Title: PREdictors of COVID19 OUtcomeS (PRECIOUS)
Funder: Chief Scientist Office, Scotland

Abstract: BACKGROUND: More than 68 million people worldwide have had COVID-19. More than 1.5 million people have died, and 32 million people need health and social service support. COVID-19 has cost more than £750 billion. In the UK, more than 200,000 people have Long-COVID: when symptoms last more than 3 weeks. These numbers continue to grow._x000D_ At first, researchers aimed to stop COVID-19 from spreading and to save lives. Now, we urgently need information about the long-term effects of COVID-19 to provide better care, including identifying who needs support, what kind of support and how much it costs._x000D_ _x000D_ AIM: To bring together international researchers and their COVID-19 data to create a large, anonymised database with information from thousands of people that have had COVID-19 to describe long-term effects, what predicts a good (or poor) recovery and what health, and social service support people need._x000D_ _x000D_ DESIGN: Searching for all existing studies that included people with COVID-19, we will organise the information relating to peoples age, health, socio-economic status, work, length of stay in hospital and long-term recovery. We will consider how independent and mobile they are, whether they have any breathing problems, tiredness or reduced quality of life._x000D_ _x000D_ BENEFITS TO PATIENTS AND NHS: We will use individual anonymised patient information instead of summaries of people’s health. This is more powerful, as it allows us to look at specific patterns and plan care and support for individuals. Better understanding of long-term COVID-19 recovery and the people that experience poor recovery will help people with COVID-19 and healthcare staff understand and identify problems earlier, organise suitable support, advice and treatment for those who need it most._x000D_ _x000D_ RESEARCH_x000D_ We will:_x000D_ 1. Gather information on long-term recovery from COVID-19._x000D_ 2. Examine which people have good (or poor) long-term recovery from COVID-19. _x000D_ 3. Determine the cost of COVID-19 to the person, health services and to wider communities._x000D_ _x000D_ TEAM: We are specialist healthcare professionals (therapists and doctors) and rehabilitation researchers. We have a lot of rehabilitation research experience, working together for many years. We know how to bring people and information together from different specialists and across the world. Importantly, our team includes lay people, people who had COVID-19 and cared for people with COVID-19. We aim to get people get back to their lives after COVID-19, give doctors and therapists the information they need to provide the best rehabilitation and the provide service managers with the information they need to put services in place for people after COVID-19._x000D_ _x000D_ OUTPUTS We will produce information on_x000D_ 1. long-term recovery after COVID-19 _x000D_ 2. what predicts whether people will have long-term problems _x000D_ 3. the individual, healthcare and community costs of COVID-19_x000D_ _x000D_ ETHICS: We will obtain university ethical approval for our study. We will use anonymised data and store it securely._x000D_ COSTS: Bringing international experts together, we will use existing information to study the full range of long-term recovery. Using existing information takes less time and costs less money than gathering new data. We need experienced researchers and statisticians to conduct our research. At the end of the project, we will share our database with other researchers so that they can answer other COVID-19 questions.

Lay abstract: BACKGROUND: COVID-19 has impacted >68 million people worldwide; up to 32 million people need health and social support. Addressing the long-term impacts, areas of rehabilitation need within the COVID-19 population and establishing costs of care are a priority. _x000D_ _x000D_ AIM: Create an international, multidisciplinary COVID-19 database, synthesising long-term outcomes, predictors and costs._x000D_ _x000D_ OBJECTIVES: _x000D_ Describe:_x000D_ • long-term outcomes and predictors, by International Classification of Functioning, Disability and Health (ICF) domains_x000D_ • financial costs of COVID-19_x000D_ • findings to patients, public, health professionals and researchers _x000D_ _x000D_ METHODS _x000D_ DESIGN: Systematic identification and recruitment of COVID-19 datasets, creating an international multidisciplinary database to support individual participant data (IPD) meta-analysis. Patients & Public Involvement (PPI) and health professionals will inform methodological decisions & dissemination._x000D_ _x000D_ STAGE 1: A systematic search of electronic databases, trial registries, grey literature, forward & backward citation tracking, with no language restrictions, for COVID-19 cohort studies and randomised controlled trials, from any setting, where assessments are recorded >=1 month of symptom onset. Investigators will be invited to contribute IPD. Data will be securely stored, cleaned & mapped to ICF domains. _x000D_ _x000D_ STAGE 2: Demographic, socioeconomic, clinical, treatment, resource use data (in natural units), and long-term outcomes will be extracted. Our existing algorithm will support data standardisation within ICF domains. Planned IPD meta-analyses will consider the effects of demographic, socio-economic, comorbidity, clinical & treatment variables on (A) long-term outcomes using a one-step regression approach; and (B) resource use (individual, healthcare & community costs). Data permitting, a prediction algorithm will be developed for clinical use._x000D_ _x000D_ FEASIBILITY: >8000 IPD (14 studies; 10 countries) secured and is expected to increase._x000D_ _x000D_ OUTCOMES, IMPACT & DISSEMINATION will describe the COVID-19 population in whom evidence is based, highlight gaps, applicability of findings & direct future research; map expected long-term impacts; provide information for people with COVID-19, families, GPs, clinicians, researchers & policy makers; inform resource allocation, prognosis and avenues for early intervention; develop a prediction algorithm for clinical use; quantify the cost of COVID-19, direct resources and support to areas of need. A legacy dataset will facilitate future analyses. Outputs will be delivered via a website, peer-reviewed papers, engagement with health professionals via existing networks, people with COVID-19 & their families via PPI led activities & social media._x000D_ _x000D_ DURATION: 2 years-outputs from month 11._x000D_ _x000D_ ETHICS: University ethics approval is pending for anonymised data analysis. IRAS registration has been requested. Data sharing will be subject to local approvals. Data contribution, preparation and analysis will adhere to a data management plan. _x000D_ _x000D_ COSTS: An international IPD database will permit efficient analyses. Costs support experienced IPD meta-analysis rehabilitation researchers, statisticians, health economists, clinical researchers in long-term conditions, rehabilitation (OT, Physio, SLT, Audiology), respiratory medicine, infectious diseases and PPI partners. Our shared legacy database will reduce research waste.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: INFECTION