Select campus:UKDubai
University of Birmingham
Menu

About the TLC Study

Approximately 1 in 10 people with COVID-19 continue to experience symptoms and impaired quality of life beyond 12 weeks, which is known as ‘Long COVID’.

Common Long COVID symptoms include, extreme tiredness, shortness of breath, chest pain or tightness, ‘brain fog’, insomnia, heart palpitations, dizziness, pins and needles, joint pain, depression, anxiety, tinnitus, earaches, nausea, diarrhoea, stomach aches, loss of appetite, a high temperature, cough, headaches, sore throat, and changes to sense of smell or taste.

Through a partnership with the Clinical Practice Research Datalink using electronic GP records, the University of Birmingham-led team will identify and recruit thousands of non-hospitalised patients with Long COVID who have had symptoms for 12 weeks or longer to a major clinical digital study.

At the heart of the study will be the use of a digital platform, called Atom5™ from med-tech company Aparito Limited, which will be configured for the study by experts from the University of Birmingham with patient input. Participating patients will be given access to the digital platform, allowing them to self-report symptoms, quality of life and work capability.

A subgroup of patients will receive blood and other biological tests to understand the immunology of Long COVID, and will wear a device that will measure their heart rate, oxygen saturation, step count and sleep quality.

Using their findings, the researchers will co-produce with patients a targeted intervention for Long COVID, tailored to individual patient need. Delivered remotely in the community, via the Atom5TM app, it will provide critical support and information to empower patients in self-managing long COVID. In addition, they will provide tailored resources to support symptom management and nurse-led support for those with the severest symptoms.

The researchers will also use the digital platform to assess whether the treatments and supportive interventions reduce symptoms, improve quality of life, and are good value for money.

All data gathered will be used to help the scientists characterise the symptoms, health impacts, and underlying causes of Long COVID syndromes in non-hospitalised patients – providing invaluable insight not currently available.

Team members

University of Birmingham

MHRA CPRD

Medicines & Healthcare products Regulatory Agency Clinical Practice Research Datalink team:

  • Dr Puja Myles

  • Dr Tim Williams

Aparito Ltd.

  • Dr Elin Haf Davies

Publications

2021

  • Aiyegbusi, Olalekan Lee; Hughes, Sarah E; Turner, Grace; Rivera, Samantha Cruz; McMullan, Christel; Chandan, Joht Singh; Haroon, Shamil; Price, Gary; Davies, Elin Haf; Nirantharakumar, Krishnarajah; Symptoms, complications and management of long COVID: a review. Journal of the Royal Society of Medicine; 114;9:428-442. 2021

2022

  • Routen, Ash; O’Mahoney, Lauren; Ayoubkhani, Daniel; Banerjee, Amitava; Brightling, Chris; Calvert, Melanie; Chaturvedi, Nishi; Diamond, Ian; Eggo, Rosalind; Elliott, Paul; Understanding and tracking the impact of long COVID in the United Kingdom. Nature medicine. 28;1. 2022

  • Hughes, Sarah E; Haroon, Shamil; Subramanian, Anuradhaa; McMullan, Christel; Aiyegbusi, Olalekan L; Turner, Grace M; Jackson, Louise; Davies, Elin Haf; Frost, Chris; McNamara, Gary; Development and validation of the symptom burden questionnaire for long covid (SBQ-LC): Rasch analysis. BMJ. 377. 2022

  • Brown, Kirsty; Yahyouche, Asma; Haroon, Shamil; Camaradou, Jenny; Turner, Grace; Long COVID and self-management. Lancet. 399. 10322;355. 2022

  • Chandan, Joht Singh; Brown, Kirsty; Simms-Williams, Nikita; Camaradou, Jenny; Bashir, Nasir; Heining, Dominic; Aiyegbusi, Olalekan Lee; Turner, Grace; Rivera, Samantha Cruz; Hotham, Richard; Non-pharmacological therapies for postviral syndromes, including Long COVID: a systematic review and meta-analysis protocol. BMJ open. 12;4. 2022

  • Haroon, Shamil; Nirantharakumar, Krishnarajah; Hughes, Sarah E; Subramanian, Anuradhaa; Aiyegbusi, Olalekan Lee; Davies, Elin Haf; Myles, Puja; Williams, Tim; Turner, Grace; Chandan, Joht Singh; McMullan, Christel; Lord, Janet; Wraith David C; McGee, K; Denniston, Alastair K; Taverner, Tom; Jackson, Louise J; Sapey, Elizabeth; Gkoutos, George; Gokhale, Krishna; Leggett, Edward; Iles, Clare; Frost, Christopher; McNamara, Gary; Bamford, Amy; Marshall, Tom; Zemedikun, Dawit T; Price, Gary; Marwaha, Steven; Simms-Williams, Nikita; Brown, Kirsty; Walker, Anita; Jones, Karen; Matthews, Karen; Camaradou, Jennifer; Saint-Cricq, Michael; Kumar, Sumita; Alder, Yvonne; Stanton, David E; Agyen, Lisa; Baber, Megan; Blaize, Hannah; Calvert, Melanie. Protocol: Therapies for Long COVID in non-hospitalised individuals: from symptoms, patient-reported outcomes and immunology to targeted therapies (The TLC Study). BMJ Open. 12;4. 2022

