Low risk of Covid-19 transmission in GI endoscopy
• ACE2 and TMPRSS2 variants and expression as candidates to sex and country differences in COVID-19 severity in Italy.
• Impact of anti-androgenic therapies on COVID-19: an observational study in male population from a COVID-19 regional centre of Lombardy (Italy)
• Handling of allergen immunotherapy in the COVID-19 pandemic: An ARIA-EAACI statement
• Who should perform the rhinopharyngeal swab in COVID-19 positive patients?
• Complement as a target in COVID-19?
• Being a foot and ankle surgeon in Italy in the era of COVID-19