10 things to know about Covid-19 research

To help you find your way through the vast and ever changing situation on research and evidence in relation to COVID-19 the NECS (NHS North of England Commissioning Support Unit) have developed this special bulletin. If there is anything else you need to know please contact necsu.reteam@nhs.net

1.  GLOBALLY, RESEARCH HAS BEEN QUICK TO RESPOND TO COVID-19

Just days after the virus was first identified in January, the genome was published by Chinese researchers. More than 50 research papers had been published on COVID-19 by the end of January, rising to over 1,000 per week by April.

A database of publications on COVID-19 is updated daily by the World Health Organisation, a list of COVID-19 trials is available to download from the International Clinical Trials Registry Platform and the majority of journals have made papers related to COVID-19 free to access.

In the UK, the Health Research Authority are publishing details about all approved COVID-19 research studies within three days of approval and the National Institute for Health Research have published a list of nationally prioritised studies.

2.  THE QUALITY OF RESEARCH PAPERS IS BEING RAPIDLY ASSESSED

Concise evidence synthesis for COVID-19 related questions are available from The Oxford COVID-19 Evidence Service (Centre for Evidence-Based Medicine).

A collective of European Cochrane researchers are carrying out live mapping and meta-analysis of COVID-19 studies, updated daily with studies, their outcomes and risk of bias. All investigators of RCTs are encouraged to contact the team as soon as results are available.

You can also do your bit as a citizen scientist by taking part in a Cochrane Crowd for COVID-19 research - an online event where you can contribute anywhere from 10 minutes to 3 hours participating in a set challenge, such as screening studies for review.

3. RESEARCHERS ARE USING TWITTER TO COMMUNICATE THEIR FINDINGS

Twitter is useful for keeping up to date with the latest research – but as always, whether or not you get useful and reliable information depends on who you follow.

Remember:
Look at the credentials of the person tweeting and the evidence behind the tweet. Check whether the research has been published and who has published it - is it a peer reviewed journal? Is it a study or an opinion piece? What are other researchers saying about it?

Research is all about asking questions and identifying gaps. When researchers disagree on Twitter, they are often just doing their job. Being open about limitations and constructive criticism is important, particularly where new evidence is being put into practice quickly.

If you don’t know who to follow, start with one or two reputable organisations, journals or individuals. See who they follow, retweet or are in conversation with. Here are some good places to start* @NHSRDForum, @NIHRresearch, @HRA_Latest, @NIHRCRN_NENCumb , @TheLancet, @bmj_latest, @BJGPjournal, @CMO_England, @trishgreenhalgh, @jburnmurdoch, @AdamJKucharski

*Views represented on these accounts do not represent NECS and may not necessarily represent the organisations individuals work for.

4.  NEW EVIDENCE-BASED GUIDANCE IS BEING PRODUCED AND UPDATED QUICKLY

Researchers and policy makers are rising to the challenge of writing evidence- based guidance at pace. There are still gaps in our knowledge about COVID- 19, meaning guidance is being updated to reflect new questions and emerging evidence.

NICE have a COVID-19 summary page including links to a dashboard of relevant NICE guidance (available and forthcoming) and clinical knowledge summaries.

Many organisations and journals have created COVID-19 evidence libraries or hubs to help find the best evidence available for practice – including Public Health England, the British Medical Journal Best Practice, the Lancet and Evidence Aid.

The Royal College of GPs COVID-19 Resource Hub is updated daily with the latest developments and guidance for primary care. Recent updates include guidance on how to carry out remote consultations in primary care.

5.  COVID-19 RESEARCH HAS BEEN PRIORITISED

All studies supported through the National Institute of Health Research (NIHR) Clinical Research Network have been paused to focus on COVID-19. There is a national process for prioritising COVID-19 research - studies can apply to be nationally supported or funded as high priority (a range of other funding opportunities are also available). All COVID-19 Urgent Public Health Research is listed on the NIHR website.

The Health Research Authority has published guidance about COVID-19 for researchers, and COVID-19 studies submitted for fast track review are currently being approved in as little as 24 to 72 hours.

