Covid-19 and mitochondrial activity. Version 2.0
Research type
Research Study
Full title
Investigating the impact of COVID-19 infection on skeletal muscle.
IRAS ID
288936
Contact name
Beth Phillips
Contact email
Sponsor organisation
Nottingham University
Duration of Study in the UK
2 years, 4 months, 10 days
Research summary
The outbreak of COVID-19 in 2020 has led to over 1million infections and over 50,000 deaths in the UK. The impact that COVID-19 has varies significantly between individuals and the reason behind this is not fully understood.
Our study aims to investigate the impact that COVID-19 infection has upon skeletal muscle. We will investigate the cellular impact of COVID-19 upon skeletal muscle by performing a biopsy of the vastus lateralis muscle. This biopsy sample will then be investigated for mitochondrial function, protein, and gene expression.
By performing bedside ultrasound scan measurements of the vastus lateralis muscle we will also be able to assess muscle structure. Neuromuscular studies will also be performed to investigate if COVID-19 infection leads to an impact upon the nerve supply to the muscle.
We plan to perform these investigations at 3-time points to investigate if the changes seen during the acute stage are longstanding and if there are any long-term impacts, as well as to assess the rate of recovery from infection.
Acute infection – performed during admission to hospital with COVID-19 associated illness
6-months post-infection
12- months post-infection
To attempt to gain knowledge on as to why some individuals are asymptomatic, others require levels of ventilatory support and for others, it is a fatal infection we will identify 2-groups of COVID-19 patients to see if there is an altered response within the muscle between these groups:
Admission but only oxygen requirement
Non-invasive ventilatory support
Our control group for comparison will be those patients with non-COVID-19 associated community-acquired pneumonia. The reason behind this is to ensure it is not the process of having a respiratory compromising condition leading to alterations in the muscle, but a specific change caused by the COVID-19 pathogen.
Summary of results
This study concept was generated at the outbreak of the COVID-19 pandemic, with the aim being to investigate the impact of COVID-19 infection upon skeletal muscle mitochondrial OXPHOS function.Following gaining ethical approval in January 2021, there had been a shift in clinical practice in the management of COVID-19 infections. This was due to early evidence suggesting a large role of thrombosis and emboli in COVID-19, leading to patients being placed upon high dose low-molecular weight heparin (a blood thinner) to improve clinical outcomes.
Due to the original study involving muscle biopsies, which have a risk of bleeding and heamatoma associated, an exclusion criteria for the study was being upon blood thinners. The above change in clinical practice meant that it was not feasible to perform the study. Despite getting an amendment to make the biopsy element of the study optional in June 21, there had been a significant reduction in the number of COVID-19 admissions due to the success of the vaccine program.
Sadly all potential participants approached prior to the ending of the study either declined, or were excluded due to the above issue. This meant that with the development of the COVID-19 vaccine and the reduction in cases the study failed to recruit and was therefore terminated.
REC name
East Midlands - Derby Research Ethics Committee
REC reference
21/EM/0002
Date of REC Opinion
26 Jan 2021
REC opinion
Further Information Favourable Opinion