The NIHR Health Protection Research Unit in Emerging and Zoonotic Infections at Liverpool and the Centre of Excellence in Infectious Diseases Research (CEIDR) led by Professor Tom Solomon and Professor William Hope , respectively are working together to deliver an ambitious and innovative program of work. CEIDR is a joint initiative between the University of Liverpool (UoL) and the Liverpool School of Tropical Medicine (LSTM). Other key partners are the Liverpool City Council and the Malawi-Liverpool Wellcome Clinical Research Programme.

 

COVID-19 Research Themes

Liverpool (University of Liverpool (UoL), Liverpool School of Tropical Medicine (LSTM) and the NHS all joined by Liverpool Health Partners) has united to redirect the majority of its research efforts to COVID-19.  Research programs designed to have immediate benefits for public health.  This programme is supported by approximately £1 million in pump priming from the University of Liverpool and The Liverpool School of Tropical Medicine and the efforts of >200 researchers, underpinned by equipment and laboratory space across the Liverpool City Region. 

The #Liverpool_Malawai_COVID19 research effort consists of:

Clinical Characterisation and Biobanking
Diagnostics
Drug Discovery
Viral Dynamics and Protective Immunity
Pathogen Biology
Epidemiology and Public Health Informatics
Therapeutics, Early Phase Clinical Trials and Pharmacokinetics-Pharmacodynamics
Vaccines
Knowledge Mobilisation, Public and Community Involvement

Latest COVID-19 News

Andrea Collins of HPRU EZI on BBC Radio Merseyside
Due to the expertise of LSTM’s Respiratory Clinical Research Group, and working in collaboration with the National Institute of Health Research, the Liverpool University Hospitals NHS Foundation Trust and the Well-Travelled Clinic, LSTM has been selected as one of the UK sites for Phase III of the University of Oxford’s COVID-19 vaccine clinical trial.

Posted on: 22/05/2020

The COVID Hot Potato 5
This week: General practitioners (GPs) describe the challenge of managing patient referrals to hospital services after the initial suspension of non-urgent and routine referrals during the peak of COVID-19. Despite NHS England guidance advising that referrals should resume, ongoing difficulties and inability to refer patients has produced extra work, and challenges in identifying who is responsible for patients’ care.

Posted on: 21/05/2020

The COVID Hot Potato 4
This week: Healthcare professionals reflect on health system resilience, with those in Scotland talking about how relationship-building within and between community and hospital teams has been important in responding well to COVID-19.

Posted on: 14/05/2020

Previous News Items

COVID-19 Projects

ISARIC-4C Study

CO-CIN

Prof Calum Semple, member of the HPRU and the ISARIC-4C consortium, is analysing and reporting clinical characteristics of patients admitted to hospital with SARS-CoV-2 infection in near real-time to the COVID-19 Clinical Information Network (CO-CIN). CO-CIN informs the Department of Health and Social Care (DHSC) on a weekly basis about the clinical evolution of disease in the United Kingdom. To achieve this, clinical research nurses and administrators gather anonymised data from clinical notes and enter it into a simple online database. This allows to characterise the patients’ clinical features as well as risk factors associated with severity, risk of hospitalisation and death. The information gathered is essential to help health service planning and provision, and to rapidly evaluate the impact of interventions such as new therapeutics or vaccines. The first summary report is available here.

Prof Calum Semple is leading an International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) - Clinical Characterisation Protocol UK (CCP-UK), a nationwide observational study that is intended to activate in the event of the appearance or outbreak of a disease of public health importance. Calum’s Medical Research Council-funded CCP-UK study, with additional support from the NIHR Health Protection Research Unit in Emerging and Zoonotic Infections at Liverpool, is collecting clinical data and biological samples to describe and characterise COVID-19 disease, inform management, and to act as a platform for clinical trials into new treatments. Samples from patients have been shared with co-applicants at Liverpool, Glasgow, Bristol and Public Health England (PHE).

