Does gut bacteria play a role in rheumatoid arthritis?

26th June 2020 – Paz Garcia

Image by Alicia Harper

A group of gut bacteria is linked with high genetic risk of rheumatoid arthritis, according to new TwinsUK research published today.

These findings will help researchers understand how rheumatoid arthritis may develop in the very early stages.

Rheumatoid arthritis (RA) is a long-term condition that causes swelling and stiffness in the joints and can lead to disability. It affects around 400,000 people in the UK.

We know from previous research that certain genes can make some people are more likely to develop RA than others, and that a combination of genetic and environmental factors lead to RA. In this study, the team investigated whether high-risk genes were linked with certain types of gut bacteria.

The researchers analysed genetic and microbiome data of 1,650 TwinsUK participants with no history of RA, so that they could see if they could spot any early warning signs before the onset of symptoms. The team calculated the twins’ genetic risk for RA and then looked at the gut bacteria identified from stool samples.

The team found that bacteria from a group named Prevotella were associated with high genetic risk of RA. In addition, the researchers found bacteria from the same group were linked with early stages of RA when they analysed data from participants in another cohort study.

First author Philippa Wells explained:

“Our findings are in agreement with the gut microbiome having a role in the development of RA. Speculatively, in the future this could be a possible target for treating the condition. This is something future studies will need to explore.”

The work was funded by charity Versus Arthritis. Head of Research Engagement at Versus Arthritis Natalie Carter said:

“8 out of 10 people who experience chronic pain every day have arthritis. Despite treatments for rheumatoid arthritis improving over the years, there are still too many people who live with persistent pain because they do not respond to available therapies.

“By understanding how specific bacteria in the gut affect the development of rheumatoid arthritis we not only open the door to more targeted, effective treatments, but we can begin to tackle the disease sooner. Implementing treatment that works as early as possible will keep joint damage to a minimum, help people manage their condition and allow them to lead full and active lives.”

Wells et al. Associations between gut microbiota and genetic risk for rheumatoid arthritis in the absence of disease: a cross-sectional study. Lancet Rheumatology, 2020.

Can diverse gut bacteria help protect against type 2 diabetes?

24th June 2020 – Paz Garcia

Gut bacteria could be key players when it comes to reducing your risk of type 2 diabetes, according to new research from TwinsUK.

The team, led by Dr Cristina Menni from the Department of Twin Research, identified six molecules produced by gut bacteria that appear to play a role in type 2 diabetes risk.

Type 2 diabetes develops when the body is no longer able to respond appropriately to insulin, which the body needs to process glucose. If untreated, this leads to high levels of glucose in the bloodstream.

Previous research found a link between type 2 diabetes and low gut microbiome diversity, but the cause was unclear. In this study, the team investigated whether molecules – known as metabolites – produced by the gut bacteria could be the reason for this link.

The team studied microbiome and blood glucose data collected from 1,018 TwinsUK participants, and then checked their findings by analysing an additional cohort from the USA.

The researchers found that two metabolites that correlated with higher microbiome diversity have previously been linked to lower rates of type 2 diabetes.

One of the metabolites that correlated with lower microbiome diversity however is thought to have a role in insulin resistance, a key feature of type 2 diabetes.

Dr Cristina Menni explained the implications of the study’s results:

“Our findings help us understand how exactly gut bacteria may help or hinder us when it comes to type 2 diabetes. We know that we can change our gut bacteria – and so the metabolites produced – by altering our diet.

“What’s potentially exciting about our results is that they imply that it may be possible to reduce your risk for type 2 diabetes by changing your diet to change your gut bacteria in order to reduce the harmful metabolites and increase the protective ones.

“Moving forward, clinical studies should investigate the metabolites identified and determine whether modifying these molecules through diet could help reduce or monitor type 2 diabetes.

Menni et al. Serum metabolites reflecting gut microbiome alpha diversity predict type 2 diabetes. Gut Microbes, 2020.

Landmark nutritional study PREDICT shows dietary inflammation after meals varies dramatically among healthy adults

11th June 2020

Researchers led by the Department of Twin Research announced today the first published results from PREDICT, the largest ongoing nutritional study of its kind.  

The team found a wide range of metabolic responses after eating in apparently healthy adults, and that inflammation triggered by the food we eat varies up to ten-fold. 

