HEMOCOVID-19: An international initiative is testing a biophotonics tool for use within intensive care units to aid clinicians to better manage COVID-19 severely ill patients at multiple stages, hence supporting a continuum of care.
A non-invasive, portable and easy-to-use biophotonics device is envisioned to provide an evidence-based decision-making tool to test the efficiency of personalized treatments targeting the health of the smallest blood vessels.
OBJECTIVE
As coronavirus disease 2019 (COVID-19) has spread across the world, the rapid diagnosis and isolation, clinical management, and infection prevention are the main challenges associated with this pandemic. When the disease becomes critical, adequate management of acute respiratory failure and supporting the hemodynamics is key in order to minimize the negative impact on survival. However, many questions on prognosis and efficient clinical management remain unanswered. HEMOCOVID-19 uses near-infrared diffuse optical technologies to non-invasively evaluate endothelial and microvascular dysfunction to aid both the development of targeted therapies and also to personalize therapies.
SCIENCE
Technologies
Near-infrared spectroscopy (NIRS) uses near-infrared light to penetrate deep (~1 cm) into the tissues and allows the non-invasive, portable, wireless measurement of peripheral, microvascular blood oxygen saturation.
Hypothesis
Hemodynamic biomarkers measured from the peripheral muscles will allow the assessment of the endothelial and microvascular health.
CONSORTIUM & STRUCTURE
13 partners from 6 countries are currently (05/2021) part of the HEMOCOVID-19 consortium. We welcome additional partners to join the consortium. We support open-science done in a collaborative, multi-disciplinary fashion.
Our ClinicalTrials.gov Identifiers: NCT04689477 (Link), NCT04692129 (Link).
Coordination & management
Coordinator: Dr. Turgut Durduran, ICFO (SPAIN)
Clinical Coordinator: Dr. Jaume Mesquida, Parc Tauli (SPAIN)
Project Manager: Dr. Ariadna Martinez, ICFO (SPAIN)
Partners
ICFO-The Institute of Photonic Sciences (Spain)
PI: Turgut Durduran TEAM: Marta Zanoletti, Lorenzo Cortese, Umut Karadeniz
Vall D’hebron Barcelona Hospital (Spain)
PI: Ricard Ferrer TEAM: Marina Garcia Garcia De Acilu, Luis Chiscano, Abraham Mera
Parc Taulí Hospital Universitari (Spain)
PI: Jaume Mesquida TEAM: Alba Caballer, Sara Nogales, Cristina Espinal, Guillem Gruartmoner
Hospital Clínic De Barcelona (Spain)
PI: Pedro Castro TEAM: Adrián Téllez, Sara Fernández, Ana Matas
Hospital del Mar-IMIM (Spain)
PI: Judith Marin Corral TEAM: Puri Pérez Terán, Clara Vilà, Lucía Picazo, Francisco J Parrilla-Gómez
Centre de Recerca Matemàtica (Spain)
PI: Isabel Serra TEAM: David Romero, Francesc Font, Tim Myers, Iqra Jabeen
University of Texas Southwestern Medical Center (USA)
PI: David Busch TEAM: Siddharth Dave, Sreekanth Cheruku, Christopher Choi, Peiman Lahsaei, DaiWai Olson
Hospital General De México (Mexico)
PI: Argelia Pérez Pacheco TEAM: Raúl Serrano Loyola, Verónica Carbajal Robles, Rosa María Quispe Siccha, Enrique Santillan Aguayo, Melvin Parada Guzmán, Félix Jerandy Monte De Oca Hernández, Diana Pineda Vasquez
Hospital Das Clínicas University of Sao Paulo Medical School (Brazil)
PI: Leandro Utino Taniguchi
Institute of Physics, University of Campinas (Brazil)
PI: Rickson Coelho Mesquita TEAM: Rodrigo Menezes Forti, Andrés Fabián Quiroga Soto
Clinical Hospital, University of Campinas (Brazil)
PI: Antonio Luis Eiras Falcão TEAM: Ana Lúcia Cavallaro, Bruna do Nascimento, Gabriela Lívio Emídio, Laís Bacchin de Oliveira, Lígia dos Santos Roceto Ratti, Lilian Elisabete Bernardes Delazari
BioPixS Ltd.
