Blood samples will be studied and stored at the MCG Center for Biotechnology and Genomic Medicine where Dr. Jin-Xiong She, center director, also will be looking at variants in the ACE2 receptor that may make some more vulnerable to neurological problems, as well as antibodies people are making to the natural sugar coating on the virus. She says the antibodies may provide a disease history and help determine whether the severity of symptoms is associated with certain antibodies.

Other collaborators include Dr. John Morgan, director of the Parkinson's Foundation Center of Excellence and Movement and Memory Disorder Programs in the MCG Department of Neurology, who is conducting cognitive testing; and Dr. Lynnette McCluskey, neurobiologist in the MCG Department of Neuroscience and Regenerative Medicine, who is coordinating smell and taste testing.


Information collected during the study will be shared with the participants' primary care physician if desired. The investigators hope to add brain imaging to the examination if funding becomes available, Hess says.

In terms of addressing the disease's impact today, the blood thinner, low molecular weight heparin, used to prevent clots and treat deep vein thrombosis and pulmonary embolism and whose effect is considered to last longer and be more predictable than standard heparin, may be useful in reducing excessive clotting and potentially avoiding a stroke as well as other clot-related organ damage, they say. Rutkowski and Hess note that some physicians are already using it prophylactically and that it's essentially impossible in the midst of a pandemic to do standard clinical trials to more objectively measure if patients benefit from different therapies.

A more targeted therapy for these patients may be human recombinant soluble ACE2, which has been shown to help restore healthier ACE2 levels and interfere with SARS-CoV-2's ability to attach to cells, reducing the overall viral load, which decreases disease severity. The clinical grade ACE2 has already undergone early human studies for adult respiratory distress syndrome, the often deadly consequence of this virus, and other significant infections. An interventional study is now enrolling hospitalized adults in Austria, Denmark and Germany.

A clinical trial also is underway in patients with COVID-19 or suspected of having it who have bilateral viral pneumonia, infusing them with the blood vessel dilator angiotensin (1-7), which is significantly depleted in COVID-19 to hopefully improve lung function. Drugs that block the receptor for blood vessel constricting angiotensin II may work from another direction to help restore a healthier balance, the investigators say.

The published research was supported in part by the National Institutes of Health.

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