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.
- interstitial fibrosis
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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.