Sanathana Konugolu Venakata Sekar, Claudia Guadagno
Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico (Italy)
PI: Giacomo Grasselli TEAM: Alberto Zanella, Amedeo Guzzardella
Emory University Hospital
PI: Erin M. Buckley, Maxwell Weinmann
Committees
HEMOCOVID-19 is collaborative, is pledged to open-science, is organized in a lateral manner. All partners participate in decision-making.
Steering committee: Consists of principal investigators of all teams and participates in all decision-making processes.
Development Committee: Consists of volunteers interested in further involvement in the details of the technical aspects of the project.
Questions?
HEMOCOVID-19 STORY
Adapting to the new realities during the COVID-19 lockdown
It all started when Spain went into lockdown in mid-March and, as everyone else, ICFO groups begun to work from home. ICFO Medical Optics group found itself struggling to imagine what would happen to its ongoing clinical studies in the region and internationally as hospitals were being converted to deal with COVID-19 patients and clinical research was put on ice. The team carried out a brainstorming session and while combing through the literature, Dr. Marco Pagliazzi, a postdoctoral fellow and a recent PhD graduate of the group, found out that there was indeed a link between acute respiratory distress syndrome and the blood oxygenation of the microvasculature. Thus, with many years of experience in research and development in diffuse optics for applications in neurology and oncology, the team decided to seek a system that was suitable for the conditions of the pandemic. It had to be easy to disinfect, should not cross-contaminate patients, health-care professionals and other units, and, should be easy-to-use without requiring face-to-face training.
It turned out that Dr Turgut Durduran, group leader, and the knowledge and transfer unit, Dr Ariadna Martinez and Dr Martina Giovannella, have met intensivists at Hospital Parc Taulí early 2020 to evaluate potential collaborations. This rang a bell and they have contacted Dr Jaume Mesquida, an intensivist, who had prior experience with near-infrared spectroscopy (NIRS). The idea made sense. At that point there was a growing body of evidence showing that the microvasculature played a key role in COVID-19. Since then this has become widely accepted and therapies targeting the microvasculare are being considered.
In a period of a couple of weeks, during complete lockdown in Spain, the team rapidly worked online to take NIRS devices and customize them with their algorithms to provide a detailed, yet practical, evaluation of a patient’s microvascular well-being. The group had a small device from a Dutch company, Artinis (NL), and it seemed suitable for the purpose. However, Spain’s lockdown was one of the strictest in the world. One of us was allowed to enter ICFO with extraordinary precautions, take the system out and develop training videos while others worked on the necessary customizations at their homes. The documentation for ethical approvals, protocols, data analysis methods were all developed through virtual meetings. Once the approvals were obtained, the device was delivered via a taxi-service operating with a special permission. Parc Taulí team learned how to use it by watching videos and begun to use it.
Since then, we have secured device loans, purchased a number of new units and involved four countries in the consortium titled HEMOCOVID-19. As of the writing of this text, end of July 2020, we have not had a full face-to-face meeting.
ICFO’s consolidated knowledge in the field as well as assistance of the knowledge and technology transfer unit in the institute has made this project possible. As Durduran mentions, “I would have never imagined that we could go from having an idea, to one week later to developing materials and sending it to hospitals, and within another two weeks to obtaining ethical approvals and starting to take data. This is an indication that our technology has reached a level of maturity that has allowed us to take this big step forward. We are yet to see where this takes us.”
We acknowledge support from Fundació Privada Cellex and Ajuntament de Barcelona as well as the collaboration and an instrument loan from Artinis (Netherlands).