As well as being on the front line of fighting COVID-19, Sunnybrook has been on the leading edge of novel coronavirus research.
“Since the onset of the COVID-19 pandemic, Sunnybrook researchers have been quick to rise to the challenge, initiating more than 100 research studies related to COVID-19 that seek to make a substantive impact in better understanding the virus or proposing solutions to the many questions posed by the pandemic,” says Dr. Kullervo Hynynen, PhD, vice-president of research and innovation at Sunnybrook.
These studies were launched thanks in large part to donor support. Close to 11,500 donors from the community stepped up to help Sunnybrook’s COVID-19 response, contributing more than $7-million.
While insights into the virus are still evolving, it appears that although COVID-19 is best known as a respiratory disease, it also has repercussions elsewhere in the body. Here is a look at some of the research projects ongoing at Sunnybrook:
What impact does COVID-19 have on mental health?
Having seen the effects of the pandemic on mental health firsthand, Dr. Anthony Levitt, chief of the Hurvitz Brain Sciences Program and medical director of the Family Navigation Project (FNP), was spurred to lead a formal study into its wide-ranging impact, with the FNP team.
“I do not think we yet fully understand the tremendous negative, and even positive, impact of the pandemic on the mental health of our society,” Dr. Levitt says. “Our study is designed to explore this and the specific effects of having contracted COVID on mental illness and addiction.”
At the end of the project, around 7,500 Ontarians will have been surveyed over a period of a year and a half. Early findings have revealed that people who have contracted COVID-19 are at a greater risk of having depression, anxiety and substance misuse, compared to those who have not. As well, the data shows that several factors are associated with higher risk of suicidal ideation during the pandemic, including younger age, COVID-19 exposure and reduced socio-economic status.
The study has revealed that greater long-term social support is potentially protective of people experiencing these kinds of challenges, says Dr. Levitt. He hopes the study’s results will assist the province in creating better supports for people experiencing mental health challenges not only from the COVID-19 pandemic, but also for future pandemics.
What is the impact of COVID-19 on the brain?
Neuroscientist Dr. Simon Graham, PhD, is leading a team looking at the longer-term cognitive effects of infection. “The brain effects of COVID-19 are somewhat under-appreciated, and we don’t know the full extent to which they’re occurring,” he says.
Using magnetic resonance imaging (MRI) and behavioural assessments, Dr. Graham’s study has already shown some patients who were on a ventilator before recovering suffered from brain micro-bleeds or mini-hemorrhagic strokes. Some recovered patients have also been found to have evidence of inflammation in the brain.
These discoveries are particularly important given the growing number of “long haulers,” patients who experience lingering problems from the virus like brain fog and poor memory, Dr. Graham adds.
“Even if their persistent symptoms have to do with shortness of breath or abnormal heart rate, those things are actually controlled by the brain, so it could be COVID-19’s impact on the brain is causing those problems, too.”
What is the relationship between COVID-19 and the heart?
Cardiologist Dr. Idan Roifman in the Schulich Heart Research Program at Sunnybrook is leading research examining how COVID-19 may lead to inflammation of the heart muscle or cause damage to the heart similar to a heart attack.
The study is building on considerable research globally showing COVID-19 increases the risk of blood clots.
Using magnetic resonance imaging (MRI), Dr. Roifman’s work seeks to find evidence of heart damage in patients who have recovered from COVID-19 and determine the type of damage that has occurred. The study is also investigating how risk factors like diabetes and high blood pressure may elevate the risk of developing cardiac complications like heart failure.
Already, the research has revealed heart function abnormalities in some patients in recovery. “That alerted us to follow them closely and led to a potential change in their long-term management,” Dr. Roifman says.
Why do COVID-19 symptoms persist in some people?
Sunnybrook’s Dr. Hubert Tsui, head of hematopathology, and clinical microbiologist Dr. Robert Kozak, PhD, are poring over blood tests and nasal swabs from patients with COVID-19 to understand why some individuals become so-called long haulers. “The research literature states as much as 50 per cent of people could have some long-term COVID symptoms,” says Dr. Tsui.
The researchers have been looking at early diagnostics from patients who became long haulers, while comparing them with other patients who have fully recovered to see if they have a different initial immune system response. “Some of our preliminary data is indeed showing that something very early on, even at the diagnostic point, is different – providing a clue in terms of risk to developing long COVID,” he adds.
Understanding the basic science regarding immune response to COVID-19 could lead to identifying patients who are likely to experience long-term problems early on, Dr. Kozak notes. Research could even lead to therapeutics to prevent and treat long-hauler symptoms.
“The more we can help people now, the more they will benefit down the road,” he says.