Tri-Cities COVID patients helping scientists learn more about the disease

Some of the sickest patients at Kadlec Regional Medical Center may provide researchers the information they need to develop better tests for the coronavirus and better treatments for COVID-19.

Scientists at Pacific Northwest National Laboratory in Richland are working with help from the Richland hospital to understand more about how the human body reacts when infected with the virus.

They hope that important clues may be found in the proteins of the breath of COVID-19 patients, and they can collect those proteins from what would normally be trash.

The COVID-19 research is possible because of research done by PNNL scientist last year to investigate the health of firefighters under stress by collecting information from Los Angeles County firefighters during drills.

As part of the research they developed a technique to study the proteins in their breath to look for signatures that indicated an immune response to smoke exposure.

It was a noninvasive technique — as opposed to drawing blood, for example — that allowed researchers to collect multiple samples to get as much as needed.

With the COVID-19 pandemic, PNNL scientists are using the same technique to learn more about the body’s response to infection with the coronavirus.

But first they had to overcome the issue of how to collect breath samples from ill patients. That’s where Kadlec is helping.

Kadlec patients volunteer

The Richland hospital is collecting used filters from the ventilators of patients who agree to volunteer for the study before being ventilated or their families agree on their behalf after they are sedated.

Ventilators use a plastic heat moisture exchanger that captures moist air leaving their lungs.

The filters are typically used for about 24 hours, giving ample time for enough proteins from patient breath to collect to allow study. Very small amounts of protein are exhaled in the breath.

“We are not changing anything about patient care ... just taking the filter that they would normally throw away,” said Paul Piehowski, a PNNL chemist and the leader of the research team.

The Kadlec intensive care unit team has been happy to help, and nearly all patients who are asked if their ventilator filters could be used for the study have agreed, said Dr. Phani Kantamneni, an ICU physician.

“Any information that can come out of PNNL would be greatly helpful and to be a part of such a venture is always a good thing,” said Dr. Phani Kantamneni, an ICU physician.

With the coronavirus only known to be in the United States for about a year, there is much to be learned.

Researchers are hoping that the breath samples they analyze will explain more about the fundamental biology of the still-new coronavirus.

That information about the body’s immune response could help explain the delay in the development of symptoms and why some patients get much sicker than others.

At a minimum more information could help doctors understand how sick an infected person is and better predict how the disease might progress in the patient, Kantamneni said.

Longer term the information also could help develop a breath test for diagnosing COVID-19, Piehowski said.

Protein response to COVID

PNNL researchers are looking at proteins, which do the work within individual cells. Seeing which proteins are being activated by cells should give an indication about the body’s response to the coronavirus.

Measuring the proteins collected on ventilator filters will require the sophisticated scientific research instruments available at the Environmental Molecular Sciences Laboratory on the PNNL campus.

“Being a national laboratory we have the technology,” Piehowski said. “It’s not something hospitals have or even most research universities.”

The research is looking across all proteins coded in the human genome, which contains more than 20,000 genes.

Researchers are looking for which of those, which could possibly be thousands of proteins, that are detected in the breath of COVID patients and not others. They also will be looking at which proteins are increasing and decreasing with the infection.

Researchers also are collecting ventilator filters from Kadlec patients who volunteer with non-COVID respiratory illnesses and from illnesses without a respiratory component to compare with the filters from COVID patients.

Scientists call it “hypothesis generating research.”

Results could be available within months, but still will need to be analyzed.

PNNL will share the data publicly so any scientists with a background in proteomics, or the study of proteins, can download it and look at it in different ways for their research projects.