Poor metabolic responses to food, where the body takes longer and works harder to clear the blood of fat and sugar, are linked with increased risk of conditions such as low-grade inflammatory diseases including heart disease, type 2 diabetes and obesity.   

The results suggests improved health could be achieved by eating foods that are personalised to reduce inflammation after meals.   

Senior researcher on the study Professor Tim Spector said:  

 “When it comes to weight, we’ve traditionally put a huge emphasis on factors we have no control over, like genetics. The fact is, while genetics plays a role, there are many more important factors that impact an individual’s response to food and maintenance of a healthy metabolism. This study shows that achieving a healthy weight requires a scientific approach to eating that takes into account an individual’s unique biology.”  

Led by Professor Tim Spector and his team at King’s College London and spin-out  health science company ZOE, the PREDICT study consisted of 1,103 participants, including 660 identical and non-identical twins from TwinsUK.   

The study measured a wide range of markers from blood glucose, fat and insulin levels to exercise, sleep and gut bacteria (microbiome) over two weeks. It is the most detailed study to date to look at all the different factors that affect our responses to food together.  

Despite wide variation in metabolic responses between participants, results from identical meals eaten on different days showed that individual responses to the same foods were remarkably consistent for each person.   

The team also found that the optimal time to eat for nutritional health also depends on the individual rather than fixed “perfect” mealtimes. The researchers found that some people clearly metabolised food better at breakfast while others saw no difference.   

Dr Sarah Berry, Senior Lecturer of Nutrition Sciences at King’s College London, led on the inflammation part of the study. She said:  

“We found that the increase in fat and glucose in our blood after eating a meal initiates an inflammatory response which differs hugely between individuals. Dietary and lifestyle strategies to reduce prolonged elevations in blood fat and glucose may therefore be a useful target to reduce low-grade inflammation, and protect people from low-grade inflammatory conditions such as type 2 diabetes and cardiovascular disease.”  

Berry, S et al. Human postprandial responses to food and potential for precision nutrition. Nature Medicine, 2020.

Berry, S et al. Impact of Postprandial Lipemia and Glycemia on Inflammatory Factors in over 1000 Individuals in the US and UK: Insights from the PREDICT 1 and InterCardio Studies. Curr Dev Nutr, 2020.

Use loss of taste and smell as key screening tool for COVID-19, researchers urge

5th June 2020

King’s College London researchers have called for the immediate use of additional COVID-19 symptoms to detect new cases, reduce infections and save lives.

In a letter published in The Lancet, the team discussed how loss of taste and smell – anosmia – should form part of screening measures for the virus.

They said:

“As countries slowly emerge from lockdown measures, it is imperative to correctly contact-trace infected individuals. We believe that having added loss of smell and taste to the list of COVID-19 symptoms is of great value as it will help tracing almost 16% of cases that otherwise would have been missed.”

The team, led by Professor Tim Spector, previously reported that loss of smell and taste is a key predictor of COVID-19 in addition to the most established symptoms of a high temperature and a new, continuous cough. The relative importance of the extra symptom was however disputed by sections of the UK government when it announced it was including the extra symptom. This additional analysis of the COVID Symptom Study app data and its 3.7 million users sought to quantify the clinical value of recording loss of smell in the population.

From 76,260 people with symptoms who tested positive for COVID-19 up to 19 May, 28.5% never reported any fever or cough and 16% reported loss of smell but not fever or cough. The prevalence of loss of smell and taste was three-fold higher in individuals testing positive (65%) than in those testing negative (22%), the strongest single predictor of being infected, suggesting that people with loss of smell and taste should self-isolate for at least seven days or until they can be tested.

Professor Spector said:

We believe that loss of smell and taste is a very common COVID-19 symptom and in fact, occurs more often than fever and lasts longer (5 days on average compared to only 2 for fever). Infections could be reduced, and lives saved now that this non-flu-like symptom is widely recognised, and actions are taken.

The researchers suggest that policymakers should consider these findings and their implications for mass screening as part of other public health measures in key areas such as schools, hospitals, airports and care homes.

Professor Spector said:

“Our data suggests that low-cost so-called ‘smell the difference’ screening tests, that are already being used in some workplaces to screen people has they enter buildings, would capture a larger number of positive cases than temperature sensors do. We therefore feel that it should form part of a wider public health approach to reducing the infection rate.”

