A study team from the NIHR Leicester Biomedical Research Centre (BRC) have been reflecting on their world leading research into Long Covid ahead of International Long Covid Awareness Day on Saturday, March 15, 2025
The PHOSP-COVID study was set up at pace and scale in response to the Covid-19 pandemic in July 2020. The UKRI and NIHR funded this long-term research study which is led by Professor Chris Brightling, NIHR Senior Investigator and Clinical Professor in Respiratory Medicine and Professor Rachael Evans, Respiratory Physician from the University of Leicester.
Professor Brightling said: “It was vitally important that we rapidly gathered evidence on the longer-term consequences of contracting severe COVID-19 so that we can develop and test new treatment strategies for them and other people affected by future waves of the disease”.
PHOSP-COVID is a UK consortium of multidisciplinary researchers and clinicians working together to understand and improve
long-term health outcomes for adults who were hospitalised with COVID-19.
Patients, clinicians, and scientists worked together in 2020 to agree priority research questions for underlying mechanisms, diagnostic/ prognostic tools and interventions. 7935 adults who were discharged from hospital after COVID-19 between February 2020 and March 2021 were recruited into three tiers of research, which included medical notes review (Tier 1), clinical follow-up assessments at around 5 months and 12 months after discharge for phenotyping and biological sampling (Tier 2), and detailed immune profiling and multi-organ imaging (Tier 3).
Throughout the study, there has been close engagement between the consortium, patients and the wider public. The team are proud of the patient and public involvement and engagement (PPIE) that has been central to the study from the offset.
PPIE is led by Dr Linzy Houchen-Wolloff; working with patient partners, the team has produced two public webinars, a series of newsletters and the PHOSP Scientific Summit (held in Leicester 28–29 March, 2023), which included patient experience videos as a core focus of the day.
Dr Houchen-Wolloff reflected: “I personally value the important difference our PPIE group continue to make to the PHOSP COVID study and more widely to promote Long Covid research, advocacy and policy. To do all of this on top of having a long-term health condition is humbling.”
Five years on the consortium team are able to celebrate more than 45 peer-reviewed publications. Key outputs from the group can be found at: https://phosp.org/publications/ and include studies of the long term impact of COVID-19 on mental and physical health, and studies investigating biological mechanisms responsible for long COVID, including the role of the immune system, hormones and organ damage.
Although recruitment across the four UK nations (64 centres) is now complete, analyses are ongoing and the samples remain a fruitful resource for future work (>70,000); there are a further 20 publications in the pipeline.
Professor Louise Wain, Co-Principal Investigator of the study stated: “This study was only possible thanks to the participants who took part and provided valuable biological samples that enable us to uncover the molecular changes in the blood and look at how they might relate to recovery from COVID-19.”
New interventional trials to understand the role of various therapies for Long Covid have also commenced.
The PHOSP-Rehabilitation (PHOSP-R) study led by Dr Enya Daynes has just been published in the European Respiratory Journal:
https://publications.ersnet.org/content/erj/early/2025/01/16/1399300302152-2024
The trial in 181 patients found that exercise-based rehabilitation improved short-term exercise capacity in those with Long Covid following an acute hospitalisation and showed potential for beneficial immunomodulatory effects.
The PHOSP-Inflammation (PHOSP-I) trial is currently recruiting patients with Long Covid and persistent inflammation in 15 UK centres. This trial aims to investigate whether a medication called Tocilizumab will improve symptoms and help improve health-related quality of life in people living with Long Covid.
Professor Rachael Evans, Co-Principal Investigator of the PHOSP-COVID study and PHOSP-I lead explains: “We have previously shown a link between the severity of ongoing health impairments and inflammation. We believe that Tocilizumab, which is already used to treat patients with acute COVID-19, may be effective in treating patients with Long Covid by reducing inflammation.”
Long Covid remains a significant challenge for the millions of people who have persistent symptoms, for health-care systems and for economies through loss of work. It is important that Long Covid remains a health-care and research priority.
The planned ongoing work of the PHOSP collaborative to develop new treatments and improved outcomes for people living with Long Covid, strives to do this.
People with Long Covid can get support here: https://www.longcovid.org/
For more information on PHOSP-COVID please visit the website: PHOSP