Outputs from the ISARIC4C consortium

This page is intended to provide updates for participants on the work that has been done with their samples and data. We will keep this page updated with research results, reports and plans.

During its first 3 months, the ISARIC4C consortium expanded from the initial 34 co-investigators to more than 150 active contributors, and provides a data and sampling infrastructure for follow-up of COVID cases in the P-HOSP consortium.

As well as these outputs, see the dynamic report of age, sex, and 28 day status of patients admitted with COVID.

Outputs

Sharing samples and data

ISARIC4C was designed from the outset as a foundation for the UK outbreak response, supporting researchers across the country. The 4C consortium has: Responded to clinical 120 data requests, providing data to 100 collaborators Shipped out a...

Impacting Policy

ISARIC4C and CO-CIN (Tier 0) feed data dynamically to Public Health Scotland, Public Health England, SPI-M, NERVTAG and SAGE. SPI-M have been high productive and published several analysis that informed Policy. Key UK policy documents citing ISAR...

Risk prediction: the 4C Mortality Score

BMJ 9 Mar 2020 Using data from 57, 824 hospital admissions, we developed and validated an easy-to-use risk stratification score based on commonly available parameters at hospital presentation. The 4C Mortality Score outperformed existing scores, ...

Characterisation of hospitalised cases of COVID-19

BMJ: 2020; 369 Within weeks of being funded, we produced the largest study anywhere in the world of COVID-19 cases, enabling us to produce the most accurate risk prediction models for the UK population. These will continue to improve. The first o...

Genetic mechanisms of severe Covid-19

MedRxiv September 2020; Nature online December 2020 In collaboration with the ISARIC GenOMICC study we discovered multiple genes that underlie critical illness in Covid-19, including several that led directly to potential therapeutic targets. In...

Clinical characterisation of Covid-19 in children

BMJ 2020;370:m3249 We have comprehensively characterised the burden and patterns of disease in children in the UK, demonstrating that life-threatening disease in otherwise healthy children is extremely rare. This had direct impact on public healt...

Long Covid in adults discharged from UK hospitals after Covid-19

MedRxiv pre-prints 25 March 2021 It is emerging that long-term symptoms are often present in people who have had acute Covid-19 disease. We found that over half of patients reported not feeling fully recovered several months after onset of Covid-...

Non-steroidal anti-inflammatory drug use and outcomes of COVID-19

The Lancet: Rheumatology May 07, 2021 Early in the pandemic it was suggested that pre-existing use of non-steroidal anti-inflammatory drugs (NSAIDs) could lead to increased disease severity in patients with COVID-19. NSAIDs are an important analg...

Role of blood cytokines IL-6 and GM-CSF in severe COVID-19

Science Immunology 10 Mar 2021 We have identified new biomarkers of inflammation that both reveal the severity of COVID-19 and set it apart from severe influenza. Many inflammatory cytokines were found in greater numbers in severe COVID-19 and th...

T cells target many different parts of the virus

Nature Immunology (4th September 2020)) This study by Yanchung Peng, Alex Mentzer, Tao Dong and colleagues reveals that the immune system responds to many different parts of the SARS-CoV-2 virus. This will influence vaccine design, which often ...

Setting Serology Standards

Setting the standard ISARIC 4C defined the international reference standard for SARS-CoV-2 serology by providing the first samples to the National Institute for Biological Standards and Control (NIBSC) from COVID-19 cases. These were used to make...

Viral spike variants evading antibody-mediated immunity

Cell 4 Mar 2021 We showed that the N439K viral mutation has enhanced binding affinity to the ACE2 receptor and that this variant cause infections with similar clinical outcomes compared to the wild type. This mutation is resistant against neutral...

Using a double binding antigen assay to detect and measure SARS-CoV-2 antibodies

Lancet Pre-Prints 5 Jan 2021 Hybrid DABA displayed attributes necessary for accurate and sensitive detection of antibody to SARS-CoV-2 to predict neutralising activity and the vaccine response.

Impact of ethnicity

SSRN July 2020 We have carefully studied the effect of ethnicity on outcomes in hospitalised patients, revealing the effect of comorbidities in mediating part of the increased susceptibility in some ethic groups.

SARS-CoV-2 surface and air contamination in a healthcare setting

Clinical Infectious Diseases 8 Jul 2020 We have explored the mechanisms of viral transmission. Our findings of extensive viral RNA contamination of surfaces and air across a range of acute healthcare settings in the absence of cultured virus high...

Supporting vaccine development

The Lancet, 15 August 2020 At the start of the pandemic, ISARIC4C was able to provide convalescent samples of PCR-positive hospitalised patients with COVID-19 to characterise the immunological properties of COVID-19. This was essential to the dev...