COVID-19 prevalence and severity higher in urban and most deprived areas

29th April 2020

COVID-19 is disproportionally more common and more severe in people living in urban areas and regions of higher poverty, a new study from the Department of Twin Research reports. 

These results come from the analysis of the health data logged by more than 2 million people over 24 days on the COVID Symptom Tracker app in the UK. 

The team also found that COVID-19 cases and severity has decreased since the lockdown began. 

These results illustrate how data from symptom tracking apps can be used to successfully monitor the pandemic over time, helping to identify areas that need more support and healthcare resources to cope. 

As part of the response to the COVID-19 pandemic, researchers at King’s College London and healthcare science company ZOE developed the COVID Symptom Tracker app. More than two million UK users nationwide are now using it to report daily updates on symptoms, healthcare visits and COVID-19 testing results. 

The team studied 2,266,235 unique app users reporting daily on COVID-19 symptoms, hospitalisation, COVID-19 test outcomes, demographic information and pre-existing medical conditions over 24 days immediately following the introduction of major social distancing lockdown measures announced by Prime Minister Boris Johnson on 23rd March 2020. 

On the link between COVID-19 and poverty, lead researcher Dr Cristina Menni said: 

“This could reflect that individuals in more deprived areas are more exposed or vulnerable to the virus.  It may be that they work in jobs requiring work out of the home, where they are more likely to be exposed to circulating virus. We know from previous research that deprivation is closely linked with increased health issues and disease burden; our results suggest that COVID-19 is no exception.” 

Dr Claire Steves, joint senior author said: 

“This finding is important for allocation of resources in this pandemic.  Areas with higher rates of poverty will need greater supply of PPE and more hospital capacity.  This is likely to continue to be important when the social distancing measures are eased.” 

The map below shows the identified hotspots in red:

The research paper with the full findings is available in non-peer reviewed archive format at the medRxiv site here

Study of 2,600 TwinsUK twins finds COVID-19 symptoms partly due to genes

27th April 2020

Genes are 50% responsible for the presentation of key symptoms of COVID-19 including fever, fatigue and loss of taste and smell, according to the latest data from TwinsUK researchers.

These results suggest that some people are more susceptible to COVID-19 infection than others because of their genetic makeup.

The genetic basis of this variation in response could provide researchers with important clues for developing treatments for COVID-19 and could help identify high-risk groups of people.

The team, led by Professor Frances Williams and Professor Tim Spector, analysed data logged on the COVID19 Symptom Tracker app which has been downloaded by more than 2 million people in the UK including 2,600 twins from TwinsUK.

15,000 twins take part in TwinsUK, which is the most clinically-detailed adult twin registry in the world. Identical and non-identical twins allow researchers to understand to what extent health and disease is affected by genes – nature – and the environment – nurture.

The team used information regarding the twins’ health, symptoms and level of contact with their co-twin to develop a model to understand how much genes influence symptom presentation in COVID-19.

Genes were almost 50% responsible for the development of symptoms of delirium, fever, fatigue, shortness of breath, diarrhoea and loss of taste and smell in individuals. The environment meanwhile was responsible for the development of other symptoms such as hoarse voice, cough, chest pain and abdominal pain.

Professor Frances Williams from TwinsUK said:

“I would like to say a big thank you to all our twins for logging their symptoms and health status regularly in the app. It’s because of their tremendous commitment to health research over the years that we are able to carry out this crucial research so quickly.”

Professor Tim Spector added:

“It’s essential that everybody keeps logging their health status in the app – even if you feel well. The data you provide enables us to carry out this urgent research to understand the behaviour and progression of the virus.”

The research paper with the full findings is available in non-peer reviewed archive format at the medRxiv site here.

COVID-19: helping those at-risk, together

24th April 2020

Today, the COVID Symptom Tracker app, The Academy of Medical Royal Colleges and the UK’s largest health based charities are joining forces in order to reach the most at risk groups, including those with pre-existing health conditions such as heart disease, diabetes and asthma and those over 70s. 

The COVID-19 Symptom Tracker app has been developed by King’s College London and health science company ZOE, and it is endorsed by the Welsh Government, NHS Wales, the Scottish Government and NHS Scotland. More than 2.5 million participants have downloaded the app and are using it to regularly report on their health, making it the largest public science project of its kind anywhere in the world.

