COVID-19 is a key aim of GenOMICC
Susceptibility to COVID-19 is almost certainly, in part, genetic. GenOMICC can find the genes that cause susceptibility, which may help us to prioritise treatments to respond to the global crisis.
GenOMICCwas designed for this crisis. Since 2016, the open, global GenOMICC collaboration has been recruit patients with emerging infections, including COVID-19. All patients with confirmed COVID-19 in critical care are eligible for GenOMICC; please recruit them as normal, following local infection control precautions.
In particular, we aim to recruit every intubated patient with COVID-19. If you need to prioritise, please start with the youngest.
GenOMICCis prioritised as an NIHR Urgent Public Health Study in the UK
Establish GenOMICC in your country or region
- Hong Kong
Click to see the full study protocol and related documents.
To establish recruitment, you will need to obtain local/regional ethical and management approval (from a research ethics board, institutional review board or equivalent). In different legal jusrisdictions this may require some changes to the consent forms. Recruiting a patient is easy and takes very little research nurse time - around 1h in total is a reasonable estimate, including follow-up. DNA extraction and genotyping can be done in a local or national lab. It is usually easier to do this within the country that the patient was recruited from.
Inclusion criteria are stratified to facilitate recruitment under conditions in which resources are limited (Dunning et al. 2014). Lower tiers include syndromes with a high probability of genetic susceptibility, and will be prioritised in resource-limited settings. Higher tiers describe less-specific syndromes with a focus on mortality.
Patients will be recruited who:
Are deemed, in the view of the treating physician, to require continuous cardiovascular or respiratory monitoring or invasive mechanical ventilation,
AND provide appropriate consent or assent,
AND present with one of the following primary diagnoses:
Group 1: specific infectious syndromes in highly-selected patients
COVID-19. Confirmed or suspected COVID-19.
Influenza. Confirmed or suspected infection with influenza virus.
Secondary pneumonia. Acute pneumonia complicating confirmed infection with influenza virus.
Dengue. Confirmed or suspected infection with dengue virus.
RSV. Confirmed infection with respiratory syncytial virus.
Emerging infections. Confirmed or suspected infection with an emerging infection (see below).
Group 2: specific non-infectious critical illness syndromes
Burns. Full thickness burns covering > 20% of body surface area.
Emerging critical illness syndromes. Confirmed or suspected presence of an emerging critical illness syndrome. These are unexplained or idiosyncratic presentations of acute organ injury, or suspected reactions to therapeutic agents, including:
acute disease associated with inhalation of noxious substances or vapours, such as "vaping"
acute disease associated with CAR T-cell therapy
Group 3: extreme critical illness
Extra-corporeal life support. Requirement for continuous veno-venous extra-corporeal support for respiratory failure of any aetiology.
Group 4: common/nonspecific critical illness syndromes
Cellulitis. Soft tissue infections causing systemic sepsis.
Pneumonia. Primary pneumonia of any aetiology, with radiographic changes at presentation to critical care. Pneumonia is defined as: symptoms and signs consistent with an acute lower respiratory tract infection associated with new radiographic shadowing for which there is no other explanation (eg, not pulmonary oedema or infarction). Where this illness is the primary reason for hospital admission and is managed as pneumonia, the patient is eligible for inclusion.(Harris et al, 2011) No microbiology information is required to meet this entry criterion.
Pancreatitis. Pancreatitis of any aetiology.
Emerging infections are by their nature unpredictable and present a significant challenge to the international research community. In order to ensure research preparedness, in accordance with the principles laid out by the International Severe Acute and Emerging Infection Consortium (ISARIC)(Dunning et al. 2014), patients will be recruited to this study if they have confirmed or suspected infection with a novel pathogen, a new strain of an existing pathogen, or a re-emerging known pathogen, that causes life-threatening illness. This will include the Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS), highly pathogenic strains of influenza, Ebola virus disease and other epidemics of viral haemorrhagic fever.