Leading the way: Cleveland Clinic focuses research on both current and future pandemics

The COVID-19 global pandemic has highlighted the need for ongoing and expansive virus research and therapeutic innovation with a focus on public health. As COVID-19 continues to evolve worldwide, Cleveland Clinic has significantly expanded its global commitment to infectious disease research and translational programs by forming the Global Center for Pathogen Research & Human Health.

Global Center for Pathogen Research and Human Health is led by Jae Jung, Ph.D.Established in January 2021, the Global Center for Pathogen Research and Human Health is a global hub for state-of- the-art research in emerging pathogens and virus-related diseases. Through a multi-million-dollar partnership with funding from the State of Ohio, JobsOhio and Ohio Development Services Center, the Global Center will also create new start-up technology companies in the Cleveland Innovation District, attract world-leading corporations to Ohio, and generate an estimated 7,500 new jobs in Ohio by 2034.

The Global Center is led by Jae Jung, Ph.D., a world-class researcher and internationally renowned expert in virology and virus-induced cancers, who also serves as chair of the Cleveland Clinic Lerner Research Institute’s Department of Cancer Biology.

Dr. Jung sees the pathogen research center as a place where multiple disciplines collaborate on major discoveries, bringing new drugs, vaccines, and rapid diagnostic tests to doctors and patients.

“We have a true global center under one large umbrella program,” says Dr. Jung. “We also have a public health component in our program including training and educating public health workers to rapidly translate and deliver therapy to patients. Our mission is to not only study the current pandemic but to also prepare for the next pandemic.”

A collaborative, multidisciplinary research team which spans Cleveland Clinic’s international footprint is focused on broadening understanding of viral pathogens, virus-induced cancers, genomics, immunology, and immunotherapies, as well as technology development, education, and the integration of big data with patient care. Researchers are expanding critical work on studying, preparing, and protecting against public health threats such as HIV/AIDS, Dengue fever, Zika, and COVID-19.

The center is organized around six highly collaborative programs which include: studying the virus, studying the individual, the population, and exposures, testing and development of diagnostics, technologies for drug development and vaccines, and health care deliverables.

“Health care deliverables is perhaps the most important one,” says Dr. Jung. “All of these research programs are based on training community health care workers to ultimately direct and deliver our findings as a clinical application to the patient.”




Since the launch of the Global Center for Pathogen Research & Human Health, Cleveland Clinic researchers have been awarded more than $12 million in National Institute of Health (NIH) grants related to pathogen research including a $2.8 million grant to develop a vaccine to counter an emerging tick-borne virus. These funds, the first to go to Cleveland Clinic’s new Center for Global Center for Pathogen Research & Human Health, support work to test four vaccine candidates against the virus that causes severe fever with thrombocytopenia.

Additionally, Cleveland Clinic researchers have published several research articles related to advancing treatment for pathogen-related diseases, including COVID-19.

“We recently published a paper about an anti-viral drug against the SARS CoV-2 and also developed a vaccine to show that this neutralizing antibody is important,” says Dr. Jung.

“We are focused on drug development, vaccines and patient treatment,” says Dr. Jung. “Going forward, we are watching for future COVID-19 variants and studying patients with post-COVID syndrome.”

Dr. Jung says the center is also planning to look at another important virus known as “frozen virus” that is being brought to light by global warming in areas like Alaska where the ice is melting. “There are a number of deadly viruses or bacteria in that ice that can infect and cause potential death and a major pandemic,” says Dr. Jung. “We want to be prepared for this as well.”

Cleveland Clinic researchers have developed the world’s first risk prediction model for healthcare providers to predict an individual patient’s risk of testing positive for COVID-19.COVID-19 risk calculators: Predicting risks and outcomes
Cleveland Clinic researchers have developed the world’s first risk prediction model for healthcare providers to predict an individual patient’s risk of testing positive for COVID-19, as well as possible outcomes if infected with the disease.

The initial risk calculator, which predicts an individual’s risk of having COVID-19, became available for public use in November 2020. An additional calculator uses slightly different variables to predict disease progression and outcomes for individuals who have already been diagnosed with COVID-19.

“When we first developed the calculator, we used the clinical data of more than 12,000 patients from Cleveland, which included all individuals tested for the disease at Cleveland Clinic,” says Dr. Lara Jehi, Chief Research Information Officer at Cleveland Clinic. “Then we tested it in a few thousand patients in Florida to make sure it was accurate. We published it in “CHEST.” Independently, the “British Medical Journal” evaluated 108 different statistical models to predict COVID and identified ours as being the most robust.”
 
The calculator, which has 86% to 90% accuracy, is currently available through EPIC to health systems around the world and to all 250,000 million MyChart users worldwide. Patients can complete a short self-assessment in MyChart, documenting information like symptoms they are experiencing and potential exposure to COVID-19. The model uses that information, as well as clinical and demographic data already in their electronic chart, to calculate their score.

“All of these calculators are basically online tools that ask users to answer very specific yet simple questions,” says Dr. Jehi. “Based on the answers, it calculates an individualized risk for that one user for having whatever outcome it is evaluating.” Patients with high risk for having COVID-19 are advised to be tested.

The risk calculator is a useful tool to help healthcare providers predict patient risk and tailor decision-making about care. “When patients are first diagnosed with COVID-19, the challenge as a physician is that you don’t really know if an individual patient is going to do just fine and recover in a few days, or if they will end up in the Intensive Care Unit with severe disease,” explains Dr. Jehi. “The calculator results can be used by the physician to help guide their decision whether or not to escalate care.”

Use of the COVID-19 calculators has also resulted in more efficient and timely use of resources including clinical personnel. “At the beginning of the pandemic, everyone who tested positive for COVID-19 was enrolled in a home monitoring program and contacted every day for two weeks by a chronic disease management nurse,” Dr. Jehi says. “Now, with the calculator integrated into our electronic health records, the nurse can immediately pull up patients who are very sick and at high risk, leaving time to follow up with patients with other chronic conditions.”

Dr. Jung sees the pathogen research center as a place where multiple disciplines collaborate on major discoveries, bringing new drugs, vaccines, and rapid diagnostic tests to doctors and patients.The risk prediction model, called a nomogram, also shows the relevance of age, race, gender, socioeconomic status, vaccination history and current medications in COVID-19 risk.

“We have obtained a lot of useful information from the calculators regarding patient characteristics such as gender, age and race and how each one can influence risk,” says Dr. Jehi. “As a result, we’ve designed research studies tailored specifically towards a better understanding of these characteristics and have learned so much about how COVID-19 affects the body, and what could be done to prevent it or make it less severe.”

The COVID-19 research registry, which now has data from more than 360,000 patients tested for COVID-19 at Cleveland Clinic, is being used to inform a variety of other research studies across the Cleveland Clinic enterprise—including more than 250 COVID-19-related research projects in areas such as cancer, pediatrics, and intensive care.

“With COVID-19, we learned how much we were unprepared for a pandemic,” says Dr. Jung. “The goal going forward is to be prepared, not just for any single virus but for a multitude of viruses.”

This story is part of a five-part series on the Cleveland Clinic’s response to the COVID-19 pandemic and efforts toward recovery. To view the full series, click here.
 

Read more articles by Jo Donofrio.

Jo Donofrio is a marketing professional and freelance writer with a specific interest in medical and health care topics and human interest stories. In addition to Freshwater, her work has been published in Cleveland Magazine, MD News, Angels on Earth (Guideposts), Old Brooklyn News and Dental Products Report. She also teaches a business writing workshop at Cleveland State University and is an adjunct instructor for Southern New Hampshire University.