Scientific Community Unites to Tackle Coronavirus Outbreak

As the number of 2019-nCoV cases continues to mount with no relief in sight, the rapid spread of the virus and the growing number of deaths have generated a formidable response by the scientific community.

While cruise ship quarantines, face mask shortages, and the death of a young Chinese doctor who had warned of a coronavirus outbreak late last year have dominated the headlines and preoccupied many of us, an extraordinary number of infectious disease researchers from academia and industry have stepped up and, in many cases, combined forces to gain a better understanding of the virus in order to help contain the outbreak as well as develop safe and effective diagnostics and treatments.

Among the groups funding the massive coronavirus response effort is the Coalition for Epidemic Preparedness Innovations (CEPI), which has four initiatives underway, including one with CureVac to rapidly develop vaccines to protect against the virus. The Bill and Melinda Gates Foundation has also committed up to $100 million to “help strengthen detection, isolation and treatment efforts; protect at-risk populations; and develop vaccines, treatments and diagnostics.”

In addition to the combined efforts of thousands of scientific experts and availability of essential funding, quick and easy access to the latest research data is essential. In that vein, Springer Nature reported last week that it had entered into an agreement with other publishers, funders, and scientific societies to facilitate the rapid sharing of data. As part of the agreement, all peer-reviewed research from the partners related to 2019-nCoV will be open access for the duration of the outbreak.

For over a month, there have been tens of 2019-nCoV-related announcements daily from a slew of sources with news of novel findings that shed light on the virus; potential diagnostics or treatments; or even the availability of tools, technologies, and expertise to address the outbreak. Some findings have been disputed and a paper retracted, but progress is still being made on many fronts.

Repurposing treatments

Thailand has had a substantial number of confirmed cases (32 as of Feb 10), and doctors in the country reported recently that an older woman treated with a cocktail of antivirals including oseltamivir (used to treat the flu) as well as lopinavir and ritonavir (antivirals used to treat HIV) has shown significant improvement.

Thai scientists are not alone in looking to use existing antivirals to treat 2019-nCoV.

A small clinical trial with Gilead Sciences’ antiviral remdesivir is currently underway in China. There is no data at this time that show the investigational compound will be effective against 2019-nCoV, but in lieu of other treatment options, Chinese health officials authorized the trial, perhaps encouraged by the fact that remdesivir has demonstrated in vitro and in vivo activity in animal models against MERS and SARS, which are structurally similar to 2019-nCoV.

CytoDyn’s leronlimab, a viral-entry inhibitor when used to treat HIV/AIDS, is also being explored as a potential treatment for 2019-nCoV. “Leronlimab has both the potential to enhance the cellular immune response by suppressing Treg cells that, in turn, inhibit the anti-viral T-cell responses and the potential to repolarize macrophage activity,” the company reported in a statement.

Enabling technologies

Regeneron isn’t repurposing an existing antiviral but instead applying its drug development expertise and proprietary technology to 2019-nCoV. The company just reported the expansion of an agreement with the U.S. DHHS focused on developing antibody treatments for 2019-nCoV. The initiative will leverage its VelocImmune® platform, which uses a genetically engineered mouse with a humanized immune system that can be challenged with all (or parts of) a virus of interest to facilitate swift identification, preclinical validation, and development of promising antibody candidates. “The life-saving results seen with our investigational Ebola therapy last year underscore the potential impact of Regeneron’s rapid response platform for addressing emerging outbreaks,” president and CSO George Yancopoulos said.

Unlike with many other viral outbreaks in the not-too-distant past, sequencing of the coronavirus has occurred very quickly. A French team reported receiving samples from three suspected cases on January 24 and confirming and sharing the whole sequence by January 30.

Oxford Nanopore reported that its sequencing technology was used in many of the early coronavirus genomes, and it recently shipped an additional 200 MinION sequencers to China to support ongoing efforts.

GenapSys just launched its gene sequencer in the Asia Pacific region and hopes to partner with local health agencies and researchers to “help support the control and limit the spread of current and future outbreaks.” The affordably priced GenapSys sequencer is 100x smaller than traditional high-throughput sequencers, which facilitates its use in hospitals and transportation hubs.

Diagnostics

Among the first companies to report the availability of a 2019-n-CoV detection kit was BGI. Late last month, the company announced that it had scaled up production of its new real-time fluorescent RT-PCR kits for detecting the virus. Early on, it also donated 20,000 kits to support the response in Wuhan and Hubei Province.

In addition to the rapid detection kit, BGI has also developed a metagenomic sequencing detection kit (2019-nCoV nucleic acid detection kit—combinatorial Probe-Anchor Synthesis sequencing method) to monitor mutations. The metagenomic sequencing kit can reportedly identify and diagnose other coronaviruses, including new coronaviruses and respiratory tract infections, and achieve rapid detection of viral sequences.

Last week, the U.S. FDA granted emergency use authorization to the CDC’s coronavirus diagnostic allowing the RT-PCR panel to be used at qualified labs across the country. Previously, the test could be used only in CDC laboratories. The diagnostic provides presumptive detection of 2019-nCoV from respiratory secretions, such as nasal or oral swabs.

Also last week, Co-Diagnostics said that its RUO CoPrimer test for 2019-nCoV is ready for sale. The test was designed using the company’s proprietary process to rapidly identify and verify the optimal target on the 2019-nCoV genome for a PCR assay. The company believes that the test’s unique design will provide enhanced accuracy when detecting the presence of the coronavirus, including improved specificity over tests designed on a different platform.

The company also said that it is working with the FDA regarding clearance of the test on an emergency use basis. If approved, the company will commercialize the test as an IVD.

Mammoth Biosciences is reportedly also involved with the development of a 2019-nCoV diagnostic, working with Charles Chiu from University of California San Francisco. According to Chiu, the test, which uses CRISPR technology, could be ready for use in point-of-care settings within weeks.

In the coming weeks and months, there will undoubtedly be many more research findings, product launches, and approved tests, as well as the initiation of clinical trials and commencement of vaccine and therapeutic manufacturing operations, but encouraging progress has already been made combatting a virus unknown to the scientific community just a few months ago.