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Understanding the burden of interstitial lung disease post-COVID-19: the UK Interstitial Lung Disease-Long COVID Study (UKILD-Long COVID)
  1. Jim M Wild1,
  2. Joanna C Porter2,3,4,
  3. Philip L Molyneaux5,6,
  4. Peter M George5,6,
  5. Iain Stewart5,
  6. Richard James Allen7,
  7. Raminder Aul8,
  8. John Kenneth Baillie9,
  9. Shaney L Barratt10,
  10. Paul Beirne11,
  11. Stephen M Bianchi12,
  12. John F Blaikley13,14,
  13. Jonathan Brooke15,16,17,
  14. Nazia Chaudhuri14,18,
  15. Guilhem Collier1,
  16. Emma K Denneny2,3,4,
  17. Annemarie Docherty19,
  18. Laura Fabbri5,
  19. Michael A Gibbons20,21,
  20. Fergus V Gleeson22,
  21. Bibek Gooptu23,24,
  22. Ian P Hall16,17,
  23. Neil A Hanley14,25,
  24. Melissa Heightman3,
  25. Toby E Hillman3,
  26. Simon R Johnson16,17,
  27. Mark G Jones26,27,
  28. Fasihul Khan16,17,
  29. Rod Lawson12,
  30. Puja Mehta2,28,
  31. Jane A Mitchell5,
  32. Manuela Platé2,29,
  33. Krisnah Poinasamy30,
  34. Jennifer K Quint5,
  35. Pilar Rivera-Ortega18,
  36. Malcolm Semple31,
  37. A John Simpson32,33,
  38. DJF Smith5,6,
  39. Mark Spears34,35,
  40. LIsa G Spencer36,
  41. Stefan C Stanel18,37,
  42. David R Thickett38,39,
  43. A A Roger Thompson1,
  44. Simon LF Walsh5,
  45. Nicholas D Weatherley1,
  46. Mark Everard Weeks5,
  47. Dan G Wootton36,40,
  48. Chris E Brightling24,
  49. Rachel C Chambers2,
  50. Ling-Pei Ho41,42,
  51. Joseph Jacob4,43,
  52. Karen Piper Hanley37,
  53. Louise V Wain7,24 and
  54. R Gisli Jenkins5,6
  1. 1Department of Infection, Immunity and Cardiovascular Disease, The University of Sheffield, Sheffield, UK
  2. 2Centre for Inflammation and Tissue Repair, UCL Respiratory, University College London, London, UK
  3. 3Respiratory Medicine, University College London Hospitals NHS Foundation Trust, London, UK
  4. 4Department of Respiratory Medicine, University College London, London, UK
  5. 5National Heart and Lung Institute, Imperial College London, London, UK
  6. 6Department of Interstitial Lung Disease, Royal Brompton and Harefield Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK
  7. 7Department of Health Sciences, University of Leicester, Leicester, UK
  8. 8Respiratory Medicine, St George's Hospital NHS Foundation Trust, London, UK
  9. 9Roslin Institute, University of Edinburgh, Midlothian, UK
  10. 10Bristol Interstitial Lung Diseases Service, North Bristol NHS Trust, Bristol, UK
  11. 11Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  12. 12Academic Department of Respiratory Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  13. 13Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
  14. 14Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
  15. 15Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
  16. 16NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK
  17. 17School of Medicine, University of Nottingham, Nottingham, UK
  18. 18Respiratory Department, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK
  19. 19Centre for Medical Informatics, The Usher Institute, University of Edinburgh, Edinburgh, UK
  20. 20Respiratory Medicine, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
  21. 21College of Medicine and Health, University of Exeter, Exeter, UK
  22. 22Department of Oncology, University of Oxford, Oxford, UK
  23. 23Department of Molecular and Cell Biology, University of Leicester, Leicester, UK
  24. 24Institute for Lung Health, Leicester NIHR Biomedical Research Centre, University of Leicester, Leicester, UK
  25. 25Wythenshaw Hospital, Manchester University NHS Foundation Trust, Manchester, UK
  26. 26Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
  27. 27Southampton NIHR Biomedical Research Centre, University Hospital Southampton, Southampton, UK
  28. 28School of Life & Medical Sciences, UCL, London, UK
  29. 29UCL Respiratory, UCL, London, UK
  30. 30Head of Research and Innovation Advocacy, Asthma UK, London, UK
  31. 31Child Health, University of Liverpool, Liverpool, UK
  32. 32Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
  33. 33Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  34. 34Respiratory Medicine, Perth Royal Infirmary, NHS Tayside, Perth, UK
  35. 35School of Medicine, University of Dundee, Dundee, UK
  36. 36Respiratory Medicine, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
  37. 37Division of Diabetes, Endocrinology & Gastroenterology, The University of Manchester, Manchester, UK
  38. 38Birmingham Acute Care Research Group, University of Birmingham, Birmingham, UK
  39. 39Acute and Respiratory Medicine, University Hospitals Birmingham Foundation Trust, Birmingham, uk
  40. 40Institute of Infection Veterinary and Ecological Science, University of Liverpool, Liverpool, UK
  41. 41MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine Oncology, Oxford, UK
  42. 42Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford, UK
  43. 43Centre for Medical Imaging and Computing, University College London, London, UK
  1. Correspondence to Prof R Gisli Jenkins; gisli.jenkins{at}


