Lessons of COVID-19 research pivot in 2020 could improve medical studies

Clinical research has been impacted by the COVID-19 pandemic, both positively and negatively, experts say. Photo by Cincinnati Children's Hospital
Clinical research has been impacted by the COVID-19 pandemic, both positively and negatively, experts say. Photo by Cincinnati Children's Hospital

Dec. 28 (UPI) -- The COVID-19 pandemic has had both a positive and negative impact on medical research in 2020, delaying some trials while streamlining the process for others, according to experts.

The complexities of the pandemic, and quick shift in research focus toward better understanding of the coronavirus and finding a cure, put many studies looking into other diseases on hold for the short term.


Those delayed studies, many involving chronic, non-life-threatening diseases, were put on hold primarily because study participants were blocked from visiting research centers and a vast amount of medical resources were allocated for COVID-19 treatment.

Over the long-term, however, lessons learned from the unprecedented speed with which researchers pivoted in response to the pandemic could help streamline medical studies going forward, experts say.

"As of February or March, most clinical trials in large medical centers stopped," clinical research expert Dr. Reynold A. Panettieri Jr. told UPI.


"Although this likely delayed some of these trials for four or five months, overall I think the pandemic will end up being transformative in terms of how we do research in medicine," said Panettieri, vice chancellor of clinical and translational science at Rutgers University in New Jersey.

Most clinical trials, at least in the United States, restarted over the summer, when universities and academic medical centers began reopening more fully, according to Panettieri.

Most of these research centers defined "life-threatening" broadly, meaning that if discontinuing a treatment being evaluated in a trial entailed any risks to the participants the studies were allowed to continue, even during the pandemic lockdown.

Any disruption to medical research caused by the pandemic has yet to be quantified, he said, though a handful of studies have attempted to assess the impact in specific diseases and fields.

For example, in a survey of 300 surgeon researchers, conducted in April and published in September by the journal Surgery, 70% cited a negative impact on research productivity due to mandatory building shutdowns, social distancing and suspensions of clinical trials.

"Clinical trials were halted ... for the safety of researchers and patients [and] most available resources at the time were being reallocated towards COVID-19," study co-author Dr. Sundeep G. Keswani told UPI.


"However, it is too early to tell what true downstream effects are going to be of this pandemic on both clinical and basic science research," said Keswani, chief of pediatric surgery at Texas Children's Hospital in Houston.

Similarly, an analysis of studies published between October 2019 and April found a small decline in articles not related to COVID-19 over that period. This most likely reflects virus research that "was undergoing faster peer review than normal," study co-author Dr. Shelly Bian told UPI.

"I think these delays in clinical trial accrual may cause delays in research advancement in non-COVID-19 areas, [but] I think the focus of research will likely not be shifted, just pushed back," said Bian, a clinical assistant professor of radiation oncology at the University of Southern California.

Now that research has restarted in most places across the United States, what the pandemic has done has changed the way research studies are conducted and participants are monitored, Panettieri said.

Trial protocols that do not require physical examinations of study participants have largely moved follow-up consultations online, primarily to platforms such as Zoom, he said.

This has led to greater efficiencies, allowing more time for data collection and analysis, while reducing inconvenience for study participants and, potentially, the costs of running studies, Panettieri said.


Limiting in-person visits by study participants also reduces their risk for potential exposure to infectious diseases, including COVID-19, when visiting research centers, he said.

Similarly, the process with which clinical trials are evaluated and approved at research institutions has largely moved online, streamlining the process and allowing more trials to start and start earlier, Keswani said.

"There is a recognition now that, 'Hey, we don't need to have people schlep into clinical research units and spend time and energy on monitoring if we can do this virtually,'" Panettieri said. "I think this is really going to be a game-changer.

Researchers in other fields, from chronic diseases such as diabetes to more life-threatening conditions like cancer and heart disease, can draw inspiration from the speed with which COVID-19 studies were launched and yielded results.

The rapidly evolving technologies used to create viable vaccines against the virus, in less than a year, can be applied to other diseases, as well, according to Panettieri, Keswani and Bian.

"There are some bright spots that have come out of the COVID-19 pandemic -- just as we have transitioned much of our patient encounters to telemedicine, we have developed ways to conduct clinical research through remote platforms," Keswani said.


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