Courtesy of the CDC
It started as a mystery illness. A widespread viral outbreak in Wuhan, China, was infecting scores of people in early January and leaving medical experts at a loss. What first appeared to be a form of pneumonia—with symptoms of fever, cough, and difficulty breathing—turned out to be something more menacing, a novel coronavirus that was about to spread around the world.
Researchers, including some in St. Louis, reacted quickly to understand the new virus. The first case in the United States occurred in Washington state in January. The first case in Missouri was reported in early March, and daily life was soon upended. Long before, however, experts at Washington University and Saint Louis University had shifted their focus to study the novel coronavirus and prepare for widespread COVID-19 infection.
The virus is new, but researchers have been able to steadily gain an understanding of what it is, how people catch it, and how it leads to COVID-19, the disease it causes. Yet basic questions remain: Why is it so harmful to humans, and why is it worse than other known coronaviruses?
Now, as the death toll rises and cities shut down, it’s hard not to feel helpless. All that most citizens can do is keep their distance and wait. Fortunately, the experts at Wash. U. and SLU are doing their part to find vital answers and help get the world back on its feet.
Quick Study
Dr. Amelia Pinto, an assistant professor of molecular microbiology and immunology at SLU, is playing a key role in increasing the world’s understanding of this new virus. The university’s Center for Vaccine Development, which has one of only nine elite Vaccine Treatment and Evaluation units, is working on a vaccine. SLU also recently announced that it is working on a potential treatment for the virus. Pinto’s laboratory is focused on comparing immune responses between SARS and COVID-19.
For the bulk of her career, Pinto has studied how viruses evade the immune system, zeroing in on Zika virus and SARS, the closest relative of the novel coronavirus, which is officially known as SARS-CoV-2. That background has informed her current studies. That the two viruses share a receptor is among the more interesting similarities Pinto has learned about the new virus.
“So far, what we’ve found is that it’s not strikingly different from other viruses,” Pinto says. “Some of the issues we’re having with studying it are issues because of its size. Most of the work I’ve been doing for the last few years is on flaviviruses, which are genetically very small. This coronavirus, for being an RNA virus, it’s a big one, so we’re very interested in trying to figure out how to work with such a large virus, because some of the shortcuts you take with smaller viruses, you can’t do with this one. It’s a challenging virus to work with. For one that seems to grow so well in the human population, it doesn’t necessarily behave as nicely in the controlled setting that we use.”
Beyond comparing the viruses, Pinto and her colleagues have two additional goals in studying the novel coronavirus. One is to find a way to study the virus in animals. Because the novel coronavirus is a human disease, the animals scientists typically use to study immune responses wouldn’t contract COVID-19 unless their cells are modified to more closely resemble human cells. The lab is working to alter receptors in the cells of animals so the virus can infect certain tissues and show scientists how it prompts an immune response in the human body. Another goal for Pinto’s laboratory: helping a separate team of university researchers develop a test with which to screen people after they’ve cleared the virus.
“Right now, everybody is screening mostly for the live virus during the course of infection,” Pinto says. “The question that has already come around is, how many people are asymptomatic? How many people have been infected, have cleared the virus, and then are walking around presumably immune to infection? So I think it will help a lot with the denominator as far as trying to understand the disease severity, as well as to understand how quickly it is spreading.”
Tag Team
At Wash. U., a group effort to better understand the virus that causes COVID-19 is underway. Clinical infectious disease physicians and other scientists have teamed up to look for ways to treat the virus, reduce its spread, and answer some of the more pressing questions, such as why the virus is more pathogenic than other coronaviruses and why it causes such severe reactions in some people compared with others.
Not long after the virus first appeared, in China, teams across the Wash. U. medical and scientific communities began collecting ideas for how the university could make a swift pivot to studying this new disease. Ideas included starting discussion groups, handling regulatory issues, and obtaining a sample of the virus from the Centers for Disease Control and Prevention.
As the pandemic spread, a team of researchers began working on the basic science side to develop blood tests that will help determine who has been exposed to the virus for future evaluation. Experts at Wash. U. are also trying to figure out the structure of the virus and its proteins; developing vaccines to prevent infection; and working on tests to determine whether people have cleared the virus. They are also working on how to treat the disease in people who become infected.
Dr. Jacco Boon is an associate professor of medicine at Wash. U. On the clinical side, he’s among the team members marrying doctors’ patient care with researchers’ work.
“We’ve put together a protocol that will allow us to collect specimens from patients with confirmed COVID-19 and patients that do not have COVID-19,” Boon says. “Later, once the pandemic has settled a little bit, we want to determine what are the correlates to severe disease, what causes severe disease, and can we identify anything in these individuals that would give us a hint or a clue as to what set it up? What is it about them that generates the severe disease, whereas the majority of us will just have some symptoms but we’ll be fine after a week?”
Just as daily life is feeling unrecognizable for so many of us, scientists and physicians are experiencing enormous changes to the research process. Rather than closely guarding information for later publication, experts are sharing knowledge constantly and working together toward the common goal of stopping the spread of the novel coronavirus.
“That is one of the silver linings of this pandemic,” Boon says. “The world is coming together, and we all seem to want to prevent further spread and infections. There are a lot of collaborations. There’s perhaps some duplications here and there, but right now, that doesn’t matter. The more, the better.”
Timeline: COVID-19 comes to Missouri
December 29
The first cases of then-unknown COVID-19, in Wuhan, China, are reported to the World Health Organization.
January 20
The National Institutes of Health announces work on a vaccine.
January 21
The first U.S. case of COVID-19 is reported in Washington state.
March 7
Missouri Governor Mike Parson announces the state’s first “presumptive positive” COVID-19 case, a young woman in St. Louis County.
March 11
The WHO declares a pandemic.
March 16
St. Louis Mayor Lyda Krewson announces the first COVID-19 case in St. Louis City.
March 18
A patient in Boone County is the state’s first COVID-19 death.
March 20
The number of cases in Missouri jumps to 73.
March 23
Page and Krewson enact stay-at-home orders. Residents may only leave their homes for essential activities like grocery shopping and healthcare.
