uci medical center is the site of a clinical trial to track undetected COVID-19 in front line hospital staff

The clinical trial will lead to an understanding of the risk of COVID-19 infection and the immune response in front line healthcare workers.

As researchers race to understand COVID-19, one group holds particular interest: asymptomatic healthcare workers on the front lines.

UCI School of Nursing faculty Miriam Bender, PhD, RN, and Sanghyuk Shin, PhD, are collaborating with the Department of Molecular Biology and Biochemistry Professor Ilhem Messaoudi, PhD, on a biomedical study that is examining undetected COVID-19 in UCI Health clinical staff.

The effort also involves researchers from the Departments of Statistics and Population Health and Disease Prevention.    

It’s all part of an effort to understand the risk of COVID-19 infection and the immune response in front line healthcare workers who do not show symptoms of the disease. 

“We know they’re at risk for exposure,” says Dr. Bender. “But if they don’t show symptoms, we don’t know what that means in terms of infection and immune response. That’s what we decided to focus on.”

Targeting immune response for testing

Even when someone is infected with COVID-19, their symptoms may be mild to totally absent, explains Dr. Shin. 

The presence of an immune response can signal who has been exposed to the coronavirus, whether or not they ever knew it or had symptoms.

“We really want to know how prevalent COVID-19 is and was during the past few months among care providers,” Dr. Shin says.

“We don’t know about people who have been exposed yet don’t ever show symptoms. We’re finding that to be a population that exists, but we don’t know much about them.”

How the study works

Currently, the study is open to all asymptomatic front-line clinicians working in areas of UCI Health where their risk exposure is greatest. 

Each study participant receives a link to a survey, which asks:

  • Where they work
  • If they have any active symptoms
  • If they have had any potential exposure

Blood samples and nasopharyngeal swabs are taken from the participants once a month.

By doing this, Bender says, they can monitor their exposure and immunological profile and identify changes over time.

Modeling COVID-19 spread and immune response

Eventually, with enough data, the research team will be able to model how COVID-19 spreads and in what ways the immune response develops.

The study could ultimately lead to better ways to protect healthcare staff and the patients they encounter. 

Clinical staff eager for information

Rather than feeling nervous, Dr. Shin finds that his colleagues are ready and willing to participate.

“They are very eager to know if they’ve been exposed. Many suspect that they have.”

The information will allow healthcare staff to get a better handle on what is happening, something they have wanted to do.

Dr. Bender says the key was education before the study ever started.  

“We worked with everyone beforehand to plan how the study would proceed and understand what front line clinicians wanted out of it. We wanted to make sure it was beneficial for everyone.”

The education and awareness plan appears to have been very successful, as the study has enrolled nearly 300 participants within 12 days of receiving Institutional Review Board (IRB) approval. 

“It just goes to show how interested the participants are in participating in this kind of research and contributing to what the findings will be,” says Dr. Bender.

Filling the knowledge gaps

The question of immunity — meaning is there a specific immune response that provides protection against COVID-19? — isn’t answerable right now. 

Tracking over time and comparing it with data about exposure will eventually lead to predictive models. Dr. Shin says the study may give a better idea about the immune response within a year.  

“It will hopefully fill the gaps in our knowledge about viral exposure and immunological response for those who are non-symptomatic,” Dr. Bender says. 

Whatever the outcome, she feels that being able to contribute to the understanding of a devastating disease is its own reward.

“It’s been a real privilege working on this study.”