Through the department of Biomedical Laboratory Sciences, INES-Ruhengeri is running a research project called “Predicting the risk of SARS-Cov2 infection and co-morbidity and Reducing Socioeconomic Impacts: Identification of high risk population”
The analysis of the risk/benefit balance of the currently pursued screening test systems indicates that the primary objective of a national health system must be the identification of people who may be at risk before saturation of the public health system capacity. With the aim to take this challenge we reasoned that the current understanding of the COVID-19 indicates that only a fraction of infected people develops clinically relevant signs.
From a clinical point of view, we still don’t know why some people remain asympthomatic, other develop mild conditions, some other, instead, develop serious pneumonia, microtrombosis, vasculopathy and eventually die. What we know, is that SARS-Cov2 infection can induce a hyperimmune response and a systemic inflammatory state. Understanding why this happens to some but not to the others, is crucial for stratification of patients and efficient use of medicines and medical resources. For most people the infection is very mild, similar to common flu, and certainly does not require massive measures impacting the economy and the social stability (including school and religious event closure) Thus, an ideal approach would be to identify and isolate only those individuals who are at risk to develop hyperimmune response and sustained inflammatory states.
Scientific literature is becoming populated with potential biomarkers which can help predicting a potential risk for hyperimmune response and inflammatory storm. For example, the d-dimer is predictive for the risk of coagulopathy, while B and T lymphocyte counts can be associated to the risk of cytokine storm. However, these and other markers require vein blood sampling, certified clinical chemistry labs and instructed personnel to both collect sample and carry out analysis. However, the markers of oxidative stress and evaluation of the pro- and anti-oxidant competence of a subject may be conveniently employed as an indication of the likelihood of positive or negative follow up after infection and also a as a primary screening for the general population.
The present project, therefore, aims at implementing an efficient system of measure and analysis of biomarkers for oxidative stress as surrogate points for the risk of hyperimmune response, in the perspective of an efficient and optimized use of clinical resources as well as preservation of socioeconomic activities.
The experience of these months of pandemic COVID-19 clearly indicate that the ‘lockdown’ and restriction measures may be as harmful as the disease. An evolved society which cares its own citizens cannot leave them alone, even if the apparent risk/benefit balance may seem to lean toward the economical preservation. So, it’s like a ‘loose-loose’ situation, in which if you care the health of small portion of people you severely impact the wealth of the whole community; but if you decide to preserve the economic situation, you ‘sacrifice’ the most exposed, weak and sensible people to the pandemics.
This knotty problem requires an expert decision pattern which may help the governance to take the right measure in the interest of both the public health and the public wealth.
INES-Ruhengeri believes that researchers, academicians, health professionals, and policy makers can contribute to the management of this pandemic by taking innovative research initiatives. As we are observing, all over the world the lockdown, and the subsequent containment measures have succeeded to result in a marginal impact of the epidemics.Said Vice Chancellor of INES-Ruhengeri, Fr Dr Fabien HAGENIMANA
In addition to the collaboration we have with Ruhengeri Referral Hospital, the District of Musanze and through the collaboration with our partner from University of Parma (Italy), and the support from the National Council of Sciences and Technologies (NCST) we believe that the present project, will contribute to an efficient and optimized use of clinical resources as well as preservation of socioeconomic activities.