Allies in the War Against COVID-19

MUSC Health Network joins forces to study COVID-19 across South Carolina

by Kimberly McGhee

As MUSC Health leaders began to plan for the onslaught of COVID-19, they thought that Charleston would see the highest increases in hospitalizations in South Carolina. Instead, some of MUSC Health’s regional hospitals were the hardest hit. For example, early in the COVID-19 pandemic, MUSC Health Florence Medical Center had one-fourth the patient census of MUSC Health Charleston but four times the number of COVID-19 cases.

From the start, MUSC Health opted to take a “systems” approach to COVID-19, according to Rami C. Zebian, M.D., chief medical officer of the MUSC Health Florence and Marion Medical Centers.

“We said that, as a system, we don’t know where COVID-19 will strike hardest, but we have to be ready to mobilize resources, anywhere in the system,” said Zebian.

Although MUSC Health has provided regional hospitals with the necessary resources to face the crisis, frontline health care workers, like their fellow caregivers across the nation, keenly felt the lack of treatment options to offer patients against this new foe.

“It’s hard for me as a physician and for the medical staff in general to see someone get severely ill and feel that you are helpless, that you don’t have much to offer,” said Zebian. “When we have a new disease, often the only things that are available are experimental therapies offered through clinical trials.”

Zebian had been encouraged by MUSC Health leadership at every turn to ask for what he needed. So when he heard that a convalescent plasma study had opened at MUSC Health Charleston, he picked up the phone to ask whether it could be brought to Florence. The study was testing whether antibodies in plasma from patients who have had COVID-19 can help patients with severe COVID-19 fight the disease better.

On the other end of the telephone call were leaders at the South Carolina Clinical & Translational Research (SCTR) Institute. SCTR is one of more than 60 Clinical and Translational Awards hubs nationwide dedicated to speeding the translation of research breakthroughs into the clinic. Last fall, Zebian met with SCTR leaders, including SCTR co-principal investigator Patrick Flume, M.D., to discuss opportunities for expanding the availability of clinical trials.

Expanding clinical research to the regional hospitals and to rural areas is one of the goals of SCTR, which was just awarded a five-year grant renewal to continue its work. To meet that goal, it had already been working to build the infrastructure to conduct trials remotely. Those efforts ramped up during the COVID-19 lockdown, when many traditional trials adapted to a virtual format.

“When COVID hit, that was an accelerant,” said Flume.

So when SCTR received Zebian’s call, a number of research teams jumped into action to field potential COVID-19 trials and assess their fit for the regional hospitals, to help gain approval for the trials, and to run the trials.

“Our team is staffing these trials seven days a week to make this happen,” said Ashley Warden, clinical research manager for the MUSC Pulmonary and Critical Care Clinical Research program. “We are helping regional sites to enroll patients into the trials while also providing support to the physicians in Charleston who are running the trials here.”

“It’s really been a collaboration of a bunch of people who understand it, are passionate about it and made it work,” said Flume.

“The MUSC and SCTR teams were very helpful and embraced us,” said Zebian. “They told us that there’s no difference between doing clinical trials in Florence and in Charleston. We’re already doing it via tablets or remotely or signing in via telemedicine. So it doesn’t matter where the patient is.”

Within weeks, MUSC Health Florence Medical Center began enrolling its first patients into the convalescent plasma study. Soon after, patients from Marion and Lancaster also began receiving plasma. By August, when the U.S. Food and Drug Administration issued emergency authorization for convalescent plasma and the trial was closed, more than 346 patients from the MUSC Health system had been enrolled.

“It’s unbelievable when I look back at where we were a few months ago, when we just hoped that one day we might have research or clinical trials. And now, at Lancaster and Marion, a lot of people have designated research roles. That would not have been possible without the health system and without SCTR’s support,” said Zebian.

Currently, COVID-positive patients in Florence and Charleston can donate blood and saliva to the SCTR COVID-19 biorepository, a collection of specimens that researchers can use to better understand the disease and how to combat it.

SCTR is continuing to review and open new COVID-19 trials in Charleston and at the regional hospitals. It carefully vets potential trials, according to Flume, to choose those that show the most promise and are the best fit for the needs and the resources of the area.

Flume said, “We want to bring hope and real opportunity. And when you have something that actually hits and works, it’s a major home run. You know that you can bring something to these people, and our commitment is to the people that we serve in the state of South Carolina, not just Charleston.”

And SCTR’s dedication to serving the citizens of South Carolina will not end with COVID-19, according to Flume. The relationships and research infrastructure currently being built will make it easier to conduct clinical trials on other health problems being faced by local communities, such as the opioid crisis and high levels of smoking.

“I think that the relationships we’re building during the COVID-19 crisis show that we’re fully invested with our regional sites,” said Flume. “We need for them to be the front line, and we’ve got the infrastructure for these types of studies, and we’ll work together to make that happen.”

Zebian could not agree more.

“We are starting with COVID-19, but we’re not stopping there,” said Zebian. “Adding clinical trials to the arsenal of treatments for many diseases here at MUSC Health Florence Medical Center will be a huge win for the community.” 

Learn more about active COVID-19 trials.