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As the COVID-19 pandemic has continued for a year and a half, many people from all walks of life are feeling the impacts especially when it comes to their mental health and wellbeing.  

Hospital researchers through Lawson Health Research Institute, along with its hospital partners, have been studying the impacts for some key groups.

Health care workers have been at the forefront of the pandemic. These heroes have worked tirelessly through every wave and continue to provide excellent care to their patients and community. Dr. Kamia Honarmand, Critical Care Physician at London Health Sciences Centre (LHSC), remembers the stress that she and her colleagues were feeling, and know that something needed to be done.

“Our team wanted to better understand the impact of the pandemic on the lives of health care workers, both personally and professionally, and understand how they were coping when it came to their mental health,” says Dr. Honarmand who is also an Associate Scientist at Lawson. “There was a lot of reasons to be stressed even before the height of the first wave in our region. There was a lot of anxiety. The hospital wanted to find ways to support health care workers and identify resources that would assist them.”

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Dr. Kamia Honarmand, Critical Care Physcian at LHSC and Lawson Associate Scientist 

Frontline health care workers across the region were invited to take part in an online survey about their experiences during the pandemic. “We looked at both the impacts and the preferred coping strategies, and what supportive strategies they would like to have in the hospital in the future.”

• Read more about the study examining how the pandemic affects Southwestern Ontario's frontline hospital workers
   

The Veterans Care Program located at Parkwood Institute, a part of St. Joseph’s Health Care London, provides complex continuing and long-term care for Canadian war Veterans. Dr. Don Richardson, Director of the MacDonald Franklin OSI Research Centre at Parkwood Institute, has been treating and studying mental health among Veterans for many years. He believed this was a group was likely to be affected by the pandemic in unique ways.

“We know that Veterans in general are at a higher risk for depression, anxiety and PTSD,” explains Dr. Richardson, who is also a Scientist at Lawson. “We also knew the pandemic and forced restrictions would have significant impact on Veterans and their families who would be more isolated than they already are.”

More than 1,100 Veterans and around 250 spouses were recruited for the study, completing an online survey every three months for 18 months.

The study is still ongoing, but Dr. Richardson says the initial data has been telling. “We have been able to analyze some of the preliminary data and what we have found is that almost 50 per cent did not indicate their mental health had worsened during the pandemic but 40 to 50 per cent have had difficulty accessing care.”

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Dr. Don Richardson, Director, Macdonald Franklin OSI Research Centre

The hope is that this study will lead to better preparedness in the future to safeguard the mental health of Veterans and ensure their access to care during a pandemic.

• Read more about the Veterans’ study
   

Many people have felt isolation during the pandemic, but that feeling may have even more of an impact for youth suffering from mood and anxiety disorders.

Dr. Elizabeth Osuch, Director of the First Episode Mood and Anxiety Program (FEMAP) at LHSC says the pandemic-led lockdown forced more than a hundred mental health clients out of in-person services.

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Dr. Elizabeth Osuch, Director of FEMAP and Lawson Scientist

“They lost their resources for mental health services and support as soon as the quarantine was announced,” shares Dr. Osuch, who is also a Scientist at Lawson. “We were concerned that it would be devastating to people – and to some people it was. We wanted to make sure they had an avenue to connect with the program.”

Dr. Osuch and the FEMAP team created an online research platform to find out how patients were doing by having them fill out a symptoms and function questionnaire.

“We have analyzed the first wave so far and it shows that male patients were doing better and female patients were doing worse, which was a surprise. One of the risk factors for not doing well was the loss of their job.”

• Read more about the FEMAP study here
   

The pandemic added an extra layer of stress and worry for women who were having a baby.

“This has been an enormous and pivotal time for everyone in the world,” says Dr. Genevieve Eastabrook, Obstetrician-Gynecologist at LHSC. “The experiences during pregnancy and post-partum for both the birthing person and their baby can have effects later in life for children. For example, their overall cardiovascular and metabolic health, bonding experiences and the risk of mood disorders.”

Dr. Eastabrook, who is also an Associate Scientist at Lawson and Assistant Professor at Western University’s Schulich School of Medicine & Dentistry, is working with a team to examine the effects the pandemic may be having for mothers and their babies. As part of the study, the London research team is using an approach called ‘One Health’ which offers a holistic perspective to explore how various risk factors and social determinants of health interact.

