NHLBI director outlines multi-pronged strategy for COVID-19 response
Gary Gibbons, MD, the director of the National Heart, Lung, and Blood Institute, outlined his organization's multi-pronged, collaborative response to COVID-19 in a rare Director's Message on the NHLBI website on April 29.
"For decades, the NHLBI’s wide circle of partners—researchers, patients, advocates, policymakers, industry and many others—have supported and advanced our mission to enhance health for all individuals. With ongoing input from this committed community, we are gaining new knowledge about COVID-19, examining critical, unresolved questions, and seeking ways to accelerate priority research that will provide the answers we need to curtail this outbreak and protect people around the world from its potential detrimental effects on the heart, lung, blood and vascular system," Gibbons wrote.
Bolstered by $103.4 million in additional support from Congress’s Coronavirus Aid, Relief, and Economic Security Act (CARES Act), he wrote, the NHLBI has formed a trans-NHLBI COVID-19 Response Team to address the viral threat from a multi-organ, multi-system perspective. This team is working quickly to refine and implement a multi-pronged research program strategy. These prongs are:
* Translational Research. Addressing the public health threat posed by novel coronaviruses will require foundational pre-clinical research to understand the host response to viral infection across pulmonary, cardiac, vascular and blood systems. A deeper understanding of the pathobiology of COVID-19 will catalyze the development of new therapeutic options.
* Clinical Trial Networks. The Institute will build upon its existing clinical trial networks to rapidly launch randomized-controlled trials with patients-participants affected by COVID-19 to assess the safety, effectiveness, and long-term consequences of various treatments designed to ameliorate the course of the disease.
* Clinical Epidemiology. This research program will leverage existing clinical and community-based research platforms to establish patient registries and clinical cohorts that will facilitate the systematic characterization of the clinical features and disease course of COVID-19. These resources should enable researchers to discover biomarkers that facilitate patient risk stratification and refine therapeutic strategies.
* Population Science and Data Resources. An important element of the NHLBI’s research response to the public health threat posed by COVID-19 is to leverage the legacy of community-based cohorts and surveillance capabilities across our heart, lung, and blood science portfolios. For example, blood safety surveillance systems are likely to be valuable assets in detecting seroconversion among a subset of the population that has been exposed to COVID-19 within the community, yet may not have been captured within the medical care system. Similarly, the NHLBI’s networks may be well-suited to accelerate the development of blood-derived products potentially useful for treating patients with COVID-19.
* Investigator–Initiated Proposals. Another important element of NHLBI’s approach is to fund investigator-initiated proposals involving other types of clinical research that are (1) patient-oriented, 2) epidemiologic and behavioral, or 3) focused on outcomes research and health services research, and which complement or expand on the high priority objectives and approaches above.
Gibbons also noted the funding opportunities and other collaborative initiatives being deployed by the institute.
As a first step to implement this cross-portfolio strategy, the NHLBI issued a Notice of Special Interest (NOSI) to stimulate urgently needed research on COVID-19. This funding opportunity invites currently funded investigators to quickly leverage existing research projects to help us better understand the body’s response to the virus; with the intersections between COVID-19 and heart, lung, and blood diseases; the potential impacts on transfusion safety; and clinical outcomes of infected individuals. Additional funding opportunities have also been announced and the NHLBI COVID-19 Response Team continues to develop other new initiatives and funding opportunities, including a new webpage with COVID-19-related guidance for researchers, practicing clinicians and the general public.
In addition, the NHLBI is receiving valuable input from the research community about projects that could be rapidly implemented to address COVID-19, including identifying the most promising treatment interventions. Those interventions include both host-directed approaches that slow the progression of the virus, and viral-directed interventions that are ready to be tested in clinical trials in COVID-19 patients--including trials of hydroxychloroquine and remdesivir.
Read more: https://www.nhlbi.nih.gov/directors-messages/coronavirus-covid-19-nhlbi-...
Visit the new NHLBI COVID-19 website: https://www.nhlbi.nih.gov/coronavirus