COVID-19 is the UK’s largest public health crisis since World War II. There is an urgent need to identify why some patients with the virus do very well whereas others need to be admitted to intensive care and may die from the disease. A new observational study aimed at identifying markers that predict how COVID-19 affects patients is being led by clinicians and academics at North Bristol NHS Trust and the University of Bristol.
The DISCOVER (DIagnostic and Severity markers of COVID-19 to Enable Rapid triage) study is focused on blood-based biomarkers and their ability to predict a patient’s disease course alongside demographic factors such as age, sex, frailty and other medical conditions.
When patients with suspected or confirmed COVID-19 are admitted to hospital, they will be approached by the research team and consented for blood sampling and access to their medical history. These patients will then be followed up for 28 days, remotely, and their clinical progress recorded. Blood samples from the study will be stored anonymously for future research.
One biomarker the research team will test is suPAR (soluble urokinase plasminogen activating receptor), which has already had encouraging results from Greek data, alongside other more conventional tests, such as troponin, NT-proBNP and ferritin. The team will also test a variety of molecules that control the immune system, known as “cytokines”. This is very important as, although the majority of patients with COVID-19 recover quickly, at the present time doctors do not yet know the best way to predict which patients to keep in hospital to monitor more closely. This early triage of patients is crucial to manage the pressure on hospital beds safely.
Dr David Arnold at North Bristol NHS Trust and NIHR Doctoral Research Fellow in the Bristol Medical School: (THS), said: “We hope to rapidly publish this work and share our results with other UK and international centres to allow wider use of successful prognostic biomarkers. Our study could help doctors in the future decide which tests are useful in managing coronavirus and which are not.”
Dr Fergus Hamilton, Honorary Research Fellow in the Bristol Medical School: (PHS), added: “One of the key strengths of DISCOVER is that despite the rapid speed of application, ethical approval, and data collection, plans were made early to collaborate with both local and national researchers to ensure that any samples or data collected will be available to ensure the benefit to the wider research community, and ultimately, to patients. We have developed many collaborations over a short period, including with the UNCOVER group and Public Health England.”
- Development and testing of antibody testing (or ‘immunity passports’);
- Developing techniques to measure drug levels for potential treatments for COVID-19;
- Finding ways to measure live virus in blood (with one of only two labs in the UK authorized to work with SARS-CoV-2);
- Understanding the ‘microbiome’ of COVID-19 patients in the intensive care unit;
- Measurement of whether patients with cancer have a different immune response to COVID-19;
- Testing whether patients’ genes (or how they are activated) affects response to COVID-19.
Patients admitted to University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) will shortly join the North Bristol NHS Trust led study, with hospitals in Exeter and Gloucester entering in the coming weeks.
This North Bristol NHS Trust led study will be working with the Trust’s charity, Southmead Hospital Charity, to support DISCOVER. Additionally this ground-breaking research project has also received funding from the University’s Elizabeth Blackwell Institute.
If you are interested in donating to help fund DISCOVER and provide further ground-breaking research into COVID-19, please contact Southmead Hospital Charity to find out more.
Support our COVID-19 research
Bristol’s researchers are part of a global network of scientists responding urgently to the challenge of the coronavirus pandemic.
About the Bristol UNCOVER group
In response to the COVID-19 crisis, researchers at the University of Bristol formed the Bristol COVID Emergency Research (UNCOVER) Group to pool resources, capacities, and research efforts to combat this infection.
Bristol UNCOVER includes clinicians, immunologists, virologists, synthetic biologists, aerosol scientists, epidemiologists and mathematical modellers and has links to behavioural and social scientists, ethicists and lawyers and is supported by a large number of junior academic and administrative colleagues.
Follow Bristol UNCOVER on Twitter at: https://twitter.com/BristolUncover
Elizabeth Blackwell Institute (EBI) supports Bristol UNCOVER, which is led by Professor Adam Finn, and includes a number of researchers who have received grants from the EBI COVID-19 funding call.
For more information about the University of Bristol’s coronavirus (COVID-19) research priorities visit: www.bristol.ac.uk/research/impact/coronavirus/research-priorities/
About Southmead Hospital Charity
Southmead Hospital Charity funds ground-breaking medical research; provides specialist equipment at the cutting-edge of technology and improves treatment facilities for generations to come. It raises money to support the work of North Bristol NHS Trust at Southmead Hospital, Cossham Hospital and community health services in the Bristol, South Gloucestershire and North Somerset areas.
About Elizabeth Blackwell Institute
Nurturing research. Improving health.
The Elizabeth Blackwell Institute drives innovation in research to improve health for all. It nurtures interdisciplinary research to address the complex health challenges facing us today.
The institute focuses on:
- Supporting the next generation of health researchers
- Connecting people to develop interdisciplinary research
- Including everyone in research so the research can benefit all.
As well as supporting research with funding the Elizabeth Blackwell Institute is also helping to connect research up across the University as a whole, so that people working on COVID-19 have the chance to work together, sharing resources and expertise. This aligns with the work that the Institute already supports to galvanise research across disciplines and groups, through research networks and thematic strands, ranging from Infection and Immunity to Medical Humanities.
University of Bristol