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Dr. Genevieve Eastabrook, OBGYN at LHSC and Lawson Associate Scientist

“The unique aspect is that we have a comparative group to see if there are differences in markers such as risk of depression, perceived stress and social supports,” adds Dr. Eastabrook.

Study participants are asked to complete a 30-minute questionnaire at around 6-12 weeks after their delivery. The research team is still recruiting patients for this study.

• Read more about the mother and baby study

From the moment the COVID-19 pandemic was declared in March 2020, our teams at Lawson Health Research Institute have been at the forefront. Researchers at London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London immediately began to work towards understanding the new virus in an effort to discover lifesaving health-care solutions.

To date, dozens of research projects have been advanced through Lawson with some receiving international attention as ‘world firsts’.  As we mark the three-year anniversary of COVID-19 being declared a global pandemic by the World Health Organization (WHO), we share with you  COVID-19 research highlighted over the past year.

Study finds acute kidney injury associated with severe COVID-19 leads to high mortality rates

Severe cases of a COVID-19 infection can cause a host of serious complications, including acute kidney injury. In a published study, scientists at Lawson found that acute kidney injury in patients with a severe COVID-19 infection leads to a high mortality rate. 

By accessing data collected through the Ontario Renal Network (ORN), Dr. Peter Blake, Lawson Researcher and Provincial Medical Director at the Ontario Renal Network, and his colleagues examined 271 people at 27 renal programs across the province, including patients at LHSC, who received dialysis for acute kidney injury due to a COVID-19 infection. Read more.

Study shows a decline in Veterans’ mental health throughout the pandemic

In published findings from Lawson, more than half of Canadian Veterans reported a decline in their mental health over the course of the COVID-19 pandemic.
When it comes to mental health conditions, Veterans are an at-risk population, often having higher rates of depression and post-traumatic stress disorder (PTSD). When the COVID-19 pandemic hit, scientists at Lawson wanted to understand its effects on this already at-risk population. 

To examine the potential impacts the research team launched a longitudinal study recruiting Canadian Veterans and spouses of Canadian Veterans. Participants complete online questionnaires every three months, with questions focused on mental health and virtual health care services. Read more.

Virtual care associated with significant environmental and patient cost savings

A study published in JAMA Network Open by researchers at ICES, Lawson and Western University found that virtual care during the COVID-19 pandemic led to a significant reduction in carbon dioxide emissions and patient travel-related expenses, such as gasoline, parking or public transit costs.
Findings show that for more than 10 million patients with at least one appointment during the study period (63 million visits in total), virtual care was associated with estimated savings of:
•    3.2 billion kilometers of patient travel;
•    545 to 658 million kilograms of carbon dioxide (CO2) emissions; and
•    $569 to $733 million (Canadian [US $465-$599 million]) in expenses for gasoline, parking, or public transit. Read more. 

London researchers discover novel method to diagnose long COVID

Published in Molecular Medicine, researchers at Lawson found that patients with post-COVID-19 condition (long COVID) have unique biomarkers in their blood. The team is now working on developing a first of its kind blood test that could be used to diagnose long COVID. The discovery could also lead to new therapeutics for this condition.

The researchers studied 140 blood samples from participants at LHSC and St. Joseph’s Health Care London, including St. Joseph’s Post-Acute COVID-19 Program. Participants were those with presumed long COVID, hospital inpatients with acute COVID-19 infection and healthy control subjects. Read more.

Researchers are combining new technologies to examine blood proteins in COVID-19 patients

Published in the Journal of Cellular and Molecular Medicine, a team at Lawson discovered unique patterns of blood plasma proteins in critically ill patients that may help develop a more personalized approach to treating severe COVID-19.

Called the plasma proteome, the proteins studied are released by cells that often play an important role in the body’s immune response to viruses. The research team studied how they adapt and change to a COVID-19 infection. Read more. 

Thanks to decades of work by dedicated researchers like London, Ont.-based Dr. Paul Adams, haemochromatosis has become much easier to diagnose, though many people are still unaware of the genetic condition. And while treatment options are effective, they are limited, according to a new review published in The Lancet.

