The intensive care unit remained fully operational, primarily to treat patients with the new virus, as well as those who needed emergent care. But that meant clinicians like Dr. James de Lemos, cardiologist, didn’t have much to do, since many of the non-COVID-19 procedures he performed, like echocardiograms and surgeries to put in heart stents, were postponed or canceled.
De Lemos and many of his colleagues were frustrated; they wanted to help fight the COVID-19 pandemic, but felt sidelined. “We sort of felt powerless, working a lot from home during this terrible public health challenge,” de Lemos says.
Determined to take on the COVID crisis in some way, de Lemos, his colleagues and the cardiovascular fellows they work with brainstormed a way to join the battle: They launched a registry to collect comprehensive data on COVID-19 patients in the Dallas area. The registry also includes detailed information on how the virus attacks the heart of some patients.
UT Southwestern is a teaching hospital. De Lemos is a professor of medicine in the hospital’s cardiology division. He’s also a former director of the hospital’s cardiovascular fellowship program, and remains involved in the initiative.
The purpose of the registry is to help clinicians determine which therapies are most effective in treating COVID-19, based on the collected data. In November, de Lemos and his colleagues are scheduled to present some of their findings at a virtual meeting of the American Heart Association. The research is on race and ethnic differences in COVID-19 presentation and the impact of obesity in the severity of the illness. The findings of the studies are embargoed until then.
Within a few weeks of launching the local effort, de Lemos and his colleague, Dr. Sandeep Das, pitched the AHA on the idea of expanding the registry, taking it nationwide. The AHA quickly agreed. To date, de Lemos and his colleagues have collected data on about 15,000 COVID-19 patients from more than 100 hospitals in 35 states.
Texas is one of the states that’s been hit the hardest by the pandemic. As of Oct. 1, it had recorded more than 700,000 novel coronavirus cases, second only to California.
A registry is an observational study that tracks patients with a particular condition and collects detailed information about who they are – their age, gender, race and ethnic background – and how they respond to different treatments. De Lemos and his colleagues collect these data points – which have been de-identified so patients can remain anonymous – from participating hospitals. Patients do not have to opt in to participate in the research, and are not asked to.
Creating a registry is particularly important when clinicians are seeking to develop therapies to treat a new illness, like COVID-19, de Lemos says. Researchers use detailed hospital records to learn how patients responded to different treatments.
In the early days of the pandemic, it was widely believed that COVID-19 was a disease of the lungs; the vast majority of patients developed severe respiratory complications.
As the pandemic evolved, it became clear that COVID-19 was causing severe cardiovascular problems in some patients, even young, healthy people. For example, Eduardo Rodriguez, a pitcher with the Boston Red Sox, developed myocarditis – inflammation of the heart – after testing positive for the novel coronavirus. His condition caused Rodriguez to miss the entire season.
De Lemos says he hopes the registry will provide hospital clinicians “real-time information to modify how they treat (COVID-19) patients” as effectively as possible.
He notes that obtaining results from biomedical research typically takes 18 months to years. Creating a registry in real time is like diagnosing what’s wrong with a car as it hurtles down a highway.
“The usual research timeline isn’t going to help anyone during the pandemic,” he says. “We’ve been pushing these timelines relentlessly. To make a difference, we have to get the data to the hospitals quickly.”