The University of Liverpool is leading a new global project to better understand how and why COVID-19 affects the brain in order to develop measures to help improve patient outcomes.

The University has secured £860,000 from the National Institute for Health Research (NIHR), in partnership with UK Research and Innovation (UKRI) to establish the COVID-Neuro Global programme in partnership with five leading research organisations in Brazil, India and Malawi.

The new programme is being led by Professor Tom Solomon at the University’s Institute of Infection, Veterinary and Ecological Sciences, who said: «While most people with COVID-19 have respiratory problems, all over the world we are seeing many patients with neurological complications too, such as stroke, delirium and encephalitis. We want to understand why, and who is at highest risk of developing these problems, to see if we can prevent these devastating effects by identifying risk factors that we can treat. This is especially important in some overseas countries like India, which is seeing one of the largest COVID-19 outbreaks anywhere in the world.»

Working as part of a global network, the researchers will compile data from patients across the world to create a single large report of the full range of neurological disease in COVID-19. The team will also carry out research studies with COVID-19 patients in hospitals in Brazil, India and Malawi to identify risk factors for neurological disease, especially those which can be treated, such as lack of oxygen in the blood. They will also look at outcomes for neurological patients, to help better understand what might predict a poor outcome.

The new programme builds upon the work of the NIHR Global Health Research Group on Brain Infections (Brain Infections Global), which Liverpool coordinates. The group has already been supporting the COVID-19 response through their international COVID-Neuro Network, the COVID-Neuro Resource, and a series of webinars. The new programme also aligns closely with the work of the University’s National Institute for Health Research Health Protection Research Unit on Emerging and Zoonotic Infections (HPRU-EZI), which was set up to tackle emerging infectious diseases like COVID-19.

The COVID-Neuro Global programme partners include The College of Medicine (Malawi); Malawi-Liverpool-Wellcome Trust Clinical Research Programme (Malawi); Oswaldo Cruz Foundation (Fiocruz; Brazil); National Institute for Mental Health & Neuro Sciences (India); Christian Medical College Vellore (India) and The Encephalitis Society (UK).

Dr Tamara Phiri, Consultant Physician at Queen Elizabeth Central Hospital and Clinical Lecturer at the College of Medicine, Malawi said: «This exciting programme will help us make a difference for patients with COVID-19 across the world. Importantly for countries like Malawi, it should tell us simple, low-cost ways of predicting who is at highest risk of brain disease with COVID-19, and hopefully ways of preventing it.»

Professor Ravi Vasanthapuram, Senior Professor and former Registrar at the National Institute of Mental Health and Neuro Sciences in Bangalore, India, said: «As a large institute specialising in both neurological diseases and viral infections, we’re delighted to have the chance to delve deeper into the effects COVID-19 has on the brain, and improve care for people across India and other low- and middle-income countries.»

Professor Priscilla Rupali, Infectious Disease Professor at the Christian Medical College Vellore, India said: «Having had hundreds of patients on our COVID wards every day for months now, we have seen many people affected by neurological disorders. With people continuing to be affected globally, it’s exciting to have the opportunity to help work out how to improve care for and hopefully prevent COVID-19 neurological disease with our Indian and global partners.»

Dr Rafael França, Associate Researcher in Virology & Immunology at Fiocruz (Oswaldo Cruz Foundation) Pernambuco, Brazil, said: «Following our work with Liverpool on the way mosquito-borne viruses like Zika, dengue and chikungunya cause neurological disorders with serious effects, our team is really well set up to take on this similar challenge for COVID-19. Brazil has been hit really badly by the pandemic, as it was by the Zika emergency, and it’s a pleasure to be able to help the response here and worldwide.»

Dr Ava Easton of the Encephalitis Society, who is Chair of the programme’s Patient, Public and Community Engagement and Involvement Panel, said: «With so many people being affected by the neurological effects of COVID-19, this is a really important project. Diseases of the brain often leave the lives of those affected and their families devastated and battling with the challenging, life-long consequences. I am delighted to be leading this panel in order to guide the work of the group’s experts from around the world, ensuring it aligns with the voices and needs of patients, the public and their communities.»

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For more information about Brain Infections Global please visit: https://braininfectionsglobal.tghn.org/

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