In Canada and the United States, one in 227 people have haemochromatosis, making it more common than cystic fibrosis. However, the U.K. Biobank Project, a large-scale biomedical database and research resource, found that only 12 per cent of people who have the condition actually know they have it.

Dr. Adams, a Scientist at Lawson Health Research Institute and Professor at Western University’s Schulich School of Medicine & Dentistry, explains, “The most common genetic test done in Canada and the U.S. is the best way to make the diagnosis, but you have to think of the condition and the doctor has to know that there is a genetic test available. So those two steps are some of our stumbling blocks.”

In Ontario, testing and diagnosis often comes only after some other issue arises, “One day someone stumbles on the fact that there's a liver abnormality, or the patient is complaining of fatigue and the doctor orders blood tests, thinking blood iron is going to be low,” Dr. Adams explains. “And then it turns out to be very high.” 

Most common in people of Northern European ancestry, haemochromatosis results in excess iron in the body and includes symptoms such as fatigue and arthritis pain, and can lead to serious complications like cirrhosis of the liver, liver cancer and death.

Starting in January 2000, Dr. Adams conducted a multi-year study involving 20,000 London, Ont. residents that helped change how haemochromatosis is diagnosed – moving from testing iron levels to genetic testing. With iron levels affected by alcohol consumption, obesity, inflammation and some types of cancer, the previous measure led to many false positive tests. 

But knowing when genetic testing should be done remains a challenge. The underdiagnosis and lack of awareness also remain an issue when it comes to more serious complications.

“If this is diagnosed early, like as a young adult, then this can be treated and those complications won’t develop,” Dr. Adams says. “If you donate blood, treatment is very similar to that procedure and it's tolerated extremely well in most. People who have a lot of excess iron will have this blood taken once a week until their iron levels come down.” 

He hopes this new publication will lead to better diagnosis and treatment, and sees a future in emerging biological therapies.

Dr. Adams continues to be involved in global research, including work with the U.K. Biobank Project on genomic testing, and is investigating partnerships to develop future gene editing treatment.

People looking for more information about haemochromatosis can reach learn more on the Canadian Haemochromatosis Society’s website.

HealthCareCAN held its third annual Lobby Day “H on the Hill” event on Parliament Hill in Ottawa, on Tuesday, October 30, 2018.

Canada’s hospital CEOs and vice presidents of health research joined HealthCareCAN - the national voice of Canada’s healthcare organizations, community and research hospitals - to meet with MPs, Senators and senior government staff.

Collectively, they issued a call for federal action to unlock the tremendous economic potential of the health and life sciences sector to support better health for Canadians.

Dr. David Hill, Scientific Director for Lawson and Integrated Vice President of Research for London Health Sciences Centre and St. Joseph’s Health Care London, participated in the lobby day. Dr. Hill currently sits on the Board of Directors for HealthCareCAN.

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 “Minister of Crown Indigenous Relations @Carolyn_Bennett, Parliamentary Secretary for Science, Sport, and Accessibility @KateYoungMP, and Dr. David Hill, catching up over lunch at #HontheHill #CDNpoli #CDNhealth”

Meeting participants stressed the need for action on HealthCareCAN’s recommendations for the 2019 federal budget, specifically:

• Setting a minimum 25% funding floor for the indirect costs of research under the Research Support Fund;
• Granting eligibility to federal infrastructure funding competitions to healthcare organizations, and;
• Investing in digital health platforms to support care, training, and research in healthcare organizations.

Diverse areas of the health and life sciences sector and key health issues were discussed, including:

• Health and science research, granting councils;
• Hospital infrastructure;
• Health innovation;
• Electronic health technology;
• Opioid crisis response;
• Mental health;
• Aboriginal health; and,
• Home care.

Read Dr. Hill’s recent column in Hospital News on bridging the gap from discovery to patient care.

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HealthCareCAN provides high-quality policy research advocacy and leadership development services to our members while championing healthcare system transformation in Canada. Visit www.healthcarecan.ca to learn about our solutions to health and healthcare challenges. Follow us on Twitter: @HealthCareCAN