COVID Symptom Study app identifies ‘skin rash’ as a COVID-19 symptom
Evidence has shown that COVID-19 causes different immune-related reactions during the various stages of the disease being present in the body. Researchers, including Professor Tim Spector who is part of HDR UK London, studied data from a sample of over 330,000 users of the COVID Symptom Study app (also known as the Zoe app) and found links between the presentation of a skin rash and testing positive for COVID-19 – 8.8% of positive tests in this sample reported a rash.
Using data from an independent online survey of around 11,500 people with a rash, in 21% of positive test swabs a rash was the only clinical sign of COVID-19. The authors suggest that, despite it having a lower prevalence than some other symptoms such as a fever, it is more specific to COVID-19 and presents for a longer period of time and should therefore be considered an important indicator in early identification of the disease.
Strong association between care home size and likelihood of COVID-19 outbreak
Growing evidence has shown the impact of COVID-19 in care homes on an international scale. A recent study involving Professor Bruce Guthrie, part of HDR UK Scotland, analysed data from 189 care homes that sit within NHS Lothian. In 66 of the 70 care homes that experienced an outbreak, care-home size was strongly associated with outbreaks. In addition, when looking at deaths that were not directly caused by COVID-19, there were 73 excess deaths in care-homes with an outbreak in comparison to no excess deaths in those that did not have an outbreak.
Their findings suggest that there has been a large impact on excess deaths in care homes as a result of COVID-19 and that, in the future, it will be crucial to shield residents from potential sources of infection. It also advises that, if and when an infection is detected in a care home, rapid action should be taken to minimise the size of the outbreak.
Excess mortality in users of mental health services higher in BAME populations
A research team have recently published a pre-print paper which builds on their previous research that found a 2.4-fold excess mortality in past and present mental healthcare services users of a large mental healthcare provider in south London (South London and Maudsley NHS Trust, SLaM) during the period of the pandemic compared to the same time period in 2019.
Their latest research explores this further by examining the differences in excess mortality between different ethnic groups. Results found higher death rates in Black African/Caribbean patients followed by other ethnic groups and then White British patients. Whilst the study focused on data from one single mental health provider and grouped ethnic groups into the broad categories to allow for a sufficient sample size, the study has shown this to be an area that could be explored further.
Preliminary evidence on the effect of hydroxychloroquine in patients hospitalised with COVID-19
The RECOVERY trial, led by investigators in Oxford including HDR UK’s Professor Martin Landray and supported by NHS DigiTrials – Health Data Research Hub for Clinical Trials – previously found there to be no beneficial effect of hydroxychloroquine in patients hospitalised with COVID-19.
The team have now published further findings in a pre-print paper that explored the effect of hydroxychloroquine against usual care alone. Findings from this randomised trial have found that, whilst the drug did not show a reduction in 28-day mortality, it was associated with an increased length of stay in hospital as well as an increased risk of progressing to invasive mechanical ventilation or death.
Decrease in incidence and R number following ‘Test, Trace and Isolate’ in Isle of Wight
The Test, Trace and Isolate programme was launched in the Isle of Wight as a pilot programme and used the NHS contact tracing app. Researchers analysing the data found that there was a significant decrease in incidence rates of COVID-19, as well as the reproduction number (also known as the ‘R’ number, which represents the number of individuals who, on average, will be infected by a single person who has COVID-19) following the launch of this pilot programme.
Before the launch of the Test, Trace and Isolate programme in the Isle of Wight, it had the third highest R number in the Upper Tier Local Authorities in England and moved to having the tenth lowest. Whilst the researchers are clear that more data is needed to establish if there is a causal link, it does suggest that further research should explore the reasons behind this reduction, as it could provide evidence of intervention strategies that could be implemented on a local and national scale as we work more broadly towards a treatment and/or vaccine.
Impact of the pandemic on cardiovascular disease (CVD)
Researchers working on the 4C Initiative as part of the CVD-COVID-UK consortium, including members across the HDR UK Community and the BHF Data Science Centre, found that the presentation, diagnosis and treatment of cardiovascular disease in hospitals fell by 31-88% after lockdown. In particular they found the greatest reductions (65% or more) were in cardiovascular surgical procedures of coronary artery bypass graft surgery, carotid endarterectomy, aortic aneurysm repair and procedures for peripheral arterial disease.
The authors suggest that a tool to allow monitoring using real-time data could be a useful method in informing service provision and responses to the COVID-19 pandemic, as well as future public health emergencies.
Impact of the pandemic on cancer care provision
A research team, including Professor Mark Lawler from DATA-CAN – the UK Health Data Research Hub for Cancer, have recently published a paper that found during the lockdown period there were reductions of up to 84% in the 2-week wait referral. The paper also suggests that the large backlogs that have formed as a result of lockdown could lead to pressure on services that provide diagnosis and other areas further along the pathway around treatment. It could also mean that undiagnosed cancers could be progressing from early-stage tumours to advanced, incurable disease.
The authors have suggested that the impact on cancer diagnosis and care provision will be an ongoing concern until a vaccine or treatment for COVID-19 can be implemented and that the true excess mortality from this may not be fully understood or known for 10 years or longer.
An introduction to the International COVID-19 Data Research Alliance and Workbench
If you weren’t able to join us for the launch of our International COVID-19 Data Research Alliance and Workbench on Wednesday 8 July 2020, you can watch the full recording of it on our website where you’ll hear from a range of speakers involved in the initiative and see the panel’s Q&A.
This exciting new area of work will enable researchers to access data globally in a safe and secure way to gain with the aim of gaining instrumental insights to help respond to the global COVID-19 challenge. Over the longer-term, it will enable scientific discovery to respond to future disease outbreaks. We can’t do this on our own and there will be a number of ways to get involved.
Tweet of the Week
It’s time to highlight the ‘Tweet of the Week’. This week goes to Dr Charlie Davie, Hub Director of DATA-CAN, who highlights the collaborative work that the Health Data Research Hub for Cancer are doing around the impact of COVID-19 on cancer referral pathways.
More information and tools
1. Submit your research question or project – we are calling on anyone with a research question for COVID-19 that requires health data to share your ideas via our online form.
Questions will be shared in our HDR UK COVID-19 Knowledge + Skills Matchmaker. We prioritise all of the questions using a transparent and objective process to identify the questions that most urgently need to access to data. Progress of the prioritised questions is reported weekly to the government’s Scientific Advisory Group for Emergencies (SAGE).
2. HDR UK GitHub repository – The HDR UK community is developing computer-based tools and methodologies to analyse and handle health data, including those that can help overcome the COVID-19 challenge. These are all shared in a central repository, which is open to the public, so that we can all learn from each other and build on each other’s work. They are shared in HDR UK’s area of GitHub
3. COVID-19 Slack channels – researchers and innovators looking to collaborate to use health data to address the pandemic can apply to join our dedicated Slack channels. Complete the form to register your interest in joining here.
4. Take a look at our Skills + Knowledge Matchmaker to see a full list of COVID-19 ongoing projects, or visit COVID-19 page to see the latest version of HDR UK’s strategy to support efforts to tackle the pandemic.