ICECAP autopsy study

American Journal of Respiratory and Critical Care Medicine 2021 ISARIC 4C resources and consortium partners supported the COVID-19 post-mortem case series. This is one of several pieces of evidence that changes the model of COVID pathogenesis, su...

Adverse outcomes in COVID-19 patients with underlying respiratory conditions

Lancet Respiratory Medicine 4 March 2021 Characterisation of 75 463 hospitalised COVID-19 patients from 258 participating health-care facilities showed that underlying respiratory symptoms is common and patients with asthma were more likely, and ...

Co-Infections, Secondary Infections, and Antimicrobial Usage

Lancet Microbe 2 June 2021 We investigated the frequency and microbiological details of bacterial co-infection and secondary infection, in addition to antimicrobial usage in 48,902 patients hsopitalised with COVID-19 during the first pandemic wav...

COVID-19 and Cancer

Esmo Open 1 May 2020 The ISARIC4C investigators collaborated with Prof Carlo Palmieri and team to characterise the first 1,797 hospitalised patients with cancer and COVID-19. From here a new study was launched to assess the impact of COVID-19 o...

Detection of antibodies to determine population exposure

Eurosurveillance 22 Oct 2020 ISARIC4C provided support to this study looking at population exposure in the beginning of the outbreak showing that it is likely that SARS-CoV-2 began circulating in Scotland in late February 2020 and potentially ear...

Developing methods of sequencing the virus

Viruses 14 Oct 2020 Sequencing the viral genome as the outbreak progresses is important, particularly the identification of new variants and to identify whether any changes in the genome will impair clinical testing. Using the MinION/GridIONS pla...

Vulnerability of Down's syndrome (DS) patients to severe COVID-19

EClinical Medicine 22 Feb 2021) Providing data and support to the Trisomy 21 Society, a study was conducted to determine if health conditions, immune dysfunction, and premature aging associated with trisomy 21 (Down syndrome, DS) may impact the c...

ISARIC4C within the global ISARIC-network

An alternate weekly data share is made with global ISARIC CCP partners in 42 countries and a summary report is posted on medRxiv, the global health network (TGHN.org) and WHO. CO-CIN has contributed 82% of global data reported. Selected publicati...

Modelling the association of tiered restrictions with COVID-19 deaths and hospital admissions

Lancet Infectious Diseases 23 Dec 2020 To look at the impact of tiered restrictions, the team fitted a mathematical model of transmission to data on hospital admissions. Results showed that lockdown measures outperformed less stringent restrictio...

Multi-model forecasts to inform the response to COVID-19 in the UK

MedRxiv pre-print 4 Dec 2020 Groups of multi-model forecasts can inform the policy response to the Covid-19 pandemic by assessing future resource needs and expected population impact of morbidity and mortality.

Testing the tests

MedRxiv May 2020 We proposed and established a Diagnostic Evaluation Platform at the University of Oxford (led by Dr Alex Mentzer) which is already being used to provide evidence to the UK government about the performance of new diagnostic and an...

Outcomes of COVID-19 hospitalisation among patients with HIV

Clinical Infectious Diseases 23 Oct 2020 Providing data and support to the British HIV Association, presentation characteristics and outcomes of adults with and without HIV who were hospitalized with COVID-19 at 207 centers across the UK, were co...

Outcomes of hospitalised COVID-19 patients with interstitial lung disease

American Journal of Respiratory and Critical Care 15 Dec 2020 We completed an international multicentre audit of patients with prior diagnosis of Interstitial Lung Diseases (ILD) admitted to hospital with COVID-19. We showed that these patients a...

Pulmonary Microthrombosis and Vasculitis in Life-Threatening Respiratory Virus Diseases

Open Forum Infectious Diseases 28 Dec 2020 This study, with support and resources provided by ISARIC4C, found evidence of thrombosis present in adults with fatal influenza and SARS, with vasculitis also reported.

Symptom clusters

MedRxiv August 16th 2020. Because of the large scale of the ISARIC-4C study, we were able to detect robust groupings of patients with different patterns of symptoms. We found four patterns that are strikingly differnet from the core symptom gro...

Using imaging in COVID-19 -- UK National COVID-19 Chest Imaging Database

European Respiratory Journal 13 Aug 2020 The National COVID-19 Chest Imaging Database (NCCID) is a repository of chest radiographs, CT and MRI images and clinical data from COVID-19 patients across the UK, to support research and development of A...

Viral RNA found in blood is not infectious

Wellcome Open Research 29 Jul 2020 Laboratory diagnosis of SARS-CoV-2 infection uses PCR to detect viral RNA (vRNA) in respiratory samples. While SARS-CoV-2 RNA has been detected in other sample types, there is very little understanding about its...

Remdesivir Statistical Analysis Plan

The Remdesivir Statistical Analysis Plan was approved on 16 December 2020.