Dr Lance Turtle is receiving CCP-UK acute blood samples which will be used for flow cytometry to investigate the role of cellular immunity in COVID-19 disease. Turtle also collects convalescent samples from recovered patients and contribute to an epitope mapping project with colleagues in Sheffield and Oxford.

Prof Julian Hiscox is developing rapid approaches for sequencing SARS-CoV-2 in samples from patients as well as validating animal models for vaccine development and medical countermeasures. With Profs Al Darby and Steve Patterson in the Centre for Genomic Research (CGR) at the University of Liverpool, his laboratory are part of a PHE funded collaboration to provide virus sequencing for transmission studies in real time. His team are also working on samples from the CCP-UK study.

See update here

Understanding the dynamics of policy development and healthcare worker behaviour in the UK during the COVID-19 public health emergency

In an infectious disease outbreak public health policymakers are under tremendous pressure, especially from the media. They must respond rapidly to and take decisions which impact enormously on healthcare provision.

Prof Sally Sheard and colleagues are studying conventional and social media trends during the COVID-19 epidemic, and are linking these to changes in UK policy, gaining unique insights through collaboration with key policy players. These include members of the Strategic Advisory Group of Experts (SAGE) that advises the Government, and Public Health England leaders. These experts are recording information on key meetings and events, and giving regular interviews their perspectives can be captured in real-time.

Sheard's team also examines the impact of the policy changes on healthcare workers in general practice and hospitals, through interviews and observations. Healthcare workers' perspective on delivering care during the epidemic, and how they perceive the changes in policy is fed back to policymakers during the outbreak. The approach is novel because policy decisions are usually only studied after an event, making the findings less reliable.

This research was piloted with pump-prime funding from the NIHR Health Protection Research Unit in Emerging and Zoonotic Infections at Liverpool, and has been scaled up with support from the Medical Research Council.

Dr Emily Adams, Senior Lecturer in Diagnostics for Infectious Disease, at LSTM has begun the validation process for the Mologic COVID-19 point-of-need diagnostic test:

  • Independent assessment and validation of COVID-19 diagnostic test has been initiated at LSTM by Dr Adams and her research group, along with colleagues at St George's University London
  • Prototypes will be sent to world-leading labs in the UK, Senegal, Spain, China, Malaysia and Brazil for priority validation
  • COVID-19 tests will be jointly manufactured in the UK at Mologic and in Senegal at Institut Pasteur de Dakar for the first time
  • Dr Adams said: “These tests could be a game-changer for diagnosis and follow-up of patients both in hospital and in the community, allowing us to detect cases early and isolate patients and their families rapidly.”

Emily commented: “We are extremely pleased to be working alongside Mologic and diaTROPiX on the evaluation and validation of rapid diagnostic tests for COVID-19. These tests could be a game changer for diagnosis and follow-up of patients both in hospital and in the community, allowing us to detect cases early and isolate patients and their families rapidly. Of course in low-resource settings, where we are starting to see cases, these are the only tests that are appropriate for use. We need to manufacture and deliver as soon as we possibly can”  Read more here

Funding has been awarded to 22 projects across the Liverpool School of Tropical Medicine (LSTM) and the University of Liverpool (UoL) in response to COVID-19, working with the NHS and industry partners.

Each project and lead is outlined below:        

  

Project

  
  

Lead

  
  

Institute

  

Liverpool Household   COVID-19 Cohort Study

Professor Neil   French

UoL

Provide underpinning   virus and host biology for the Liverpool Malawi COVID-19 consortium and   investigate whether some strains of SARS-CoV-2 are more virulent than others

Professor   Julian Hiscox

UoL

Point-of-care   diagnostics for community settings in COVID-LIV

Dr Emily Adams

LSTM

SARS-CoV-2   Acquisition in Frontline Health Care Workers – Evaluation to Inform Response   (SAFER)