Introduction The COVID-19 pandemic has led to over 100 million cases worldwide. The UK has had over 4 million cases, 400 000 hospital admissions and 100 000 deaths. Many patients with COVID-19 suffer long-term symptoms, predominantly breathlessness and fatigue whether hospitalised or not. Early data suggest potentially severe long-term consequence of COVID-19 is development of long COVID-19-related interstitial lung disease (LC-ILD).

Methods and analysis The UK Interstitial Lung Disease Consortium (UKILD) will undertake longitudinal observational studies of patients with suspected ILD following COVID-19. The primary objective is to determine ILD prevalence at 12 months following infection and whether clinically severe infection correlates with severity of ILD. Secondary objectives will determine the clinical, genetic, epigenetic and biochemical factors that determine the trajectory of recovery or progression of ILD. Data will be obtained through linkage to the Post-Hospitalisation COVID platform study and community studies. Additional substudies will conduct deep phenotyping. The Xenon MRI investigation of Alveolar dysfunction Substudy will conduct longitudinal xenon alveolar gas transfer and proton perfusion MRI. The POST COVID-19 interstitial lung DiseasE substudy will conduct clinically indicated bronchoalveolar lavage with matched whole blood sampling. Assessments include exploratory single cell RNA and lung microbiomics analysis, gene expression and epigenetic assessment.

Ethics and dissemination All contributing studies have been granted appropriate ethical approvals. Results from this study will be disseminated through peer-reviewed journals.

Conclusion This study will ensure the extent and consequences of LC-ILD are established and enable strategies to mitigate progression of LC-ILD.

  • COVID-19
  • interstitial fibrosis
  • bronchoscopy

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  • JMW, JCP, PLM, PMG and IS are joint first authors.

  • RCC, L-PH, JJ, KPH, LVW and RGJ are joint senior authors.

  • Contributors RGJ*, LW*, LKP-H*, L-PH*, RCC, JJ, SW, LW*, KP-H*, L-PH*, RCC, JMW*, JCP*, PLM*, PMG* and IS* contributed to the conception and design of the study and advised on methodology. JMW*, JCP*, PLM*, PMG* and IS* reviewed and finalised study design and methodology. All authors assisted with the draft manuscript and advised on methodology. All authors revised the manuscript for important intellectual content. RGJ had final responsibility for the decision to submit for publication.

  • Funding The collaborative research programme entitled, The UK Interstitial Lung Disease-Long COVID-19 study (UKILD-Long COVID): understanding the burden of Interstitial Lung Disease in Long COVID is funded by UK Research and Innovation MRC research grant award (grant reference MR/W006111/1). The collaborative research programme entitled PHOSP-COVID Posthospitalisation COVID-19 study: a national consortium to understand and improve long-term health outcomes is jointly funded by UK Research and Innovation and National Institute of Health Research (grant references: MR/V027859/1 and COV0319 and ISRCTN number 10980107). In addition, PM is supported by MRC—GlaxoSmithKline GSK Experimental Medicine and co-funding NIHR University College London Hospitals Biomedical Research Centre. JB is supported by MRC transition award (MR/T032529/1). BG is funded by MRC-UK, the British Lung Foundation, The Alpha-1 Foundation and supported by the NIHR Leicester Biomedical Research Centre. IPH is supported by an NIHR Senior Investigator Award. SRJ is supported by Nottingham NIHR BRC. PLM is supported by an Action for Pulmonary Fibrosis Mike Bray fellowship. AART is supported by a British Heart Foundation Intermediate Clinical Fellowship (FS/18/13/3328). L-PH is supported by the NIHR Oxford Biomedical Research Centre. JJ is supported by a Wellcome Trust Clinical Research Career Development Fellowship (209553/Z/17/Z) and the NIHR UCLH Biomedical Research Centre, UK. LW holds a GSK/British Lung Foundation Chair in Respiratory Research (C17-1). The research was partially supported by the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre. RGJ is supported by an NIHR Research Professorship (RP-2017-08-ST2-014). AJS is a National Institute for Health Research (NIHR) Senior Investigator.

  • Disclaimer The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Provenance and peer review Not commissioned; internally peer reviewed.