Combatting COVID-19: a round-up of how Hong Kong’s universities are making a difference (May-Jun)
An overview of the latest scientific research on COVID-19 from Hong Kong universities from May to June 2020
Quantifying olfactory dysfunction as virus symptom
A cohort study led by Professor Yuen Kwok-yung, Director of the State Key Laboratory of Emerging Infectious Diseases, Li Ka Shing Faculty of Medicine, University of Hong Kong (Croucher Senior Medical Research Fellow 2006), indicates that as many as two-thirds of COVID-19 patients may experience olfactory dysfunction, affecting their sense of smell and taste. The research, published as an accepted manuscript by Open Forum Infectious Diseases, found that among 18 patients in the study, 12 (67 per cent) reported olfactory symptoms, while olfactory dysfunction was confirmed in six patients by butanol threshold and smell indication tests. Such dysfunction was the only symptom in two patients. The team concluded that olfactory dysfunction is a common symptom of the virus, may be severe and prolonged, and can be the only symptom. The researchers suggested that mucosal infiltration by macrophages expressing the SARS-CoV-2 viral antigen could contribute to the condition.
AI technology assists online diagnostic system
A research team led by Professor Guosheng Yin, Head of the Department of Statistics and Actuarial Science, University of Hong Kong, and Dr Bin Liu, Assistant Professor, at the Centre of Statistical Research, School of Statistics, Southwestern University of Finance and Economics (currently a University of Hong Kong post-doctoral fellow), has integrated radiography and computer vision to develop a digital online diagnostic system for COVID-19. The system requires only chest CT scans and can reach 88 per cent accuracy. To facilitate knowledge exchange, Yin and Liu made their computer codes, online system, and data open source at GitHub. The statisticians hope medical staff will use the system and share patients’ image data for collaborative research and to meet the urgent demand for COVID-19 testing.
Real-time platform for vaccine target recommendations
Hong Kong University of Science and Technology data scientists have introduced COVIDep, a real-time, web-based platform providing immune target recommendations for guiding SARS-CoV-2 vaccine development. The platform implements a protocol that pools publicly available genetic and epitope data for SARS-CoV-2 to identify B cell and T cell epitopes that present potential immune targets for the coronavirus. The user-friendly platform may help guide vaccine designs and associated experimental studies for SARS-CoV-2. The team, led by Professor Matthew McKay, Departments of Electronic and Computer Engineering and Chemical and Biological Engineering, and Dr Ahmed Abdul Quadeer, Research Associate, Department of Electronic and Computer Engineering, published this latest move on the bioRxiv pre-print service. This follows their earlier research, published in February 2020, that identified potential vaccine targets.
Leading the world in coronavirus research
According to Microsoft Academic, the University of Hong Kong leads the way in terms of saliency, number of citations, publications and H-Index in coronavirus research while Times Higher Education (THE) analysed the Microsoft data to identify the university as among the “powerful research clusters that have developed globally in the field of coronavirus research in recent years”. THE described a number of powerful research clusters globally from 2014 to 2018, with particular centres of expertise at the University of Hong Kong (closely involved in work on SARS), in the United States (most prominently, the University of North Carolina), and in Europe (centred around Utrecht University and Erasmus University Rotterdam [likely a reflection of research on MERS]). Meanwhile, the Hong Kong government has boosted its funding support for COVID-19-related research conducted by the medical faculties at the University of Hong Kong and Chinese University of Hong Kong. A total of HK$111 million is being awarded from the Health and Medical Research Fund to support 26 studies on topics including the development of vaccines and novel antiviral drug candidates; sero-epidemiological studies of the virus in the community; the properties, characteristics, spread, infection and effective therapeutic interventions of the virus; and Hong Kong’s response to the outbreak.
Eyes may be an important infection route
University of Hong Kong researchers at the Li Ka Shing Faculty of Medicine were the first in the world to provide evidence that the SARS-CoV-2 virus can infect both the upper human airways and conjunctiva (cells lining the surface of the eye), and that it is much more efficient than the SARS coronavirus (SARS-CoV) in infecting these areas in humans. The research was carried out by Dr Michael Chan Chi-wai and his team, including Professor Malik Peiris (Croucher Senior Medical Research Fellowship 2005), Professor John Nicholls (Croucher Senior Medical Research Fellowship 2009), Professor Leo Poon Lit-man (Croucher Senior Research Fellowship 2017, Croucher Scholarship 1996), and Dr Kenrie Hui Pui-yan (Croucher Studentship 2006).The finding, published in The Lancet Respiratory Medicine, highlights how the infectious virus can be spread by hand from contaminated surfaces, when people touch surfaces and then rub their eyes, and affirms the importance of people avoiding touching their eyes when in public areas, and regularly washing or cleansing their hands.
Advancing identification of drug treatments
A combination of three drugs suppressed the virus that causes COVID-19 within seven days when used on patients in Hong Kong, nearly twice as fast as when the drugs were used singly, according to a study led by University of Hong Kong infectious disease expert Professor Yuen Kwok-yung. The study, published in The Lancet and prompting intense international media interest, found that three antiviral drugs, namely interferon beta-1b, lopinavir-ritonavir and ribavirin, were “safe and more effective” in reducing the time when the coronavirus is detectable and potentially transmissible for patients with mild to moderate symptoms. Yuen and his lab have also participated in the world’s largest screening of drugs for potential COVID-19 treatment that has publicly produced results to date, collaborating with a global team led by the researchers at the Sanford Burnham Prebys Medical Discovery Institute in California. While the development of a vaccine could require at least 12 to 18 months, the teams aim to identify therapeutics that can be repurposed as SARS-CoV-2 antivirals. Yuen’s team provided cultured coronavirus for the project. Tests conducted by 31 research institutions found that 30 out of 12,000 drugs seemed to stop the virus from destroying human cells. Of the 30, six were characterised for cellular dose-activity relationships, and showed effective concentrations likely to be commensurate with therapeutic doses in patients, as reported in a paper on the pre-print service bioRiv.
