The COVID-19 pandemic has placed a spotlight on the impact of severe acute respiratory infections (SARIs). These viruses, which include COVID-19, influenza A and B viruses and other SARI-related viral infections, can cause extreme illness or death, strain our hospital systems and challenge our public health infrastructure.
In April 2020, at the outset of the COVID-19 pandemic, the CDC Foundation and partners launched Severe Acute Respiratory Infections Preparedness (SARI-Prep) research consortium. The project was designed to create a network of leading scientists and researchers from varying fields of expertise who would observe the impact of severe acute respiratory infections on hospital systems and patient care, experiences and health outcomes.
“Myself and many of my colleagues on this project have been interested in studying these public health challenges long before COVID-19,” said Laura Evans, MD, professor of medicine at the University of Washington in Seattle and the project’s principal investigator. “My co-investigator on this project, Dr. Pavan Bhatraju, knew more research needed to be done on how to prepare for the impact of these illnesses so that the US response could be proactive. From there we were fortunate to get linked up with the CDC Foundation.” A consortium like this could help improve response time to future outbreaks and advance patient treatment and outcomes from SARIs due to SARS-CoV-2.
Dr. Evans and SARI-Prep co-investigator Pavan Bhatraju, MD, MSc and assistant professor of medicine, division of pulmonary, critical care and sleep medicine at the University of Washington, received funding from the CDC Foundation, in collaboration with the Centers for Disease Control and Prevention (CDC) to officially launch SARI-Prep, a consortium of more than a dozen academic institutions. This work was done in partnership with the Society of Critical Care Medicine, the professional organization that provides oversight and guidance to critical care physicians, like the principal investigators. SCCM’s role was to support project and data management and help share the story of the consortium and the important implications of its research findings.
Over the last two years the project has partnered with 15 hospitals across the country and enrolled 806 patients diagnosed with a severe acute respiratory infection to learn more about their experiences while hospitalized.
“Having a consortium that spanned across the U.S. was important,” said Dr. Bhatraju. “One of the things we wanted to observe was when a patient gets admitted to the hospital what determines them having a good health outcome versus another patient having a poor health outcome.”
The team learned early on that patients diagnosed with COVID-19 were often experiencing vascular complications like stroke or blood clots. After analyzing nearly 5,000 different proteins in the blood they discovered a pathway called angiopoietin-like 4, which provides a target for developing drug therapies for patients experiencing vascular complications from respiratory infections. By monitoring patients continually during outbreaks, scientists and health care providers can learn which therapeutics work best to treat the SARI at hand, preventing serious illness and even deaths.
Along with researching patient experiences and outcomes, the consortium used weekly stress surveys and other methods to measure the strain on hospital staff to help hospitals and health systems better meet the demands of emerging pandemics. Their findings revealed different levels of strain experienced by staff working in the emergency department versus the intensive care unit.
“We observed that while stress related to SARI patients started at a similar time point in both the emergency department and in the intensive care unit, the duration of stress was different between the two locations,” said SARI-Prep co-investigator George Anesi, MS, MD and assistant professor of medicine in the division of pulmonary allergy and critical care at the Perlman School of Medicine at the University of Pennsylvania. “In both care locations, stress persisted for a long period even after local cases peaked, but it took notably longer for SARI-related stress in the intensive care unit to resolve than in the emergency department.”
The findings of the SARI-Prep network can help public health officials develop frameworks for fighting future outbreaks, better predict hospital stress and strain and reduce burden on staff and implement additional support resources. This work also provides important data on ways to assess health disparities in patient care and improve health outcomes.
Research findings from this project have already been published in several publications and will continue throughout the next year. You can learn more about the work of SARI-Prep here.