The over-70s and those who have pre existing health conditions appear to be most at risk from the effects of COVID-19, yet they are significantly under-represented in the group of people currently providing data through the app. However, early analysis shows that the illness may start with different symptoms in these groups, such as diarrhoea and confusion, rather than the classic cough and fever.

One of the biggest barriers to recruiting people with pre-existing health conditions and those over 70 was access to technology. Developers at ZOE – the company behind the app – have now updated it to allow multiple user profiles, so that family, friends or carers can log daily health reports on behalf of anyone who wishes to take part in the study but does not have access to a smartphone.

Charities including Cancer Research UK, the British Heart Foundation, AGE UK, Alzheimer’s Society, Diabetes UK, Versus Arthritis (full list below) and doctors’ membership bodies including the Royal College of Physicians, Royal College of General Practitioners, Royal College of Obstetricians and Gynaecologists and Royal College of Surgeons of England (full list below), have come together to urge people, especially over 70 and anyone with a pre-existing health issue such as heart disease, diabetes, arthritis, cancer, dementia and other age-related conditions to link up with their relatives, or log on themselves, to help build an accurate picture of how COVID-19 affects us all.

The findings from the research will help to answer key questions that many people are worried about, such as:

  • Which underlying health conditions increase the risk of COVID-19?
  • Does having asthma put me at higher risk?
  • Which of my medications may be protecting me?
  • I’m older but fit and healthy – am I still at increased risk?
  • Is mild high blood pressure or type II diabetes a real risk factor for COVID-19?
  • Will stopping smoking reduce my risk from COVID-19?
  • I’m living with cancer – what does COVID-19 mean for me?
  • Is it safe to take ibuprofen painkillers?
  • Should I continue to take steroids for my arthritis?
  • Is this skin rash a sign of COVID-19?
  • Is COVID-19 common in my area right now?

Anyone can join the study by downloading the simple, free COVID Symptom Tracker app from covid.joinzoe.com and answering a few questions about their health and medications. Participants then spend a minute checking in every day, whether they are feeling physically healthy or experiencing any new symptoms.

Study leader Dr Claire Steves, Clinical Senior Lecturer at King’s College London and Consultant Geriatrician at Guys and St Thomas’s NHS Foundation Trust, says: “We have been blown away by the public’s response to the app and the data collected so far has been invaluable. However, we have a clear gap in the data, so in order for us to really understand how the virus affects those over 70 and with pre-existing health conditions we need the support of the public more than ever to help us reach these individuals.”

Tim Spector, Professor of Genetic Epidemiology and PI of the overall study at King’s College London said: “Whether you’re fit and well or have an existing health condition, using the app to report daily on your own health and that of your loved ones will be making a really valuable contribution to the fight against COVID-19.”

President of the Royal College of Physicians Professor Andrew Goddard said: “One of the most difficult challenges about this coronavirus is the wide range of symptoms people are presenting with and the heart-breaking effect COVID-19 has from person to person – mild in many to life threatening for others in what seems like just moments. We urgently need to learn more about COVID-19 and until we have widespread population testing of antibodies, trackers like this app are really useful.”

Professor Martin Marshall, Chair of the Royal College of GPs, said: “This is an exciting development that is already redefining the diagnosis and treatment of COVID-19. As well as providing vital evidence to support the work of GPs and the medical profession, it could identify patients who are most susceptible at a much earlier stage. It has the potential to make a major contribution to our fight against the disease.”

President of the Royal College of Surgeons of England, Professor Derek Alderson said: “It is crucial we build as detailed a picture as possible about this devastating virus, including who is most affected and the wide range of symptoms people present with. This app will play an important contribution and I welcome its development.”

Caroline Abrahams, Charity Director at Age UK said: “For both now and the future it’s crucial that we understand in as much detail as possible the impact of this virus on older people and the fact this initiative can provide valuable new insights is potentially very exciting and  it’s one we are pleased to support.”

Professor Sir Nilesh Samani, Medical Director at British Heart Foundation said: “Information to date suggests that people with heart and circulatory diseases are at higher risk of complications caused by the novel coronavirus. We need to better understand why this may be the case and how severely they are affected. Collecting real world data from as many people as possible will help us understand this. It will also provide accurate information which can be used to plan how we emerge from the pandemic. We urge all our supporters and their families to download the app today, even if you are feeling healthy. In doing so, you’ll be contributing to the fight against the coronavirus.” 

