Kate Cheema

The COVID-19 pandemic has presented numerous and considerable challenges to the nation as a whole, with the impact on health, life, work and society felt right across the UK.

Pre-existing cardiovascular diseases and their risk factors, such as diabetes, obesity and high blood pressure, have emerged as some of the most important drivers of severe complications from COVID-19. At the same time, it has become increasingly clear that COVID-19 infection has important effects on the heart and circulatory system. This highlights why the pandemic and its consequences are of major interest to the British Heart Foundation (BHF) and the cardiovascular research community.

The BHF responded by working with the National Institute for Health Research (NIHR) to rapidly identify and prioritise the delivery of several National Flagship Projects, addressing urgent research questions on COVID-19 and cardiovascular health. One of these important projects is ‘CVD-COVID-UK’, which is linking UK-wide patient datasets to understand the relationship between COVID-19 and heart and circulatory disease.

The BHF Data Science Centre rapidly took ownership of this challenge and mobilised from scratch the large and expanding CVD-COVID-UK consortium, bringing together more than 230 interdisciplinary researchers (clinicians, epidemiologists, biostatisticians, computational scientists and others) from across more than 45 institutions in the UK to better understand the relationship between COVID-19 and cardiovascular diseases such as heart attack, heart failure, stroke, and blood clots in the lungs. The consortium conducts collaborative analyses of de-identified, linked, nationally collated healthcare datasets to answer important research questions on the effects of COVID-19 on cardiovascular health, and vice versa, as well as the indirect impact of the pandemic (for example through healthcare disruption) on patients with heart and circulatory disease.

The breadth and depth of the sixteen projects approved so far under its banner give testament to the importance of such a consortium. Current work includes looking at the risk of blood clots in the arteries (e.g. heart attacks and strokes) and veins (e.g. clots in the veins of the legs and lungs) following COVID-19 infection and following COVID-19 vaccination; developing new analysis approaches to best handle the huge quantities of data available; and a breadth of other projects, such as predicting future risk of cardiovascular diseases and studying the impact of cardiovascular diseases combined with other conditions (so-called ‘multimorbidity’). Results from this work are now coming through, being submitted to journals, and have been used to inform bodies regulating vaccines and other medicines as well as senior government health and science advisers.

The benefits of the CVD-COVID-UK consortium go beyond policy impact and scientific publications. Writing from the perspective of the BHF Health Intelligence team, a small analytics team based within the BHF itself, the ‘at scale’ collaborative working that has been enabled by the consortium has brought myriad benefits to all the teams and individuals involved.

This is best exemplified by the positive exchange of ideas and approaches between groups of individuals with very different backgrounds and experience. The consortium is bringing the best in academic thinking together with depth of knowledge of, for example, NHS datasets and their various strengths and shortcomings. Practical benefits also include exposure to a multitude of tools and data management strategies which differ between different data environments across the UK. Teams have had the opportunity, for example, to work on adapting SQL* script written in NHS Digital’s secure trusted research environment in England to the SAIL Databank trusted research environment in Wales.  Such opportunities lead to improved understanding, not just of the individual environments, but also of the datasets. And, crucially, they enable the same questions to be addressed using similar data from across the different countries of the UK.

The importance of deep knowledge of this data, and the idiosyncrasies involved in how it is queried and extracted, cannot be overstated – particularly when bringing together insights from across all four nations of the UK.  The culture of open, collaborative working within the consortium has helped to amplify these benefits, ensuring that the lessons learned by each multidisciplinary group tackling a particular research question are available to all with an interest. This provides the basis for continuous improvement and development of data analysts and the analysis methods they use.

The opportunity to share and develop new skills and insights in the process of answering some of the thorniest questions in cardiovascular research has been invaluable – not just for the individuals concerned, but also in sparking new ideas for future research and better understanding the ‘art of the possible’ for other potential applications. The BHF Health Intelligence team is not a research team, but is involved in supporting the development of critical policy positions for the charity; the team now has a better understanding of how working more closely with the BHF Data Science Centre could help inform key projects that hitherto have felt out of reach.

The ongoing COVID-19 pandemic has meant that teams with a focus and specialisation in data analysis and data science have been in high demand. By bringing together a multidisciplinary group of researchers and data specialists, the BHF Data Science Centre is already demonstrating hugely beneficial impact. The development of a wider health data expertise enriches and strengthens the growing health data and analysis community, in turn supporting leverage of the UK’s exceptional health data to help answer some of the most important heart and circulatory disease research and policy questions we are ever likely to face.

*SQL stands for structured query language and is a programming language used to manipulate and query large datasets

Find out more about the CVD-COVID-UK consortium

Find out more about the BHF Data Science Centre