Clinical Management and Outcomes Research

Working Group Leads

Lindsey Baden Lindsey R. Baden, M.D.
Director of Center for Clinical Investigation, BWH
Director of Infectious Diseases, DFCI
Associate Professor, HMS
Ingrid Bassett
Ingrid V. Bassett, M.D., M.P.H.
Associate Professor of Medicine, MGH
Rajesh Gandhi

Rajesh Gandhi, M.D.
Professor of Medicine, HMS
Director, HIV Clinical Services and Education, MGH

Karen Jacobson
Karen R. Jacobson, M.D., M.P.H.
Associate Professor of Medicine, BU School of Medicine
Director, Boston Medical Center Tuberculosis clinic


Clinical Management and Outcomes Research Working Group

The Clinical Management and Outcomes Research Working Group is focused on improving medical outcomes through understanding the behavior and physiologic effects of COVID-19 and identifying and optimizing effective treatments and supportive care. Working with patient-derived, clinical data, the working group strives to understand and optimize treatments ranging from monoclonal antibodies and antivirals, which focus on curbing viral replication during the early stages of infection to the use of anti-inflammatory, immune-modulating and anticlotting treatments in the later stages of infection, as well as supportive care such as supplemental oxygen, anticlotting and ventilation to manage symptoms or severe disease and critical illness. While clinical management has improved dramatically over the past year, the group remains focused on optimizing treatment, better risk profiling of patients prone to developing severe disease to inform individualized treatment, and understanding how a variety of factors including age, comorbidities and preexisting conditions, patients’ immune status and various socio-economic determinants of health may affect COVID-19 outcomes.

Learn more about the Clinical Management and Outcomes Research Working Group

The Clinical Management and Outcomes Working Group has contributed to the development of COVID-19 treatment guidelines for the Infectious Disease Society of America as well as the National Institutes of Health, published studies identifying the increased COVID-19 hospitalization rates of Hispanics in the Boston area, published case studies highlighting potential concerns of SARS-CoV-2 infection in specific patient populations, and continuously brought together experts to discuss and contextualize rapidly changing recommendations and data throughout the pandemic response.

Key findings funded by MassCPR

A number of important themes and findings emerged from the funded studies. Luban et al. developed tools to rapidly study nucleic acid variants of SARS-CoV-2 virus spike protein. Using these tools, they characterized mutations in multiple viral genes. They demonstrated that the D614G variant is more infectious than the ancestral form and that SARS-CoV-2 M protein is sufficient for assembly and release of virion particles. They have provided plasmids and cell lines to multiple investigators around the world. Dougan et al. characterized symptoms associated with positive COVID-19 test results, finding anosmia, fevers, and myalgias to be positively associated with COVID-19. Belcher et al. developed M13 bacteriophage-based nanomaterials to filter and decontaminate viruses (99.9% effectiveness in the lab); this work is applicable to face masks, PPE, and potentially HVAC systems. The group was also able to create non-woven textiles that incorporate the nanomaterial. Morrow et al. evaluated patients with COVID-19 and acute heart failure and compared them to those without heart failure. Patients with COVID-19 and acute myocardial injury had higher concentrations of proteins involved in inflammation/apoptosis/extracellular matrix remodeling; 26 biomarkers were positively associated with the presence of acute myocardial injury. Traverso et al. developed systems for allowing the use of one ventilator for two people without compromising individual-level care, thereby allowing for maximization of limited resources. The approach still allows for individualized care (adjustment of volume/pressure control, rebalancing of ventilation based on patients’ conditions). The system was tested first on benchtop studies, then in vivo (pigs), and finally in clinical settings. The work has been translated to the clinical setting.

Most investigators reported that their research groups were not originally studying coronaviruses, and most not working on viruses at all, but they were able to adapt their resources to study COVID-19. These actions may not have been possible without the support of MassCPR. The Luban lab also reported that they will continue to work on coronavirus as a strong focus.

Future areas of investigation in the area of clinical management and outcomes research

Belcher et al. comment on testing their nanomaterial approach to protect against new pathogens.

Dr. Dougan has led clinical trials evaluating monoclonal antibodies for treatment of COVID-19.

Dr. Luban’s lab plans to continue work on Covid-19 and other viral infections.

Morrow et al. plan further research into pathways associated with acute heart failure in COVID-19 patients.

Projects funded by MassCPR have led to many new collaborations that will allow further research to flourish.