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image of virus that causes covid-19
Microscopic image of SARS-CoV-2, the virus that causes COVID-19, isolated from a patient in the U.S. Photo credit: NIAID-RML

When it comes to those who have been infected with SARS-CoV-2, the virus that causes COVID-19, University of Hawaiʻi at Mānoa researchers are at the forefront of exploring how differences in immune health might explain why some individuals recover without serious medical complications while others do not.

A new UH study is recruiting those who have tested positive for the coronavirus within 60 days of diagnosis to donate weekly blood samples up to six times. Researchers said this baseline data will aid in designing strategies to mitigate the impacts of COVID-19 on severity and mortality, particularly among those who are more vulnerable.

Study goals

ruben juarez headshot
Ruben Juarez

The goal of this study is to “understand the natural progression of antibodies that your body produces to fight COVID-19, so the information can help others who get infected in the future,” said principal investigator Ruben Juarez, associate professor in the College of Social Sciences’ economics department and a research fellow in the UH Economic Research Organization. “As we reopen the state, we expect to see a greater strain on the healthcare system and likely new cases with severe complications.”

“Beyond the known epidemiologic risk factors that indicate who may be at a higher risk for these complications, our research will allow us to improve on this prediction by incorporating information on individual immune response, where even seemingly healthy individuals may struggle to handle the virus and may need to be hospitalized if this response is not robust enough,” added Juarez, an economist working on social and economic networks. “Study results may inform policy decisions that are more targeted at the individual level to prevent the onset of these medical complications that would also tax the healthcare system.”

The study’s other principal investigator is Alika Maunakea, an associate professor at the John A. Burns School of Medicine’s Department of Anatomy, Biochemistry & Physiology and the Institute for Biogenesis Research.

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Alika Maunakea

“Another goal that we hope to achieve with this study is an enhanced understanding of the biological and socioecological interactions that enable individuals and communities to be more resilient against COVID-19,” Maunakea said.

While Native Hawaiians make up 21 percent of the state’s population, recently disaggregated data from the Hawaiʻi State Department of Health indicate that 13 percent of all COVID-19 cases are among Native Hawaiians. This contrasts with Pacific Islanders who account for 14 percent of the cases while only comprising 4 percent of the population. Likewise, Filipinos account for 21 percent of the cases while comprising 16 percent of the population.

“Although there are certainly disparities in the infection rate of COVID-19 in the state with some populations disproportionately affected, this data may also indicate potential resilience within the Native Hawaiian community,” said Maunakea, an expert in epigenetics and health disparities research. “By recruiting a diverse cohort of individuals recovering from COVID-19, we will be able to understand the sociobiological mechanisms underlying this resilience, and learn from our communities how best to mitigate this crisis while averting severe health outcomes among our most vulnerable. We are reaching out to the community to help us understand this problem more comprehensively, so we can collectively identify the best ways to overcome this challenge that we all face.”

How to participate

For more information about the study or to enroll if recovering from COVID-19, contact the study coordinator by phone/text at (808) 989-2043 or email This study is supported in part by the Hawaiʻi Resilience Fund at the Hawaiʻi Community Foundation.

By Lisa Shirota

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