Case study: An NIHR Clinician Scientist’s journey to understand COVID-19
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Intensive care expertise
“My immunobiology expertise was really useful in this context of a new viral pandemic.”
Adjusted focus: COVID-19 research
- REMAP-CAP Due to research expertise in immunology and sepsis trials, Manu was invited to join a UK Consortium led by NHS Blood and Transplant, to design a randomised clinical trial on the effect of convalescent plasma on critically ill adults with COVID-19. In addition, Manu was asked to coordinate and lead the translational immunology of convalescent plasma therapy in this population. Therefore, he is now co-leading the convalescent plasma treatment trial as part of the REMAP-CAP trial. This international trial is testing a range of treatments for people with COVID-19 and has been given Urgent Public Health (UPH) status.
- ILIAD-7 Manu also successfully submitted a commercially funded UPH proposal for the ILIAD-7 trial, as the UK Chief Investigator. The ILIAD -7 trial is testing whether an agent medicine called human recombinant interleukin-7 [IL-7] is able to boost the immune system’s ability to fight coronavirus infection, by increasing the numbers and function of particular white blood cells (called T lymphocytes). The UK was the first country to start recruitment and recruited the first patient into this intervention.
- COVID-IP Manu’s translational research group focussed their efforts on understanding the immune responses in patients hospitalised with COVID-19 illness. To this end, they secured some local funding and collaborated with another research group within KCL to develop a project that involved understanding how white blood cells change in COVID-19 illness, at pace. The COVID-IP project produced a landmark paper on the immunology of adult COVID-19 illness, published in Nature Medicine. It reports the signature traits of white blood cell changes and highlights an immune signature that predicts the risk of severe illness in adults. These findings have been replicated by other studies.
- PIMS-TS Whilst the pandemic was ongoing, Evelina London Children’s Hospital reported a unique syndrome in children resulting in critical illness. Manu’s research group was one of the first groups internationally to report the immune cell changes in this severe illness referred to as PIMS-TS. This resulted in another landmark paper, published in Nature Medicine, which provided immunological evidence that PIMS-TS is an illness distinct from Kawasaki Disease. This has informed clinical care.
Effect on sepsis research and future career
“Overall, the pandemic has reinforced the value of the unique research skill-set I have got and given me belief in continuing to strive on excellence with my approach to translational research.”