The UK Research and Innovation (UKRI) and the National Institute for Health Research (NIHR) will give ￡8.4 million in funding to three new UK-wide studies aiming to understand the immune response to the novel SARS-CoV-2 coronavirus. It is hoped the studies will improve the treatment of COVID-19 patients and inform the development of vaccines and therapies.

The studies will bring together scientists from 17 research institutions with the intent to develop better tests to define immunity, to study the immune response to SARS-CoV-2 and to understand why some people suffer from severe life-threatening COVID-19 while others have mild or asymptomatic infections but can still transmit the virus. Perhaps most vital, these studies will also determine when and how immunity persists or whether people can become re-infected.

UK-CIC

The UK Coronavirus Immunology Consortium (UK-CIC) will receive ￡6.5 million to investigate key questions such as:

• How long does immunity from COVID-19 last?

• Why are some people’s immune systems better able to fight off the virus?

• Why do some people’s immune responses cause damage, especially to the lungs?

• How does the virus evade the immune system and how can this be tackled?

• Does immunity to previous infection with seasonal coronaviruses (which cause the common cold) alter a person’s outcome with SARS-CoV-2?

It is thought that a better understanding, particularly of the T cell response, could provide novel targets for therapies and inform the efforts to develop a vaccine.

The project will use samples and data from major UK COVID-19 projects already underway, including ISARIC-4C (characterising and following more than 75,000 hospitalised patients with COVID-19) and the genomic studies COG-UK (sequencing the SARS-CoV-2 virus genomes) and GenOMICC (sequencing the genomes of people with COVID-19).

The consortium is led by Professor Paul Moss at the University of Birmingham, who said: “Understanding the complexities of the immune response to SARS-CoV-2 is key to successfully developing new diagnostics, treatments and vaccines against COVID-19. The UK Coronavirus Immunology Consortium will see the UK immunology community come together in an unprecedented way to answer questions that are crucial in helping us control this pandemic, such as how effective immunity is developed and why individuals respond differently to the disease.”

HICC consortium

The Humoral Immune Correlates of COVID-19 (HICC) consortium will receive ￡1.5 million to study the humoral immune response by focusing on two cohorts: NHS workers (tracking immunity over 12 months) and hospitalised patients.

The study will take a deep dive into the role of antibodies in immunity to SARS-CoV-2 and characterise the antibody response in people who have mild or asymptomatic SARS-CoV-2 infection versus those who develop moderate or severe COVID-19 disease. The researchers want to better understand the differences between beneficial (protective) antibody responses and those that cause disease. The results from the study will help to develop better tests to diagnose protective immunity as well as determine how long protective antibodies persist after exposure to the virus. As well as potentially informing treatment courses for different severities of disease.

The consortium is a collaboration led by Professor Wilhelm Schwaeble and Professor Jonathan Heeney at the University of Cambridge, and Dr Helen Baxendale at Royal Papworth Hospital NHS Foundation Trust who said: “Understanding the role of antibody responses to SARS-CoV-2, and the role that the overactivation of the immediate innate immune response to the virus plays through complement activation in the initiation and maintenance of inflammatory disease, is critical to improve the clinical management of life-threatening cases of COVID-19.”

 “In critical care, we know most patients have high levels of antibody to SARS-CoV-2 however what we don’t know is whether these antibodies are helpful. Pilot data has shown that many of our NHS staff have been exposed to SARS-CoV-2, but we need to find out whether this means they are protected from further infection either in the short or the long term, or may be at risk of disease in the future. Understanding the different types of antibody responses will allow us to determine beneficial antibodies from dangerous ones.”

ICECAP

The third study will specifically focus on the key features of fatal COVID-19 and the impact the virus has upon the lungs and other vital organs. The project, titled ‘Inflammation in Covid-19: Exploration of Critical Aspects of Pathogenesis’ (ICECAP) will receive ￡394,000.

During authorised hospital post-mortem examinations of patients who have died from COVID-19, expert clinicians and scientists will collect and analyse tissue to accumulate crucial information on the presence of COVID-19 in multiple organs across the body and gain a more in-depth understanding of how the body’s immune system is responding to the virus.

The study is led by Dr Christopher Lucas at the University of Edinburgh, who said: “We have learned so much from Covid-19 patients during the past six months. However, there is only so much that we can learn from clinical examinations and blood tests. By having a deeper look at those who have died from COVID-19 through post-mortem examination, we will increase our understanding of what is happening to the body in the most severe cases of this disease. Critically, this will allow us to rapidly answer key clinical questions and help inform the care of patients and the development of new treatments.”