Pakistan continues to experience a relatively low death rate from COVID-19 and a high proportion of mild or asymptomatic cases, contrary to the expectations of many experts. Professor Zahra Hasan and her team are working to understand why by examining the biology of both the virus and its human hosts.
“The nature of the pandemic here in Pakistan has given rise to a lot of speculation,” Hasan said. “Why hasn’t it been worse? Is it because Pakistanis have a high level of immunity? Is it because our population is so young? We’re working to deliver rigorous explanations by analysing the genetic makeup and diversity of SARS-CoV-2 strains.”
Professor Hasan’s team has conducted whole genomic sequencing of the virus and has identified four different families of strains that were circulating in Pakistan at the start of the pandemic.
They are analysing these strains alongside more current strains to understand their variability and possible mutations in proteins – especially the spike protein or outer-coat proteins of the virus – that may cause different strains to be more infectious or deadly.
Biological differences between individuals can influence how they respond to viral infections. Researchers are studying genetic changes in blood samples gathered from mildly, moderately and critically ill COVID-19 patients at the Aga Khan University Hospital in Karachi to identify biomarkers that lead to unfavourable outcomes or protection from the virus.
They are also collaborating with researchers at Nova University Lisbon to explore the role of protective antibody responses in the progression of COVID-19 in patients.
“The fact that we have a high incidence of mild disease is very noteworthy,” Professor Hasan said. “It opens up the possibility that we could help deliver answers to fundamental questions about the virus that have global implications.”
The research team was able to jumpstart COVID-19 research as their SARS-CoV-2 sequencing builds on previous pathogen genomics work conducted alongside Professor Rumina Hasan. Their COVID-19 immunity work builds on the department’s ongoing research into tuberculosis and other infectious diseases.
The research team includes Rumina Hasan, Najia Ghanchi, Kiran Iqbal, Erum Khan, Asghar Nasir, Akbar Kanji and Safina Razzak from the Department of Pathology and Laboratory Medicine; Faisal Mahmood, Nosheen Nasir and Bushra Jamil from the Department of Medicine; Hani Abidi and Kulsoom Ghias from the Department of Biological and Biomedical Sciences; and Waqasuddin Khan from the Department of Paediatrics.
Research support has been provided by Health Security Partners in the United States, Pakistan’s Higher Education Commission and AKU’s University Research Council and Provost’s Academic Priorities Fund.