Dr Stephen Simpson, Director of Research at Versus Arthritis said: “The impact of COVID-19 on the elderly and those with long term conditions, like arthritis, needs to be better understood so that we can support and help them through this difficult time.  We are delighted to support innovative means of being able to monitor, track and capture vital data around health and symptoms across all the UK nations, as provided by this exciting initiative and encourage people to participate in all data opportunities to enable the fight against coronavirus.”

Deborah Alsina MBE, chief executive of the national older people’s charity Independent Age, said: “Since the Covid19 outbreak took hold, people of all ages have wanted to help our family, friends and neighbours through this difficult time. If you are over 70, taking just one minute a day to log your symptoms could help play a vital part in scientific understanding of the virus and its relative risk in different age groups.”

Dr Lucy Chambers is Head of Research Communications at Diabetes UK. She said: “We need to urgently address the current gaps in knowledge around how COVID-19 affects people living with pre-existing health conditions – including those living with any type of diabetes. This is why it is crucial that everyone does their bit to help scientists gather the information needed to respond effectively to the pandemic and save lives. If you – or someone in your family – live with diabetes, we encourage you to help advance our understanding of how the virus affects people with diabetes by downloading the COVID Symptom Tracker app and logging how you or those you might care for feel daily.”

Rachel Connor, Director of Research Partnerships at the type 1 diabetes charity JDRF, said: “There is currently no good information to tell us how type 1 diabetes interacts with COVID-19. The type 1 diabetes community knows the value – and the power – of research data. So we at JDRF are encouraging people with type 1 diabetes to use the app and help beat Covid-19.”

Dr Carol Routledge, Director of Research at Alzheimer’s Research UK, said:  “Most people with dementia are aged over 70, and will not only be at a higher risk for severe symptoms of COVID-19, but may be more likely to face challenges using smartphone technology. Research is vital for overcoming any medical condition, and we are pleased to able to support the COVID-19 Symptom Tracker app, which could also provide crucial information about how COVID-19 affects people with dementia. We encourage anyone who is currently caring for someone with dementia to help log daily symptom reports, with their loved one’s consent, if they need support.”

Tina Woods, CEO of Longevity International and Secretariat Director of APPG for Longevity, said: “Sadly, those most affected by the COVID-19 epidemic are older, in poor health and in the most deprived and often digitally excluded communities.  This initiative is urgently needed to reach these vulnerable populations as quickly as possible to get an accurate picture of the future impact of epidemic.”

Suzanne Cass, CEO at ASH Wales said: “It is crucially important that we build up a picture of  how Covid-19 affects the population so that we can better understand who is most at risk from the virus and why. We know that smokers are more likely to suffer severe complications if they catch Covid-19. Smoking weakens the body’s lung defences and leads to respiratory and heart conditions – all of which could be risk factors for Covid-19. We would urge the 17% of adults in Wales that smoke to download this app so that we can better understand the risks they face and the symptoms they could experience. Family members and those living with smokers could also provide vital information on their behalf.”

The Academy of Medical Royal Colleges is the umbrella organisation for the UK and Ireland’s 23 medical royal colleges and faculties, and represents the professional interests of the UK and Ireland’s 220,000 doctors. 

Colleges include: 

  • Association of Medical Royal Colleges
  • Royal College of General Practitioners
  • Royal College of Practitioner 
  • Royal College of Obstetricians and Gynaecologists
  • Royal College of Surgeons of England
  • Royal College of Paediatrics and Child Health

Full list of charity partners:

  • Age UK 
  • Alzheimers Research UK
  • ASH Wales 
  • British Heart Foundation 
  • Cancer Research UK 
  • Carers Mending the Gap 
  • Care England / APPG for Longevity
  • Diabetes UK 
  • Great Manchester Ageing Hub 
  • JDRF – Type 1 diabetes 
  • KENT SURREY SUSSEX AHSN LTD
  • The Physiological Society 
  • Tommy’s 
  • St Monica’s Trust
  • Versus Arthritis

Latest data from COVID Symptom Tracker app shows the lockdown is working

8th April 2020

The latest analysis of data from the COVID Symptom Tracker app, used by over 2 million people, shows the rate of new symptoms being reported nationally has slowed down significantly in the past few days.  The latest figures estimate that 1.4 million people in the UK aged 20-69 have symptomatic COVID, a fall from 1.9 million on the 1st April. 

