Blog written by Professor Nicolas Timpson, Principal Investigator of the Avon Longitudinal Study of Parents and Children (ALSPAC), and Professor John Wright, Chief Investigator of Born in Bradford (BiB)
One of the great strengths of the UK-CIC is that is brings together scientists from different fields who would normally work together. Biomedical scientists tend to work in laboratories and often struggle to translate the solutions that they develop out into communities. Epidemiologists tend to work in communities and often struggle to find laboratory solutions for the problems that they identify. The arrival of SARS-CoV-2 and COVID-19 has fundamentally bridged this divide and brought together epidemiologists and biomedical scientists to address the urgent scientific uncertainties of the pandemic.
This is illustrated by two of the community cohorts that are part of the UK-CIC. The Children of the 90s study and Born in Bradford are life course cohorts which started recruitment of participants at (or even before) birth and which have collected data and samples from participants in exquisite detail ever since. They are the medical research equivalent of ‘7 Up’ or ‘Child of our Time’. Our two cohort studies have been set the challenge of finding COVID-19 cases and recruiting them back into the clinic in order to start charting the immunological journey in convalescence (in comparison to suitably chosen control participants). Why would we do this? Well, the cohorts in the UK (of which we are only two of many) offer many assets which can help us immediately enrich the examination of this pandemic – below are just some:
The families in ALSPAC and BiB are closely engaged in research. They have participated in studies for many years and so are ‘research ready’ to respond and provide data to capture important biological and social events. Alongside the UK-CIC effort, cohorts in the UK have been issuing coordinated self-report data sweeps and new serological measures of antibody function to locate and follow-up cases and controls in rapid recruitment exercises.
BEFORE & AFTER
In addition to active and engaged participants, with a growing collection of diagnostic tools for assessing case status, population based studies are able to follow-up participants who have had COVID-19 (cases) and those who have not (controls). We can compare, in detail, how the virus affects their health and their bodies’ immune response over time. Not only are contemporary data available, legacy data over tens of years are available in birth cohorts that can be analysed against new data, in the context of events recorded both before and after the emergence of SARS-CoV2.
Participants in ALSPAC and BiB consent to have their health records linked and tracked. This allows us to identify people who get positive COVID-19 tests in the community and also track how their health changes over the following months and years. Data linkage has historically been a challenge for medical research, but SARS-CoV-2/COVID-19 has really brought forward the agenda on this and the notion of combining record linkage in all with deep data and samples in some to best use cohort data.
Lastly, there is the important opportunity to examine changes (in response to infection, vaccination, mitigation) as we move out of the current conditions and into the next phase of the pandemic. The relevance of infection for outcomes (acute and chronic) and their relationship with predisposing factors, now and in the years to come, can only be examined in prospective studies and it will be important to retain an active working relationship between the basic science of immune response and the measurement of key health and well-being factors in a diverse range of people.
SARS-CoV-2 and COVID-19 have bridged the divide between the basic sciences and population-based health research. The pandemic has enabled urgent and powerful research to take place, in an extraordinary attempt to address one of the biggest threats to society in our lifetimes. It is hugely exciting to consider that participants within the established, long-term, collections involved here are already having their samples collected and are providing the material our immunologists need to assess the long-term immunological consequences of this disease. To contemplate the types of advances this effort might bring, we only need to consider what appears to be a dynamic relationship between symptoms, antibody response, cellular response, and the lifetime health factors and confounders that could affect these relationships. Understanding this relationship could teach us much about just how vital the basic science/population science connection is.
We will be continuing our follow-up of participants within Children of the 90s and Born in Bradford over the next year as part of UK-CIC. Analyses will be continually running, but data and results from these efforts will all be made available through contributing cohorts as per all data and samples in our collections. For any further information, please contact either Nic Timpson (firstname.lastname@example.org) or John Wright (email@example.com).
Nic Timpson (left) and John Wright (right)