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The research community of the Andalusian Public Health System has focused on understanding the COVID-19 disease, its behaviour and the variants of the virus.

Two years after the WHO declared a pandemic situation due to the new coronavirus, the Regional Ministry of Health and Families takes stock of the research carried out during this period of time, which has focused the efforts of a large part of the research community.

In total, 170 research projects have been carried out within the Andalusian public health system focused on gaining a better understanding of the COVID-19 disease, its behaviour and possible treatment options. In these two years, 88 research projects have been launched, which have attracted more than 11.2 million euros. These projects address different areas of study related to the coronavirus, such as the production of therapeutic antibodies to combat the disease, the immune response, the identification of susceptibility factors in cancer patients and the importance of vitamin D, among others. To date, 59 of the 88 projects are active.

In addition, since March 2020, 82 clinical studies have been launched by healthcare professionals at centres in all Andalusian provinces, generating a total of 192 participations, i.e. the number of centres participating in all clinical studies.

Currently, 68 clinical studies are active, of which 41 are clinical trials, 26 are observational studies and one is a clinical study with a medical device. These multicentre studies, in which participation transcends borders, have addressed approaches from diverse perspectives such as internal medicine, microbiology, infectious diseases and pharmacy, to name a few.

Epidemiological surveillance and control of new variants

In addition to these research studies, epidemiological surveillance and control work has been carried out within the Andalusian Public Health System. The Directorate General of Public Health and Pharmaceutical Organisation, with the support of the Andalusian Health Service, set up a stable and well-structured circuit that allows the identification and study of the coronavirus genome. Originally, this circuit saw the light of day as a research project within the framework of the Clinical Research Programme in COVID-19 of Andalusia, which was called for in an extraordinary way to support research in this field.

In this context, a total of 21,630 complete coronavirus genomes have been sequenced to date. The genomic analysis of samples from COVID-19 positive individuals provides a better understanding of the disease and its behaviour in order to be able to offer effective therapeutic alternatives. In addition, thanks to genomic sequencing, a phylogenetic study of the virus can be carried out, showing the mutations it undergoes over time, its characteristics and its possible relationships with variants from other countries or locations, which facilitates the detection of virus introductions and transmission chains. The results of the progression of this study are publicly available on the website: https://www.clinbioinfosspa.es/COVID_circuit/.

This circuit is part of the integration of the genomic sequencing of SARS CoV-2 in the surveillance tasks carried out by the Andalusian Epidemiological Surveillance System (Sistema de Vigilancia Epidemiológica de Andalucía). This is a collaborative network for the epidemiological control of the pandemic that allows us to know how the coronavirus has been transmitted in Andalusia since the beginning, which areas have had the highest rate of contagion and also how the health measures that have been implemented have influenced it, among other aspects.

Thus, the genomes have been sequenced in the two reference hospitals designated for this purpose: the Virgen del Rocío Hospital in Seville, to sequence the samples from hospitals and primary care centres in the western area of Andalusia (the provinces of Cadiz, Cordoba, Huelva and Seville); and the San Cecilio Hospital in Granada, for those from the eastern area (Almeria, Granada, Jaen and Malaga). The information obtained has been analysed in the Clinical Bioinformatics Area of the Progreso y Salud Foundation, where an epidemiological map of the virus is interpreted and configured. This work has been promoted by the General Secretariat for R&D&I in Health.

A stable and coordinated circuit

Until reaching the two reference centres, both microbiology professionals and clinicians from hospitals and primary care centres are links in the chain that work in coordination with the Andalusian Epidemiological Surveillance System, made up of Public Health professionals from the districts and hospitals, Epidemiology from the Provincial Territorial Delegations and the Surveillance and Occupational Health Service of the General Directorate of Public Health and Pharmaceutical Organisation.

At the end of this chain, the last link is the Clinical Bioinformatics Area of the Progreso y Salud Foundation, where its professionals analyse the data obtained from the sequencing, report the results to the reference centres so that they can inform the Ministry of Health of the findings in the Andalusian community and incorporate them into the bioinformatics tools for more detailed interpretation.

With these bioinformatics tools and information and communication technologies, decision-making in the Andalusian public health system is improved, leading to a better approach to diseases and an improvement in the quality of life of patients.


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