As a junior Clifton Builders Management major with a pre-med focus, Ashley Clegg co-created her experience at the University of Nebraska–Lincoln to best prepare for her future in medicine. However, a global pandemic not only impacted her educational experience, but also brought about an opportunity to advance science and co-author an article in a respected peer-review journal.

As the COVID-19 death toll continues to rise, Clegg worked alongside a team at the Nebraska Center for Virology to explore how mortality in sub-Saharan Africa (SSA) appeared to remain relatively low compared to the rest of the world.

“People expected Africa to get hit hard with this virus, but relative to the rest of the world, their mortality rate wasn't as high. The severity of cases and COVID-19 experience in Africa was not as bad as what people expected, so we tried to figure out why that was the case,” said Clegg, who also holds minors in biological sciences, chemistry and mathematics.

The hypothesis of the research examined how prior exposure to numerous seasonal coronaviruses created a certain degree of protection to people in SSA, which others around the world may not have experienced.

“Coronaviruses aren’t new. They’ve been around a long time because it is a common cold virus. COVID-19 seems to be more pathogenic than other coronaviruses,” explained Dr. Charles Wood, former director of the Nebraska Center for Virology and co-author of the study. “We work with Africa, and even if we can’t be there physically, we have collaborators on the ground. They know they haven’t seen the cases we have in the U.S., and we think they may have some pre-protection prior to the pandemic from being exposed to so many other diseases.”

Through a collaboration with research partners in SSA, the Nebraska research team examined pre-COVID-19 pandemic plasma samples from the African region and the United States.

“We have a lot of patient samples we’ve collected over the years from our experience working in Africa with HIV and AIDS. We took those samples and tested for the presence of antibodies and if they have an immune response to recognize this new coronavirus,” said Wood.

Clegg’s main role involved screening the plasma samples to determine the reaction of antibodies to exposures of COVID-19 using a process called immunofluorescence assay (IFA). The process involves highlighting antibodies in plasma using a fluorescent agent and examining them under a microscope for cross-reactivity, having an immune response, with an introduced virus.

“The thing with IFA is this fluorescence concept. A normal negative sample is highlighted red, but if the sample indicates reactivity to something, then there will be some cells that light up green,” explained Clegg.

The results produced from the study gave tangibility to the hypothesis and revealed an estimated 15-20% of the population in SSA already had antibodies that cross-react with the COVID-19 virus, while the United States samples only showed roughly 3% who had that same immune response.

“Does this mean people in sub-Saharan Africa have some type of protected immune response? Possibly. These results may explain why they are less affected and if infected, less diseased,” said Wood.

Wood believes this research will not only continue to elevate the status of Nebraska and its virology research, but also have a larger impact on the world as it continues to move forward in the pandemic.

“Through our work, we have a better understanding of protection against COVID-19, why some people are less susceptible and what’s protecting them. Learning that can help people all over the world,” said Wood.

Working on this research project solidified Clegg’s confidence in the scientific community during this pandemic. She also looks forward to the many possibilities once it is applied.

“I'm passionate about this research because I'm interested in everything about furthering science and helping people. It's not developing a vaccine but it's answering questions that pave the way for research in the future that you can't even imagine,” she said.

The Lincoln, Nebraska native valued the research opportunity because it fed into her innate desire to help people through both science and business. Combined with her experiences exploring leadership and entrepreneurship as a Clifton Builder and pursuing her certificate in sales excellence, she is prepared to enter medical school.

“The overlap between my career choices in business and medicine is what gets me out of bed in the morning. What drives me is the concept of helping people and solving problems,” said Clegg. “Through my time as a Builder and other experiences in the College of Business, I’m more prepared for my future in medicine.”

The research team at Nebraska included Dr. John West, associate professor of biochemistry; For Yue Tso, research assistant professor; Phoebe Peña, junior biological sciences major from Los Angeles, along with Wood and Clegg. Their colleagues in Africa included Salum Lidenge, John Ngowi, Julius Mwaiselage, Owen Ngalamika and Peter Julius.

To read the full research article in the International Journal of Infectious Diseases, visit: https://www.ijidonline.com/article/S1201-9712(20)32310-9/fulltext#secsect0065.