OX79 Coronavirus Record Linkage Project
What is the aim of the study and why is it important?
The majority of UK residents will likely have been infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the virus that causes Covid-19) by the end of the current pandemic. Large numbers of people will receive hospital treatment, some on an intensive care unit (ICU); and a substantial proportion of the latter will die.
Some commonly used drugs for conditions such as hypertension and diabetes may affect the severity of Covid-19. Other drugs or therapies, used for different diseases, may have activity on Covid-19. However, we don’t know, and so need a study to gather more evidence. Of particular interest in this study are drugs used to treat high blood pressure called angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs).
Three databases, the Intensive Care National Audit and Research Centre’s (ICNARC) Case Mix Programme (CMP), Public Health England’s records of Covid-19 tests, and QResearch contain different but complementary data about the same patients. By linking them, we have created a resource that allows us to analyse data from before and after critical illness to better understand Covid-19 drugs and therapies and health resource use. This pooled data resource is of particular use in the current pandemic to study the illness pathway for patients with Covid-19 from primary to critical care.
Initially, some things we want to know are:
• what proportion of patients in ICU have chronic conditions?
• are some medications associated with a higher/lower chance of being admitted to ICU, and/or recovering?
• are some patients at higher risk of needing care in ICU, and/or at lower risk of recovering?
• if some drugs increase risk of needing care in an ICU, are there safer drugs for treatment of patients’ chronic conditions?
• are there drugs that might warrant further evaluation to treat Covid-19?
How is the research being done?
The study is a record linkage cohort study combining routinely collected health care data and data collected for clinical audit. We will link the two databases, ICNARC CMP and QResearch, to connect primary care with critical care data. This linked database is a resource that will be used to conduct studies of all patients registered with practices contributing to QResearch, including those with a recorded, suspected or confirmed diagnosis of Covid-19, and those who were admitted to ICU with Covid-19, to try to answer important questions like those posed above.
Professor Julia Hippisley-Cox Professor Peter Watkinson Professor Kathy Rowan
University of Oxford
Location of research
University of Oxford
Date on which research approved
Project reference ID
Generic ethics approval reference
Are all data accessed are in anonymised form?
Brief summary of the dataset to be released (including any sensitive data)
Variables includes demographics, diagnoses, medication, HES emergency admissions, civil registration mortality data, linked ITU data, linked Covid-19 test results
Implications and Impact
The study will:
• identify the prevalence of patients in ICU with chronic conditions
• identify which, if any, medications (focusing on specific interventions initially) are associated with an altered chance of being admitted to ICU and/or recovery
• identify risk factors for patients at higher risk of needing care in ICU, or at lower risk of recovery
• try to identify likely safer drugs for patients to treat their chronic conditions
• try to identify possible candidate drugs for evaluation to treat Covid-19
Oxford NIHR BRC, Wellcome ISSF, Cancer Research UK, John Fell Fund (and others to be confirmed)
Professor Julia Hippisley-Cox, Nuffield Department of Primary Health Care Health Sciences, University of Oxford
Professor Peter Watkinson, Nuffield Department of Neuroscences Sciences, University of Oxford
Professor Duncan Young, Professor of Intensive Care Medicine, University of Oxford
Professor Carol Coupland, Professor of Medical Statistics in Primary Care, University of Nottingham
Mr Stephen Gerry, Senior Medical Statistician, Centre for Statistics in Medicine, University of Oxford
Professor David Clifton, Professor of Clinical Machine Learning, University of Oxford
Professor David Harrison, Professor of Statistics, ICNARC Intensive Care National Audit and Research Centre
Professor Keith Channon, Field Marshal Earl Alexander Professor of Cardiovascular Medicine, University of Oxford
Dr Pui San Tan, Data Scientist, Nuffield Department of Primary Health Care Health Sciences, University of Oxford
Dr Martina Patone, Statistician, Nuffield Department of Primary Health Care Health Sciences, University of Oxford
OX79 Coronavirus Record Linkage Project - QResearch-ICNARC COVID-19 Collaboration - RESEARCH PROGRAM PROTOCOL
Authors: Professor Peter Watkinson, Professor Julia Hippisley-Cox, Professor Kathy Rowan
Risk of severe COVID-19 disease with ACE inhibitors and angiotensin receptor blockers: cohort study including 8.3 million people
Authors: Julia Hippisley-Cox, Duncan Young, Carol Coupland, Keith M Channon, Pui San Tan, David A Harrison, Kathryn Rowan, Paul Aveyard, Ian D Pavord, Peter J Watkinson
Analysis of severe outcomes associated with the SARS-CoV-2 Variant of Concern 202012/01 in England using ICNARC Case Mix Programme and QResearch databases
Authors: Martina Patone, Karen Thomas, Rob Hatch, Pui San Tan, Carol Coupland, Weiqi Liao, Paul Mouncey, David Harrison, Kathryn Rowan, Peter Horby, Peter Watkinson, Julia Hippisley-Cox
Mortality and critical care unit admission associated with the SARS-CoV-2 lineage B.1.1.7 in England: an observational cohort study
Authors: Martina Patone PhD, Karen Thomas MSc, Rob Hatch BA, Pui San Tan PhD, Prof Carol Coupland PhD, Weiqi Liao PhD, Paul Mouncey MSc, Prof David Harrison PhD, Prof Kathryn Rowan PhD, Prof Peter Horby FRCP, Peter Watkinson MD, ProfJulia Hippisley-Cox FRCP
OX79 Qresearch ICNARC Covid-19 psychological outcomes
Authors: Professor Peter Watkinson, Professor Julia Hippisley-Cox, Professor Kathy Rowan, Professor Carol Coupland, Dr Martina Patone, Professor David Harrison, Ms Karen Thomas, Dr Robert Hatch, Dr Pui San Tan, Dr Weiqi Liao, Dr Paul Mouncey, Dr Tom Alan Ranger, Dr Ash Kieran Clift, Mr Lukasz Cybulski
- Study linking together COVID-19 patient data awarded funding 7th April 2020
- Heart Best Paper Award 2021