Hamster study affirms benefits of wearing masks
In a separate University of Hong Kong study led by Professor Yuen Kwok-yung, golden Syrian hamsters were used in research that found a surgical mask partition between cages containing SARS-CoV-2 infected (challenged) and non-infected (naïve) animals significantly reduced the rate of infection between them. Non-contact transmission was found in 66.7 per cent (10/15) of the exposed naïve hamsters. The use of a mask partition for the challenged index or naïve hamsters reduced this to 25 per cent (6/24) while a partition for the challenged hamsters significantly reduced it to only 16.7 per cent (2/12) of the exposed naïve hamsters. Unlike the severe COVID-19 manifestations of challenged hamsters, infected naïve hamsters had lower clinical scores, milder histopathological changes, and lower viral nucleocapsid antigen expression in respiratory tract tissues. The study suggests transmission by respiratory or airborne droplets can be reduced when masks are worn by infected individuals. The research has been accepted for publication by Clinical Infectious Diseases and published as a preprint.
Explaining temporary loss of smell in COVID-19 patients
Dr Yen Hui-ling, Associate Professor of the School of Public Health at the University of Hong Kong, and her research team have found that the SARS-CoV-2 virus appears to infect the olfactory epithelium, an epithelial tissue inside the nasal cavity responsible for the sense of smell of golden hamsters. The finding, published in Nature, may explain the temporary loss of smell reported in infected patients. In addition, the study on the pathogenesis and transmission of the virus shows that infection in hamsters resembles that found in humans with mild symptoms, and that the animal model may be useful in future studies of the effectiveness of vaccines and drugs to fight the novel coronavirus.
Use of face masks reduces respiratory virus shedding
Medical researchers at the University of Hong Kong have found the use of surgical face masks among adults and children with seasonal human coronaviruses, influenza viruses and rhinoviruses significantly reduced the detection of influenza virus RNA in respiratory droplets and coronavirus RNA in aerosols. There was also a trend towards reduced detection of coronavirus RNA in respiratory droplets. A total of 246 individuals, randomised to wear or not wear masks, provided exhaled breath samples. The findings, published as a Brief Communication in Nature Medicine, indicated that surgical face masks could prevent transmission of human coronaviruses and influenza viruses from symptomatic individuals. Professor Benjamin Cowling, an epidemiologist from the School of Public Health, led the study.
Modelling effectiveness of mass mask-wearing
An interdisciplinary international study, co-convened by Professor De Kai, Computer Science and Engineering, at Hong Kong University of Science and Technology, found that universal mask-wearing could suppress the spread or second waves of COVID-19 before vaccines or treatments are available. The team’s first model extended the standard epidemiological SEIR model (where the population is grouped into S for susceptible, E for exposed, I for infectious and R for recovered or deceased) to predict the effects of mass face mask-wearing. The second introduced an AI-inspired agent-based model, which simulated infections occurring as a result of contact between individuals moving in physical space. The simulation results showed if 80 to 90 per cent of the public adopted masking on about day 50 after an outbreak, before the lifting of lockdown measures, new COVID-19 infections could be slowed significantly and help to avoid a second outbreak. Taking into account mask-effectiveness, the team found the effects held even with inexpensive non-medical masks or homemade masks with only 70 per cent effectiveness.
Correct use of face masks study
An observational study of 10,211 pedestrians in Hong Kong conducted in February 2020 by researchers from the Department of Health Technology and Informatics, Hong Kong Polytechnic University, and Faculty of Medicine, Chinese University of Hong Kong, identified an urgent need for public education on the correct use of face masks. In the study, 94.8 per cent of the pedestrians were observed to be wearing masks. However, 13 per cent wore them incorrectly, with 35.5 per cent worn “inside-out” or “upside-down”, and 42.5 per cent worn too low, exposing the nostrils or mouth. Many individuals who did not wear masks were smoking, eating, or covering their mouth and nose with tissues or hands. The preliminary findings were published in a letter in EClinicalMedicine. An online survey to explore local views on wearing face masks was also underway at the time of the letter’s publication. Among the 2,859 respondents, 94.1 per cent believed mass masking reduced the chance of infection and community outbreak and 76.3 per cent reused their masks. The findings showed public education was needed to prevent self-contamination and on mask usage in order not to waste resources, the authors wrote.
Transmission model for reopening plans
Research led by Hong Kong Baptist University computer scientists has used a data-driven modelling approach to answer the time-critical question of when stringent social distancing and quarantine measures against COVID-19 can be loosened. The team developed a novel computational model that characterises and quantifies the underlying transmission patterns among different populations throughout the phases of the COVID-19 outbreak. Using the model, the team carried out a prospective analysis for six cities in Mainland China, including Wuhan, of the different work resumption plans, revealing respective economic implications and levels of disease transmission risk associated with each plan. The model was developed by a research team from the university’s Department of Computer Science, led by Chair Professor Liu Jiming, in collaboration with the National Institute of Parasitic Diseases at the Chinese Center for Disease Control and Prevention (China CDC), and Chinese Academy of Sciences. The research was published in EClinicalMedicine.
Fighting COVID-19 – keeping us informed and learning
The University of Hong Kong and Chinese University of Hong Kong have developed comprehensive resources on the Covid-19 pandemic, including the latest status of the disease in Hong Kong, news of their research, podcasts, community tips and advice, and links to online courses. HKU offers the Fight COVID-19 site and CUHK the CUMED on COVID-19.
Hong Kong research-based contributions addressing the COVID-19 pandemic from January to March 2020 can be found here.