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A Responsive, Robust Research Strategy

Bolstered by $103.4 million in additional support from the Coronavirus Aid, Relief, and Economic Security (CARES) Act, the NHLBI rapidly mobilized to support research on COVID-19 by leveraging existing NIH-funded studies and infrastructure.

The NHLBI’s COVID-19 response has focused on research aiming to:

  • Understand the factors that influence risk and resilience for infection and for severe illness
  • Understand how COVID-19 attacks the body’s vital organs
  • Develop therapies to stop the disease and reduce the potential for long-term health effects
  • Test behavioral, social, and community-based interventions to improve disease prevention and recovery
  • Examine the prevalence of SARS-CoV-2 antibodies in the blood, their ability to protect against future infection, and their utility as a therapeutic

Integral to the NHLBI’s approach is the Collaborating Network of Networks for Evaluating COVID-19 and Therapeutic Strategies (CONNECTS), which brings together more than 30 clinical trial networks to identify potential therapies for COVID-19. CONNECTS allows researchers to test a variety of interventions simultaneously, easily share their data, and quickly identify the most promising treatments.

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COVID-19 Clinical Trials

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COVID-19 Observational Studies

  • The COVID-19 Observational Study (CORAL) is examining the pathobiology and outcomes among more than 3,000 adults hospitalized with COVID-19 for up to six months after discharge.
  • The Collaborative Cohort of Cohorts for COVID-19 Research (C4R) is combining existing diverse population studies to look at long-term COVID-19–related outcomes and factors that affect risk and resilience.
  • The Recipient Epidemiology and Donor Evaluation Study (REDS), an NHLBI program that monitors threats to the U.S. blood supply, has launched REDS RESPONSE to analyze the prevalence of SARS-CoV-2 antibodies (seroprevalence) among blood donors in six cities with high COVID-19 rates, setting up a framework for a nationwide seroprevalence survey.

COVID-19 Candidate Interventions

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Establishing Partnerships to Address Health Disparities

COVID-19 has taken its toll on almost every community, but some groups have been hit especially hard. Compared with whites, there are higher rates of COVID-19 among Asian Americans, Blacks, Latinos, American Indians/Alaska Natives, and Pacific Islanders. These groups also tend to be at higher risk for severe illness. Research increasingly shows that social determinants of health — conditions in the places where people live, work, and play — have a large impact on these disparities.

Building on their history of engaging communities in research, the NHLBI and the National Institute on Minority Health and Health Disparities (NIMHD) are co-leading the NIH Community Engagement Alliance (CEAL) Against COVID-19 Disparities. CEAL connects researchers to trusted community-based organizations, minority professional societies, and faith-based organizations in communities impacted by COVID-19. Together, they will address misinformation, work to increase preventive practices (e.g., wearing face masks, hand washing), and ensure the inclusion of people of color in trials of vaccines and new treatments.

In addition, the NHLBI participates in the NIH Rapid Acceleration of Diagnostics in Underserved Populations (RADx-UP) initiative, which is developing community-based projects to increase reach, access, uptake, and impact of COVID-19 testing among hard-hit populations.

Evolving Data, Evolving Research

The NHLBI remains poised to adapt and shift its focus as new information about the virus emerges. For example, we now know that some children infected with COVID-19 later develop a severe inflammatory response that requires hospitalization, with most experiencing cardiovascular complications.

In response, the NHLBI is partnering with other NIH Institutes to leverage multiple networks, such as the NHLBI’s 29-hospital Pediatric Heart Network, to gain a better understanding of this rare multisystem inflammatory syndrome in children (MIS-C). Through the 5-year Long-Term Outcomes after the Multisystem Inflammatory Syndrome In Children (MUSIC) study, clinicians will collect data from pediatric hospitalizations and medical visits to guide diagnoses and treatment. This aggregated information will support long-term evidence-based management guidelines for MIS-C.

In addition, some people who have had COVID-19 — and even asymptomatic SARS-CoV-2 infection — have continued to struggle with symptoms months later. Those with post-acute COVID-19 have developed serious conditions such as heart failure or myocarditis (heart inflammation), stroke, progressive lung disease such as pulmonary fibrosis, or kidney failure. Contingent on sufficient resources, the NHLBI plans to leverage the C4R study, as well as our data science platforms, to understand what causes these lingering health impacts of COVID-19 and to intervene early to prevent them.

The NIH is also developing a COVID-19 clinical trial data hub, which is integrating existing databases — including those housed within the NHLBI’s BioData Catalyst — that contain clinical, lab, and imaging data from COVID-19 patients. The data hub will enable more rapid responses to COVID-19 surges, as well as to subsequent emerging threats.