6. PRIMARY CARE IS AN AREA FOR PRIORITY RESEARCH

The highest priority study gathering data on management of COVID-19 in primary care is currently PRINCIPLE (Platform Randomised trial of Interventions against COVID-19 In older people). This trial aims to help evaluate potential

treatments for COVID-19 infection in older people. The study is open to expressions of interest from General Practices able to help recruit participants. More information is available here, or from the North East & North Cumbria Clinical Research Network - hilary.allan@nihr.ac.uk /emma.murray@nihr.ac.uk 

Another nationally prioritised study is FLU-CATs: Evaluation and refinement of pandemic influenza community assessment tools. This analysis aims to link criteria in a GP's assessment of patients presenting with influenza-like illness to immediate management decisions and patient outcomes. It will cumulatively analyse data recorded on the Clinical Practice Research Datalink (CPRD), to assess, refine and validate triage tools.

GP practices using EMISWeb are also being encouraged to switch on QResearch record linkage to support research by the Nuffield Departments of Clinical Neurosciences & Primary Care Health Sciences looking at the effect of commonly used medicines on COVID-19 patient outcomes.

7. EVERYBODY IS SHARING COVID-19 INFORMATION

Anyone who has seen how research can be distorted or reduced to a few lines will understand that misinformation can spread online fast - while some COVID -19 related stories may seem harmless, others can be dangerous

It’s important to use the SHARE checklist before you like, comment, or share content online, and to check information against the most relevant official guidance available - for example, the Government, the NHS and the World Health Organisation.

To support with interpreting the evidence, UK Research and Innovation have launched Coronavirus: the science explained, giving information about the virus, the disease, the epidemic, and its control in a series of short articles.

The independent fact-checking organisation Full Fact already have several pages dedicated to checking claims made in the news and on social media about COVID-19. They respond to queries about new stories and have produced a guide to checking information yourself.

8. EVERYONE CAN PLAY A PART IN CONTRIBUTING TO COVID-19 RESEARCH

The COVID-19 Symptom Tracker app, designed by King's College London, Guys and St Thomas’ Hospitals is now being used by over 2 million people. 

Everybody who can is encouraged to use the app daily, whether you feel unwell or not. The data will help researchers to identify high-risk areas in the UK, who is most at risk and how fast the virus is spreading.  

The app is already regularly sharing findings on Twitter @Join_Zoe – some of the latest data analysis suggests that while fatigue is the most common symptom, losing your sense of taste and smell may be the best way to tell whether you have COVID-19.

9. DIFFERENT TYPES OF RESEARCH ARE NEEDED TO BUILD A FULL PICTURE

To get a thorough understanding of new infectious disease outbreaks such as COVID-19, research needs to study many different aspects of the disease, including: 

• the structure and origin of the virus, how the virus spreads  
• the physiological processes that occur in the body as a result of infection
• the effectiveness of different treatments for the virus
• the development of new treatments, such as a vaccine
• factors associated with immunity
• analysis and evaluation of policies and strategies implemented by  governments and health systems

 An evidence scoping review by the European Centre for Disease Prevention and Control reflects that in  new infectious disease outbreaks, scientific uncertainty is expected which makes evidence        -driven  decision-making difficult. To help with decision making it advises:

• Improving scientific or political knowledge (what you know least about)
• Building collaborative relationships
• Building trust and promoting transparency
• Deciding in advance when and how to judge feasibility

10. RESEARCH HAS NOT FORGOTTEN ABOUT MENTAL HEALTH

Research projects are already trying to understand the impact COVID-19 is having on mental as well as physical health – and there will be more to come.

University College London have begun recruiting participants to the COVID19 Social Study. Adults in the UK are asked to fill out a weekly 10-15 minute questionnaire about their psychological and social experiences during the period of the pandemic, to help understand the effects of social distancing
on mental health. Find out more about taking part here.

The University of Oxford have begun recruiting families to the Co-SPACE study. Parents & carers of young people in school years 0-11 are asked to fill out regular surveys about how their family is coping during the pandemic, to help understand what parents can do to help support their children’s mental health. Find out more about taking part here.

You can download the orginal NECS bulletin from here