Official Title
COVID-19: Healthcare Worker Bioresource: Immune Protection and Pathogenesis in SARS-CoV-2
Brief Summary

Modelling repurposed from pandemic influenza is currently informing all strategies for SARS-CoV-2 and the disease COVID-19. A customized disease specific understanding will be important to understand subsequent disease waves, vaccine development and therapeutics. For this reason, ISARIC (the International Severe Acute Respiratory and Emerging Infection Consortium) was set up in advance. This focuses on hospitalised and convalescent serum samples to understand severe illness and associated immune response. However, many subjects are seroconverting with mild or even subclinical disease. Information is needed about subclinical infection, the significance of baseline immune status and the earliest immune changes that may occur in mild disease to compare with those of SARS-CoV-2. There is also a need to understand the vulnerability and response to COVID-19 of the NHS workforce of healthcare workers (HCWs). HCW present a cohort with likely higher exposure and seroconversion rates than the general population, but who can be followed up with potential for serial testing enabling an insight into early disease and markers of risk for disease severity. We have set up "COVID-19: Healthcare worker Bioresource: Immune Protection and Pathogenesis in SARS-CoV-2". This urgent fieldwork aims to secure significant (n=400) sampling of healthcare workers (demographics, swabs, blood sampling) at baseline, and weekly whilst they are well and attending work, with acute sampling (if hospitalised, via ISARIC, if their admission hospital is part of the ISARIC network) and convalescent samples post illness. These will be used to address specific questions around the impact of baseline immune function, the earliest immune responses to infection, and the biology of those who get non-hospitalized disease for local research and as a national resource. The proposal links directly with other ongoing ISARIC and community COVID projects sampling in children and the older age population. Reasonable estimates suggest the usable window for baseline sampling of NHS HCW is closing fast (e.g. baseline sampling within 3 weeks).

Detailed Description

The proposed study is a prospective observational cohort design which will be carried out
across three different trusts: Barts Health NHS Trust (St Bartholomew's Hospital, The Royal
London Hospital, Whipps Cross Hospital and Newham Hospital), Royal Free London NHS Foundation
Trust (Royal Free Hospital) and University College London Hospitals NHS Foundation Trust
(UCLH).

Participants will be asymptomatic front-facing HCWs who carry out their tasks in different
areas of the corresponding hospital: Accident and Emergency, Adult Medical Admissions Unit,
Medical and Surgical Wards and Intensive Care Units.

This study substantially uses existing infrastructure: Recruits into this study who are
subsequently suspected to have COVID-19 can be co-recruited into ISARIC using ISARIC Ethics
Ref: 13/SC/0149 (Oxford C Research Ethics Committee, UK CRN /CPMS ID 14152 IRAS ID126600 for
acute samples and data collection. Sampling can be delivered via existing research personnel
from furloughed projects (CLRN nurses, research fellows, Barts Bioresource). Convalescent
sampling will be via an otherwise inactive Clinical Trials unit. It

Recruiting
Health Care Worker Patient Transmission
Coronavirus
Coronavirus Infections
Immunological Abnormality

Diagnostic Test: COPAN swabbing and blood sample collection

COPAN swabbing of nostrils and/or oropharynx and blood sample collection

Eligibility Criteria

Inclusion Criteria:

- Age at least 18 years AND

- Asymptomatic (meaning healthy enough to attend work according to Trust policy at the
time) AND

- Work in the designated clinical environments for at least 5 hours for at least one day
during the study period.

Participants will be free to withdraw from the study at any point, but collection of these
data is considered to be in the public interest and will fall under the scope of a 'Public
task' by the GDPR definition. Under these conditions rights to erasure and data portability
do not apply, and archiving and further processing for scientific research purposes is
compatible with the original purpose; no further participant data from medical records will
be collected.

The research team may withdraw a participant from the study in the following situations:

- No longer meets the inclusion/exclusion criteria if participants circumstance change

Eligibility Gender
All
Eligibility Age
Minimum: 18 Years ~ Maximum: N/A
Countries
United Kingdom
Locations

Barts Heart Center
London, United Kingdom

Royal Free London NHS Foundation Trust
London, United Kingdom

Contacts

James C Moon, MD MBBS MRCP
07570911438
bartshealth.covid-hcw@nhs.net

Mahdad Noursadeghi

University College, London
NCT Number
MeSH Terms
Coronavirus Infections