null New study in Quebec long-term care facilities

Dr. Don Vinh continues his work to understand why some people are more vulnerable to COVID-19

Dr. Don Vinh (right) is a scientist in the Infectious Diseases and Immunity in Global Health Program at the Research Institute of the MUHC
Dr. Don Vinh (right) is a scientist in the Infectious Diseases and Immunity in Global Health Program at the Research Institute of the MUHC

Source: COVID-19 Immunity Task Force.  Across Canada, but particularly in Quebec, long-term care facilities have accounted for a disproportionate number of COVID-19 deaths. The Government of Canada, through its COVID-19 Immunity Task Force (CITF), is supporting a new $2.7 million study aimed at identifying the factors putting each person at risk of developing severe COVID-19 symptoms and medical complications that may lead to a fatal disease.

“We still do not understand why some long-term care residents have gotten so sick and died of COVID-19, whereas others, at the same facility, have had milder versions of the disease or have not been infected at all,” says Donald Vinh, MD, an infectious disease and immunity expert at the Research Institute of the McGill University Health Centre (RI-MUHC) and an associate professor at McGill University. “Our study brings together immunological, biochemical, and psychosocial expertise to identify key factors that determine severe COVID‑19 symptoms and complications in the elderly. If we can identify elderly people at greater risk of developing medical complications from COVID-19, it can guide better infection control measures and prioritize medical care to increase the chance that these people will have better treatment outcomes. The hope is to help avoid unnecessary hospitalization and in so doing, reduce the use of health care resources.”

The research team is multi-institutional and multi-disciplinary, involving the Research Institute of the McGill University Health Centre (RI-MUHC), Université de Montréal, Institut Universitaire de Gériatrie de Montréal (IUGM) and its Research Center (CRIUGM), Douglas Research Centre, McGill University’s Department of Psychiatry, and Concordia University's Department of Psychology. The study is being carried out in partnership with two health networks (CIUSSS Centre Sud and CIUSSS de l’Ouest-de-l’Île-de-Montréal).

The study aims to recruit 850 participants in public residential and long-term care facilities and in private seniors’ homes in Montreal. The team will take blood samples to compare the immune response in residents who were never infected, residents who were infected but had no or few symptoms, residents who had moderate cases of COVID-19, and residents who had severe cases of the disease.

The study will also look at the relationship between immune status, markers of inflammation, psychosocial factors and the severity of COVID- 19 symptoms. “In public residential and long-term care facilities, a large proportion of patients present some form of cognitive impairment,” explains Jean-Philippe Gouin, PhD, Associate Professor, Psychology, Concordia University. “We will first examine whether there is a correlation between psychosocial issues and more severe cases of COVID-19, and second,” Dr. Gouin continues, “whether a COVID-19 infection is associated with increased psychiatric symptoms, sleep disturbances, and cognitive impairment among long-term care residents.”

Cardiovascular issues, including arterial hypertension and coagulation dysfunction (not being able to properly control blood clotting), can lead to more severe cases of COVID-19. According to a study published in the European Heart Journal, patients with high blood pressure admitted to hospital with COVID-19 are twice as likely to die as those without the condition. It is estimated that almost 20% of patients with COVID-19 have significant coagulation disorders. In addition, some vaccinated patients may develop blood clots (thrombosis) after healing from COVID-19. A team led by Hélène Girouard, PhD, Professor, Faculty of Medicine, Université de Montréal, will seek to identify measurable indicators associated with high blood pressure and coagulation dysfunction that could be predictors of more severe COVID-19 cases. This will inform treatments to prevent COVID-19 complications.

“COVID-19 has been catastrophic among the elderly in long-term care facilities and studies like this one are needed so that we can better protect them going forward,” says Dr. Catherine Hankins, CITF Co-Chair. “Vaccines will help to make an enormous difference in protecting Canadians from COVID-19.”

“Vaccines are being rolled-out in long-term care facilities across Canada to help protect the elderly, who have been disproportionately impacted by the COVID-19 pandemic,” says Dr. Theresa Tam, Canada’s Chief Public Health Officer. “This study will help provide greater insight into the early immune response of elderly Canadians to this viral infection, and how the immune response—and the subsequent severity of COVID-19 and variants of concern—is affected by cardiovascular and psycho-social factors.”

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