W. Winn Chatham, M.D., professor in the Department of Medicine and Lous W Heck Clinical Scholar in Rheumatology, says his project, “Early Identification and Treatment of Cytokine Storm Syndrome in COVID-19,” took precedence over his other research, and essentially halted his other scholarly activities in 2020.

Chatham’s study focused on cytokine syndrome in COVID-19 positive patients, and was the first randomized placebo controlled trial of anakinra use in COVID-19 conducted in the U.S. “The premise and aims of the trial sensitized UAB providers to hyper-inflammation associated with COVID-19, and helped to effect incorporation of assessments for such in the standard initial assessments of patients admitted with COVID-19,” he says.

The projected outcome of Chatham’s study was that treatment with anakinra would resolve COVID-19 associated hype-inflammation and decrease the need to escalate oxygen supplementation requirements in admitted patients. Chatham says this projection was not the case on a background of steroid treatment—one that had become standard care when the trial was able to enroll the first patient.

“We also predicted that that patients admitted with severe complications of COVID-19 would have biomarkers consistent with those we have observed in other cytokine storm syndromes; what we found was that this was rarely the case. COVID-19 induces hyper-inflammation that is unique. We did predict that there would be genetic risk factors for COVID-19 hyper-inflammation, and the preliminary genetic studies appear to confirm this,” he says.

Chatham’s whole genome sequencing studies yielded results that provided preliminary data for additional studies, which confirm the prevalence of these mutations in a larger cohort of COVID-19 patients and patients with other infection-triggered hyper-inflammation syndromes. The study was a foundation for additional studies seeking to determine the functional correlates of identified mutations.