Researchers from the universities of Campinas (Unicamp) and São Paulo (USP) have joined forces to develop a fast and low-cost test to diagnose cases of COVID-19 (disease caused by the new coronavirus) and, in addition, to identify patients with risk of progressing to respiratory failure.
The method is based on the analysis of the pattern of molecules found in body fluids and has an estimated cost between R $ 40 and R $ 45 per patient. “We have already sent the approval process to the National Research Ethics Commission, the body that regulates clinical studies in Brazil [Conep], and we are already doing previous analysis and processing the data. All at the same time, due to the situation ”, stresses Rodrigo Ramos Catharino, coordinator of Unicamp’s Innovare Biomarkers Laboratory, to Agência Fapesp.
The researcher develops a line of research that combines tools of metabolomics (study of the set of metabolites in biological samples) and artificial intelligence (machine learning) to search for biomarkers that help in the diagnosis and assessment of the prognosis of several diseases, including metabolic syndrome , viral infections and cystic fibrosis.
The patient samples will initially be analyzed on a mass spectrometer (a kind of molecular scale), equipment capable of revealing all the metabolites present in the body fluid. This set of molecules, in turn, indicates to scientists the various metabolic processes active in the body.
The next step, which will be done at the Unicamp Computing Institute, under the coordination of Professor Anderson Rezende Rocha, is to use machine learning tools to analyze both the results of samples from individuals with COVID-19 and samples from healthy people, that will serve as control. Thus, it is expected to “train” the computer program to recognize the healthy pattern, the pattern of the patient infected with the new coronavirus and also the pattern associated with severe cases of the disease.
The collection of volunteers and the collection of samples are under the coordination of the collaborating professor of the Faculty of Medicine (FM) of USP Rinaldo Focaccia Siciliano, assistant physician of the Infectious and Parasitic Diseases Division of Hospital das Clínicas (HCFMUSP) and the Control Unit of Hospital Infection at Instituto do Coração (InCor).
The doctor explains that the selection of participants will be made among patients admitted to HCFMUSP with symptoms of flu syndrome, which include fever, cough, sore throat and runny nose. Patients treated at the Municipal Hospital of Lapa with the same symptoms will also be included.
“The objective is to cover a heterogeneous population, as the HC is a tertiary hospital [em que chegam pacientes graves encaminhados por prestadores de serviços primários e secundários] and the Municipal Hospital of Lapa is an emergency room with open doors, receiving cases of all kinds, ”says Rinaldo Focaccia Siciliano to Agência Fapesp.
According to the doctor, samples will be collected from three different groups: patients with confirmed diagnosis of COVID-19 by molecular techniques used today in routine, patients with confirmed diagnosis of influenza (flu virus) and patients with flu-like symptoms and negative results for both pathogens.
“We estimate that it is necessary to collect 50 samples from each group and another 50 from healthy people, who will serve as controls. We believe that, because of the pandemic, in a short time we will be able to finish the collection phase ”, says Siciliano.
In the researcher’s assessment, the advantage of the rapid test is being able to take the patient out of circulation, preventing him from transmitting the virus to more people. “In addition, if we can predict the highest risk cases, we can offer a more appropriate level of care,” he says.
According to Catharino, after the set of procedures and the software are ready and validated, it will be possible to do more than a thousand tests in a single day. “In addition to being faster than the method used today, it would be cheaper and offer more information to help health professionals when deciding on hospitalizations and treatments,” he says.
FMUSP professor Ester Sabino, one of the creators of the study, will be responsible for storing the biological material collected at the USP Institute of Tropical Medicine (IMT).
FMUSP professor José Carlos Nicolau, who heads the Clinical Unit for Acute Coronary Disease at InCor, is at the forefront of another objective of the project: to understand how the new coronavirus alters the ability of platelets to aggregate and blood coagulation, as well as the clinical implications of these processes.
“We intend to look at what happens with platelet aggregation and with other blood clotting markers. The idea is to compare these variables in the groups mentioned above [pacientes com desconforto respiratório hospitalizados com COVID-19, com influenza, sem nenhum dos dois e grupo controle] assess the differences between them. The results can have prognostic and therapeutic implications. If I notice that a certain parameter negatively influences the patient’s condition, I can try to intervene by blocking this process, in order to improve the evolution ”, points out Nicolau to Agência Fapesp.