These figures suggest that the nation staying home is having a big impact on the spread of the virus in the UK. The drop in new symptoms indicates that although the number of hospital admissions and deaths from COVID are currently rising, they should start to fall in about two weeks provided social distancing continues. This two week lag is caused by the delay between symptoms starting and becoming very severe.  

This data from millions of people lines up with what has been reported by NHS digital based on much smaller numbers. They show a decline in the number of calls to NHS 111 with COVID since the 22nd March.

While symptoms have been decreasing nationally, in all areas there are still many people with active symptoms of COVID. Therefore, this data supports both the success of lockdown, and the importance of maintaining it. It also shows that individual areas vary. Most of the country’s larger cities like London, Birmingham, Glasgow, and Liverpool continue to have very high levels of symptoms in the community, even this far into lockdown. Other hotspots include South Wales. There are significantly higher levels of symptoms across the Midlands, the North of England and Southern Scotland than in the South West of England. 

Lead researcher Professor Tim Spector said:

“It is really encouraging to see that the rate of new symptoms being reported is beginning to fall. Even though hospital admissions and deaths are still on the rise, we hope that these figures offer a much needed light at the end of the tunnel. 

We have been totally blown away by the public’s response to the app. On the first day we saw one million members of the public download the app making it one of the most successful first days for an app ever, and already probably the UK’s largest citizen science project. The altruism of the UK public combined with modern technology is allowing us to rapidly collect huge amounts of invaluable data to help us better understand this deadly virus.

We would like to take this opportunity to thank every single person who is already participating and would urge everyone else to download the app and check in every day, whether you are experiencing any symptoms or feeling fine.”

Developed by researchers at King’s College London and healthcare science company, ZOE, the COVID Symptom Tracker has been used to log symptoms by over 2 million people across the UK, with over 10 million individual reports so far. Members of the public are using the app to track their daily health whether they are healthy or showing potential COVID symptoms. It is also being used by healthcare and hospital workers nationwide so their increased risk can be recorded.

The research team at King’s College London and ZOE are working round the clock to analyse the data to generate new insights about the disease and its progression. For example, they have discovered that loss of smell or taste is more predictive of COVID in the population than the classical symptoms of fever and cough. An interactive map allowing anyone to see the distribution of COVID in their area is available at covid.joinzoe.com as well as frequent science updates.

The researchers have developed a statistical model which analyses millions of COVID Symptom Tracker data points, including thousands of people who have had tests for COVID, in order to predict which combination of symptoms indicate someone is likely to test positive for COVID. This model is then applied to the UK population aged 20-69 and then mapped to the regions of the country accounting for age and gender differences to provide maps over time. The most predictive individual symptoms, in order of importance were: lack of taste & smell, fatigue, shortness of breath, fever and persistent cough. The model estimates that 3.5% of these app users would be positive if tested. As contributors continue to share symptoms, and we link it to other health records, the model will become more accurate and sophisticated.

The app is available to download from the Apple App Store and Google Play from the links at covid.joinzoe.com.

Loss of smell and taste a key symptom over fever for COVID-19 cases

1st April 2020

Losing your sense of smell and taste may be the best way to tell whether you have COVID-19, according to the latest analysis of the data collected by our COVID Symptom Tracker App

26% of the 1.5 million app users between 24-29 March 2020 reported one or more symptoms through the app. Of these, 1,702 reported having been tested for COVID-19, with 579 positive results and 1,123 negative results. 

The data analysed from the app shows that 59% of COVID-19 positive patients reported loss of smell and taste, compared with only 18% of those who tested negative for the disease. These results were much stronger in predicting a positive COVID-19 diagnosis than self-reported fever.  

Using all the data collected, the King’s College London research team behind the app alongside ZOE data scientists developed a model to identify which combination of symptoms together could predict COVID-19 cases. 

The model features a combination of loss of smell and taste, fever, persistent cough, fatigue, diarrhoea, abdominal pain and loss of appetite, in which the strongest predictor is loss of smell and taste. 

When applied to the +400,000 individuals reporting symptoms who had not yet had a COVID-19 test, the team found that almost 13% of them are likely to be infected by the virus – meaning an extra 50,000 individuals are likely to have as-yet unconfirmed COVID-19 infections. 

