A national and global reference in public health, it has become one of the epicentres of the scientific fight against Covid-19 in our country
The Carlos III Institute of Public Health in Madrid (ISCIII -acronym in Spanish) is fully committed to the current pandemic caused by Covid-19. The public and autonomous organisation, created in 1986, has mobilised its network of epidemiological surveillance - coordinating their work with other municipalities and the network of laboratories throughout Spain - to support the National Health System and offer its scientific and technical health assistance.
The work and expertise it provides is vital, especially through the national centres of Microbiology (CNE- acronym in Spanish) and Epidemiology (CNE- acronym in Spanish). Two institutions focused, among other areas, on the analysis of samples and confirmation of cases -the CNM has established a specific PCR technique for the new virus-; the validation of diagnostic kits developed by different companies; the adaptation of the epidemiological surveillance system; the expansion of the objectives of several of its research projects to include the current Covid-19 in its field of study; and the advice of its researchers and technicians to the Ministry of Health and the Regional Ministries of Health.
In addition, it has previously participated in the European project selected in the European Commission’s last express call to create a multidisciplinary network for research, prevention and control of the disease.
Financing and coordination of Covid-19 projects
To coordinate research efforts against Covid-19, ISCIII received funding amounting to 25.2 million euros out of the 29.65 million approved by the Council of Ministers on 17 March. With this amount, ISCIII has developed an emergency support program for projects related to the new coronavirus: to better understand the biology of the virus, to develop new therapeutic and prophylactic options, to develop an epidemiological surveillance system or to observe its impact on the health services, among others. The Centro Superior de Investigaciones Científicas (CSIC), for its part, has received 4.5 million euros with which it is financing another 50 projects to help combat the coronavirus.
Since then, the ISCIII has received more than a thousand proposals from centres from all over Spain. To date, 11 are financed by the Covid-19 Fund (which consists of over 3.5 million euros). Further approvals will be communicated in the coming days.
Prevention, rapid detection and pharmacology, among the top projects
The first two projects approved, during the last week of March, study possible therapeutic approaches: the combined use of antivirals with hyperimmunity blockers in early stages of the disease, in the first; and the use of plasma with antibodies from cured patients as antiviral therapy in hospitalised patients in the second. Two studies that seek to answer urgent clinical questions, and whose objective is to find the best available treatment and use it early on in infected patients to reduce the number of ICU admissions.
Already in April, six new projects have been added to the second round of approvals. Two of the studies reinforce the analysis of antiviral drugs and treatments. The first, led by the Health Research Institute of La Paz Hospital in Madrid, compares three different treatment schemes with different antiviral drugs (hydroxychloroquine, Iopinavir-ritonavir and the combination of hydroxychloroquine and azithromycin). The second trial with antivirals, as part of the international WHO Solidarity study, and led by the Health Research Institute of the Clinical Hospital in Madrid, studies the comparative efficacy of the drugs remdesevir, ritonavir/lopinavir, hydroxychloroquine and beta interferon.
The University Hospital of Elche, for its part, is studying treatment with a weekly dose of a drug (mefloquine) as a preventive method to avoid developing the disease. Hospitals in the provinces of Alicante, Murcia and Madrid will participate in the trial.
The Instituto Murciano de Investigaciones Biomédicas (IMIB) is investigating the use of the drug defibrotide to reduce respiratory distress, the main pulmonary complication of Covid-19 and the one responsible for many patients requiring ICU treatment.
In order to improve anaesthesia for intubation, the Health Research Institute of the Clinical Hospital of Valencia (INCLIVA -acronym in Spanish) is investigating the use of sevoflurane as an alternative to propofol, also contributing to a reduction in the time required for intubation due to its anti-inflammatory properties.
And the physicists of the Madrid Institute for Advanced Studies in Nanoscience (IMDEA-Nanoscience), in turn, have obtained approval for a trial that seeks to confirm the efficacy of a new rapid diagnostic test that would reduce waiting time, thanks to nanotechnology.
As part of the third round of ISCIII approvals, the project led by the University of Santiago de Compostela will analyse the use of a technology that seeks to trigger an immune response to the virus as effectively as possible, based on the use of microspheres into which SARS-CoV-2 proteins have been inserted. The research, which will be carried out first in animals, thus diversifies the search for vaccines against Covid-19.
The ISGlobal clinical trial, in collaboration with hospitals in Barcelona and Madrid, will analyse the effect of the drug hydroxychloroquine on pregnant women with coronavirus, in order to study its preventive use as well.
And finally, the Health Research Institute of the Clinical Hospital of Valencia (INCLIVA- acronym in Spanish) is joining the search for faster and more comprehensive diagnoses with its research to reduce the time of diagnosis by PCR (the most reliable test), from 4 hours to 45 minutes. They will prove this by modifying the PCR using the technique known as isothermia.
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