Norwegian SARS-CoV-2 study - Virological, clinical and immunological characterisation of inpatients during the COVID-19 outbreak

The Norwegian SARS-CoV-2 study is designed as a multicenter hospital based cohort study that will allow us to analyse the disease outcome in relation to risk factors and intervention in a large material across institutions. All health regions in Norway are represented in this research initiative to minimise any bias in the material. To address the pathogenicity, we will investigate patients at different time points from inclusion in the cohort according to the ISARIC protocol to assess different outcomes by serial sampling and clinical data collection. We will use rapid syndrome-based point-of-care testing, Whole Genome Sequencing and Next Generation Sequencing to detect co-infections and for detailed studies of virological causes of severe outcome. Such novel sequencing techniques will be employed in collaboration with virologists at Wuhan Institute of Virology, Hubei, China, allowing for comparison with strains from the origin and start of the SARS-CoV-2 pandemic. The study will generate much needed knowledge on the clinical features of the infection, longterm morbidity and mortality and occurrence of co-infections and will describe the response to treatment, including supportive care and novel therapeutics. We will observe pathogen replication, excretion and evolution, within the host in various biological material. Further, we aim to investigate host immune responses over time during hospitalisation and at follow-up in relation to clinical outcome. This large study provides an excellent framework for a PhD fellowship focusing on the pathogenicity of SARS-CoV-2, co-infections and the study of virus mutations and dissemination in the patient over time and across cases using novel virological techniques. Furthermore, data on the whole genome of SARS-CoV-2 from our study will be compared with cases from Wuhan, the origin of the outbreak. The data will be shared with the international scientific community through the Oxford Database solution REDCap.