The app, which was developed by a King’s College London team in association with the Guy’s and St Thomas’ NHS Foundation Trust NIHR Biomedical Research Centre and a healthcare start-up ZOE Global LTD, asks users to log their symptoms (or lack thereof) daily.  

The aim is to help researchers understand the spread and progression of COVID-19. By 31st March 2020, more than 1.8 million users in the UK have signed up to help by logging their symptoms every day. 

Lead researcher Professor Tim Spector said: 

“When combined with other symptoms, people with loss of smell and taste appear to be 3 times more likely to have contracted COVID-19 according to our data and should therefore self-isolate for seven days to reduce the spread of the disease. 

This urgent research is only possible thanks to the 1.8 million citizen scientists logging their symptoms every day. This also gives us an evolving map of the UK of where symptoms are occurring two to three weeks before a strain on the NHS, which is why it’s vital to continue logging your health and symptoms, even when you feel completely healthy, and encourage others to use the app.” 

King’s College London Pioneers Symptom Reporting App to Slow Spread of COVID-19

24th March 2020

King’s College London is launching a COVID-19 symptom tracking app in the UK, allowing anyone to take 1 minute to self-report daily. Around 5,000 twins and their families across the UK have been recruited from the TwinsUK cohort study to trial the app, which tracks in real time how the disease progresses. The aim is to help slow the outbreak by helping researchers identify:

  • How fast the virus is spreading in your area 
  • High-risk areas in the UK
  • Who is most at risk, by better understanding symptoms linked to underlying health conditions

Twins using the app will record information about their health on a daily basis, including temperature, tiredness and symptoms such as coughing, breathing problems or headaches. 

The aim is to send participants COVID-19 home testing kits to better understand which symptoms truly correspond to coronavirus infection. This is an urgent clinical issue given the current limits on testing.

The app will be also available to the general public without the home testing component of the study. It can be downloaded for free from covid.joinzoe.com

Comparing genetically identical twins with non-identical twins, who are as related as regular siblings, enables researchers to separate the effects of genes from environmental factors such as diet, lifestyle, previous illnesses and infections, and the microbes within the gut (microbiome).

Samples taken from the twin group will be used to generate a biobank for use in future research projects investigating infection and immune responses.

The data from the study will reveal important information about the symptoms and progress of COVID-19 infection in different people, and why some go on to develop more severe or fatal disease while others have only mild symptoms. 

The study will support the urgent clinical need to distinguish mild coronavirus symptoms from seasonal coughs and colds, which may be leading people to unnecessarily self-isolate when they aren’t infected or inadvertently go out and spread the disease when they are.

Led by Professor Tim Spector, professor of genetic epidemiology at King’s College London, TwinsUK is a scientific study of 15,000 identical and non-identical twins, which has been running for nearly three decades. At least 5,000 members of the existing twin cohort and their families are expected to sign up for this new COVID-19 sub-study. 

This unique twin group has been studied in unprecedented detail over many years, with most already having taken part in comprehensive genetic analysis and immune profiling, as well as detailed gut microbiome profiling. 

The free monitoring app has been developed as a partnership between researchers at King’s College London and health data science company ZOE – itself a spin-out from King’s College London – and will also be widely available to health staff and the general public who wish to contribute to this vital research. It will also be used by other large population studies in the UK and US.

Professor Spector says,

“These are worrying times for everyone. Our twins are a fantastically committed enthusiastic health research participants who have already been studied in unprecedented detail, putting us in a unique position to provide vital answers to support the global fight against COVID-19. The more people who use the app, the better the real-time data we have to combat the crisis in this country.” 

The TwinsUK COVID-19 research study is funded by King’s College London, ZOE Global Ltd, the CDRF charity, and the National Institute of Health Research Guy’s and St Thomas’ Biomedical Research Centre. Any data gathered from the app and study will be used strictly for public health or academic research and will not be used commercially or sold. 

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24th March 2020 King’s College London is launching a COVID-19 symptom tracking app in the UK, allowing anyone to take...

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24th March 2020 King’s College London is launching a COVID-19 symptom tracking app in the UK, allowing anyone to take...

Celebrating International Women's Day: Stories from Twins and TwinsUK Staff

24th March 2020 King’s College London is launching a COVID-19 symptom tracking app in the UK, allowing anyone to take...