Dr Naomi Walker

LSTM

Natural history of   immunity to SARS-CoV-2

Dr Lance   Turtle

UoL

COVID-PREP (Pregnancy   Testing Pilot)

Professor   Louise Kenny

UoL

Drug Candidate   Selection of an Improved 4-Amino Quinoline for Clinical Trials against   COVID-19

Professor   Giancarlo Biagini

LSTM

Dose selection of   therapeutics targeting COVID-19 using the hollow fibre infection model

Dr Shampa Das

UoL

COVID-19 in pregnant   women, neonates and children presenting to QECH, Malawi – an in-depth study   using ISARIC protocol

Dr Samantha Lissauer

UoL

Liver-POOL together

Professor Luis   Cuevas

LSTM

Developing GCP assays   for experimental COVID therapies and preclinical proof-of-concept studies -   requested

Professor Saye   Khoo and Professor   Andrew Owen

UoL

Establishment of in   vitro SARS-CoV-2 drug screening platforms

Professor   Giancarlo Biagini

LSTM

The role of ACE2R   expression in protecting children from severe acute respiratory syndrome in   COVID-19 disease, and severe susceptibility in adults

Professor Paul   McNamara

UoL

COVID-LIV Cohort   Study: The Psychological and social impact of COVID-19

Professor Kate   Bennett and Professor   Rhiannon Corcoran

UoL

Modelling the impact   of weather on SARS-CoV-2 transmission risk

Professor   Matthew Baylis

UoL

Area D: Distortion of   Health and Social Care Systems

Professor   Sally Theobald

LSTM

Social Science Area   F: Generating actionable evidence for containing the spread of misinformation

Dr Mark Green

UoL

Biomarkers in   Respiratory Immunology

Dr Andrea   Collins

LSTM

Responding to the   COVID-19 economic (after)shocks: Developing learning and resources to   strengthen the resilience of the Liverpool City Region economy

Professor Mark   Boyle

UoL

Area B: Understanding   choice, control and risk in public and community responses to the COVID-19   epidemic across the health divide to inform public health strategies in UK   and Malawi

Dr Nicola   Desmond and Professor Mark   Gabbay

LSTM, UoL

Using Tweets to Fight   COVID-19

Professor   Simon Maskell

UoL

The impact of   COVID-19 on the mental health of young adolescents in the UK

Professor   Helen Sharp

UoL

 

 

 

 

 

 

 

 

 

Latest COVID-19 Publications

Amplicon based MinION sequencing of SARS-CoV-2 and metagenomic characterisation of nasopharyngeal swabs from patients with COVID-19

Shona C Moore, Rebekah Penrice-Randal, Muhannad Alruwaili, Xiaofeng Dong, Steven T Pullan, Daniel Carter, Kevin Bewley, Qin Zhao, Yani Sun, Catherine Hartley, En-min Zhou, Tom Solomon, Michael B. J. Beadsworth, James Cruise, Debby Bogaert, Derrick W T Crook, David A Matthews, Andrew D. Davidson, Zana Mahmood, Waleed Aljabr, Julian Druce, Richard T Vipond, Lisa Ng, Laurent Renia, Peter Openshaw, J Kenneth Baillie, Miles W Carroll, Calum Semple, Lance Turtle, Julian Alexander Hiscox.

doi: https://doi.org/10.1101/2020.03.05.20032011

 

BMJ Best Practice monograph: COVID-19

Nick Beeching, Tom Fletcher, Robert Fowler.

Characterisation of the transcriptome and proteome of SARS-CoV-2 using direct RNA sequencing and tandem mass spectrometry reveals evidence for a cell passage induced in-frame deletion in the spike glycoprotein that removes the furin-like cleavage site 

Andrew D.Davidson, Maia KavanaghWilliamson, SebastianLewis, DeborahShoemark, Miles W.Carroll, KateHeesom, MariaZambon, JoannaEllis, Phillip A.Lewis, Julian A.Hiscox, David A.Matthews