In the early days of the pandemic, physicians and clinical researchers had little understanding of the effect COVID-19 was having on specific populations such as pregnant women, at-risk children, adolescents and people with disabilities.
Dr. Diana Bianchi, director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, stepped into the breach by helping to initiate 15 large-scale studies to assess the severity of the disease for specific population groups, the safety and efficacy of treatments, and the impact of vaccines and other risk mitigation strategies, such as masking.
“Dr. Bianchi’s persistent advocacy to fund targeted research, form collaborative teams and educate the public about the needs of these populations resulted in a robust portfolio of programs to address factors affecting millions of pregnant women, parents, caregivers and individuals with disabilities,” said Alison Cernich, the institute’s deputy director. “This research has resulted in guidance for preventive strategies, diagnostics and potential treatments that are safe and effective in these groups.”
Among Bianchi’s accomplishments was her creativity in marshaling existing resources within the National Institutes of Health in response to the rapidly moving pandemic. The NIH is the largest single public funder of biomedical research in the world and was well positioned to accelerate COVID-19 research.
To determine the impact of COVID-19 on pregnancy, Bianchi worked with the NICHD-funded Maternal-Fetal Medicine Units Network to launch a national study of 24,500 pregnant women that suggested that cases of severe COVID-19 are associated with a higher risk of cesarean delivery, postpartum hemorrhage, pre-term birth and other complications. This study showed the importance of monitoring pregnant women more closely and treating them more quickly when infected.
Research funded by the institute also found that antibodies stemming from COVID-19 vaccinations pass from breastfeeding mothers to their infants, providing protection. Other studies showed that COVID-19 vaccines only have a temporary effect on menstruation and have no impact on fertility, helping to allay concerns about their use.
To understand the effects of remdesivir, an anti-viral drug used to treat COVID-19 but not approved for use in pregnancy, Bianchi worked with NIH partners and Gilead Sciences, Inc., to study how pregnant and breastfeeding women metabolize the drug and to identify potential side effects.
She helped launch studies to improve the understanding of multisystem inflammatory syndrome in children—a condition in which different parts of the body can become inflamed, including the heart, lungs, kidneys and brain. This rare but serious condition has been associated with COVID-19. In addition, she championed efforts to improve the assessment and treatment of individuals with Down syndrome and other disabilities, and examined the medical and cognitive needs of childhood survivors of COVID-19 who subsequently experience “long COVID.”
Another study undertaken at Bianchi’s direction showed that COVID-19 transmission was lower in schools than in the community if masks were worn and if handwashing and social distancing protocols were followed.
Mark Del Monte, the CEO and executive vice president of the American Academy of Pediatrics, said Bianchi contributed significantly to ensuring physicians and the public had a “better understanding of the full impact of COVID-19.”
“If there was ever a time we needed the excellent leadership of Dr. Bianchi, it was during the pandemic,” Del Monte said.
Cernich said Bianchi not only has advocated and helped initiate important research on COVID-19, but she also “created a vision and trusted her people to give her solutions that work.”
“Throughout the pandemic, Dr. Bianchi led with a high level of readiness and flexibility to adapt to evolving scientific questions,” Cernich said. “The research undertaken at her direction has given people information they need to make important decisions about their own health or the health of family members.”
Bianchi said her goal was to fill the knowledge gap regarding the health effects of COVID-19 with credible medical and scientific information.
“Children, people of reproductive age and people with intellectual disabilities are the populations that had not gotten enough attention during the initial pandemic response,” Bianchi said. “We’ve been able to speak up on behalf of all of these groups and generated evidence-based information that has improved their care.”