LOng COvid Multidisciplinary consortium Optimising Treatments and servIces
The LOCOMOTION study is funded by the National Institute of Health and Care Research (NIHR) as part of approximately £20 million provided to fund research into Long COVID (LC) in 2021. There are an estimated 1.9 million people in the UK (2.9% of the population) experiencing self-reported LC (as of 5 March 2023, data from ONS). Our aim is to use the developing science around LC to guide how health services manage the condition and ensure that patient views and outcomes are at the heart of LC services.
Chief Investigators of the project are Prof Manoj Sivan and Prof Brendan Delaney.
Led by the University of Oxford (Prof Trish Greenhalgh), workstream 1 is exploring the evidence behind what clinics and GPs should do in terms of investigation and treatment. We recognise that the ‘root cause(s)’ of LC are not yet known, but there is still much that can be done to improve functioning, ability to work, and quality of life. We are currently producing a series of reviews and practice guides as scientific publications. We will consult with patients on the new guidelines for care, which we will implement and study in the participating LC services. The workstream is also exploring the inequalities in provision of LC care and producing specific guidance for vocational rehabilitation (return to work).
Led by the University of Leeds (Dr Manoj Sivan), workstream 2 is monitoring outcomes (symptoms and responses to therapy) monthly to determine how the clinic activities affect patients and their symptom fluctuations. This is achieved via completion of the C19-YRS symptom questionnaire, which was developed in Leeds and has been adopted by the World Health Organization. The questionnaire has been rolled out in all ten participating LC services via a digital app (ELAROS), with online and paper alternatives available. In addition, we are using Fitbits and other sensors in a group of up to 400 patients to dig deeper into understanding of fatigue and the triggers for it. We aim to try and predict the kind of activities that make symptoms worse and use this data to aid self-management of LC.
Led by Imperial College London (Prof Brendan Delaney), workstream 3 is working with data from the health system (LC services and GPs) to provide numerical answers to questions of how effective different LC services are. We can make comparisons between LC services as they have slightly different operating models (staff specialisms, remote vs in person, etc.). This means we can observe the differences in care provision as an onlooker without intervening. We are using retrospective data from patients seen in LC services over the past two years, and GP data via North-West London Whole Systems Integrated Care, alongside national data from the Royal College of GPs Research and Surveillance Network (with approval from the Health Research Authority). We are also working to develop an economic model that will help the NHS determine the most effective and efficient ways of healthcare delivery.
Each workstream of the study contains multiple 'tasks, which are also referred to as 'work packages'. Find out about the findings from these work packages by visiting our 'Outputs' page.
Whilst we appreciate the enthusiasm for participating in such crucial LC research, for most work packages we are only able to recruit from participating clinics. If you are a patient at one of the clinics, a member of staff will have already contacted you.
However, people without LC can also support our research, by participating in 'aAP Study' and/or 'Prevalence study of Orthostatic Intolerance on standing' work packages.
Please be aware that for reasons of ethical clinical practice we are unable to offer advice on specific matters for individual patients.