There is now increasing medical evidence and patient testimony showing that a small but significant minority of people who contract and survive COVID-19 report chronic symptoms ranging from breathlessness, chronic fatigue, ‘brain fog’, anxiety and stress for months after initially falling ill.
Read more about this evidence:
These ongoing problems, commonly termed ‘long COVID’, may be experienced by patients regardless of how severe their COVID-19 infection was and irrespective of whether they were hospitalised.
NHS England has recently launched a plan to support long COVID patients in the community.
The Department of Health and Social Care (DHSC), through the NIHR, and UKRI are jointly funding major studies to characterise acute and longer-term disease in hospitalised patients.
The NIHR and UKRI are now launching a UK-wide further joint research call of up to £20 million to fund ambitious and comprehensive research into understanding, mitigating and addressing the longer term, physical and mental health effects, of COVID-19 in non-hospitalised individuals.
Projects are expected to start early in the new year and may be funded for up to three years in the first instance.
The call specification draws on several recent publications as referenced above and following advice from a specially convened external expert group.
Proposals are invited which address the causes (biological and environmental), mechanisms and management of the longer term physical and mental health effects of COVID-19 infection as well as reducing health inequalities in non-hospitalised individuals.
In addition, proposals may wish to draw upon the learnings from other conditions or syndromes that might have some similar symptoms encountered by long COVID (for example, stroke, multiple sclerosis, chronic fatigue syndrome or myalgic encephalomyelitis, and post-traumatic stress disorder) and their management.
However, gaining a greater insight into the sequalae, their pathogenesis or management of long COVID must remain the primary objective.
While the scope of the funding call is on the longer term biological and health impacts of COVID-19, proposals may also wish to capture or consider societal factors and demographic characteristics that influence these outcomes, and any downstream social and economic effects (for example, returning to work, impacts on carers).
Example areas that the research may address include but are not limited to:
- determining whether long COVID is a distinct syndrome or a set of syndromes
- identifying whether an identifiable subgroup of symptoms exists
- determining the prevalence of long COVID
- understanding factors that increase or diminish the risk of long COVID, this might include viral titre, age, gender, ethnicity, socioeconomic status or comorbidities
- comparison with other cohorts, for example, seasonal influenza
- understanding the trajectory and how people experience long COVID over time including any biological, social or ecological interactions that impact on the severity of symptoms
- determining the pathogenesis of long COVID
- developing and assessing the effectiveness of approaches to reduce the risk of long COVID or interventions and therapies to address its impacts
- management of long COVID in primary care and social care settings.
This call is looking to fund two or three ambitious and comprehensive proposals and a small number of study extensions which take a holistic approach through either:
- extending existing studies, platform or population resources, including data linkage activities, with justification for clear added value to these established activities
- establishing new large scale collaborative research programmes, which include other disciplines, cohorts and data sources where possible and appropriate, including those already supported by UKRI or NIHR COVID-19 funding (COVID-19 funded research).
The call is not looking to fund small-scale, standalone projects focusing on discrete areas.
Where possible, research platforms or cohorts should be designed in such a way that they can also support intervention assessment, either as part of original plans or in due course.
Proposals should also consider the lived experiences of those suffering with the effects of COVID-19 and include plans for patient and public involvement.
This should include engagement of participants in the co-production of research questions and their delivery, with consideration of representative participation including from social care, under served and less frequently heard communities.
Please note that the funders recognise that proposed research may be based on preliminary findings or require further partnership or consortium development.
Proposals are recommended to consider adaptive design or consortium development approaches, supported by provision of risk management strategies or milestones to manage research or consortium refinement along the time course.
The funders are however keen to see studies start as soon as possible in the new year in order to include the current wave of COVID-19 infections.
Up to £20 million will be available for this call. The size of grants will vary according to the needs of each proposal but will need to provide a robust case for value for money.
Requested costs for UK-based researchers should be 80% of full economic costs (fEC) and, where relevant, for overseas researchers should be 100% of direct costs only. Funded projects in academia will be subject to standard UKRI terms and conditions for fEC research grants.
In line with NIHR funding policy this call will cover 100% direct costs for SME and NHS trusts across the whole of the UK.
NIHR funding for NHS trusts and SMEs, where they are the lead applicant, will be subject to a research contract which sets out a revenue sharing approach.
Contractual terms for awards provided to UK-based, non-SME commercial entities will be agreed on a case-by-case basis between NIHR and the applicant.
There are no set rules on the split between collaborators, however, as the contracted organisation, the lead applicant will receive funding payments and would be required to distribute to co-applicants or contractors where applicable.
Awards issued to NHS organisations through this initiative will be eligible for research capability funding.