  • Munblit, Daniel; Nicholson, Timothy; Akrami, Athena; Apfelbacher, Christian; Chen, Jessica; De Groote, Wouter; Diaz, Janet V; Gorst, Sarah L; Harman, Nicola; Kokorina, Alisa; A core outcome set for post-COVID-19 condition in adults for use in clinical practice and research: an international Delphi consensus study. The Lancet Respiratory Medicine. 10;7;715-724. 2022

  • Subramanian, Anuradhaa; Nirantharakumar, Krishnarajah; Hughes, Sarah; Myles, Puja; Williams, Tim; Gokhale, Krishna M; Taverner, Tom; Chandan, Joht Singh; Brown, Kirsty; Simms-Williams, Nikita; Symptoms and risk factors for long COVID in non-hospitalized adults. Nature medicine. 28;8;1706-1714. 2022

2023

  • Syed, Umer; Subramanian, Anuradhaa; Wraith, David C; Lord, Janet M; McGee, Kirsty; Ghokale, Krishna; Nirantharakumar, Krishnarajah; Haroon, Shamil; Incidence of immune-mediated inflammatory diseases following COVID-19: a matched cohort study in UK primary care. BMC medicine. 21;1;363. 2023

  • Shah, Anoop D; Subramanian, Anuradhaa; Lewis, Jadene; Dhalla, Samir; Ford, Elizabeth; Haroon, Shamil; Kuan, Valerie; Nirantharakumar, Krishnarajah; Long Covid symptoms and diagnosis in primary care: a cohort study using structured and unstructured data in the Health Improvement Network primary care database. Plos one. 18;9. 2023

  • Aiyegbusi, Olalekan Lee; Davies, Elin Haf; Myles, Puja; Williams, Tim; Frost, Chris; Haroon, Shamil; Hughes, Sarah E; Wilson, Roger; McMullan, Christel; Subramanian, Anuradhaa; Digitally enabled decentralised research: opportunities to improve the efficiency of clinical trials and observational studies. BMJ evidence-based medicine. 28;5;328-331. 2023

  • Routen, Ash; O’Mahoney, Lauren; Aiyegbusi, Olalekan Lee; Alder, Yvonne; Banerjee, Amitava; Buckland, Lewis; Brightling, Chris; Calvert, Melanie; Camaradou, Jenny; Chaturvedi, Nishi; Patient and public involvement within epidemiological studies of long COVID in the UK. Nature Medicine. 29;4;771-773. 2023

  • Chandan, Joht Singh; Brown, Kirsty R; Simms-Williams, Nikita; Bashir, Nasir Z; Camaradou, Jenny; Heining, Dominic; Turner, Grace M; Rivera, Samantha Cruz; Hotham, Richard; Minhas, Sonica; Non-pharmacological therapies for post-viral syndromes, including Long COVID: a systematic review. International journal of environmental research and public health. 20;4;3477. 2023

  • Tufts, Jake; Guan, Naijie; Zemedikun, Dawit T; Subramanian, Anuradhaa; Gokhale, Krishna; Myles, Puja; Williams, Tim; Marshall, Tom; Calvert, Melanie; Matthews, Karen**; The cost of primary care consultations associated with long COVID in non-hospitalised adults: a retrospective cohort study using UK primary care data.** BMC Primary Care. 24;1245. 2023

  • Turner, Grace M; McMullan, Christel; Aiyegbusi, Olalekan Lee; Hughes, Sarah E; Walker, Anita; Jeyes, Felicity; Adler, Yvonne; Chong, Amy; Buckland, Lewis; Stanton, David; Co-production of a feasibility trial of pacing interventions for Long COVID. Research Involvement and Engagement. 9;1;18. 2023

  • Aiyegbusi, Olalekan Lee; McMullan, Christel; Hughes, Sarah E; Turner, Grace M; Subramanian, Anuradhaa; Hotham, Richard; Davies, Elin Haf; Frost, Chris; Alder, Yvonne; Agyen, Lisa; Considerations for patient and public involvement and engagement in health research. Nature Medicine. 29;8;1922-1929. 2023

  • Gorst, Sarah L; Seylanova, Nina; Dodd, Susanna R; Harman, Nicola L; O'hara, Margaret; Terwee, Caroline B; Williamson, Paula R; Needham, Dale M; Munblit, Daniel; Nicholson, Timothy R; Core outcome measurement instruments for use in clinical and research settings for adults with post-COVID-19 condition: an international Delphi consensus study. The Lancet Respiratory Medicine. 11;12;1101-1114. 2023

2024

  • McMullan, Christel; Haroon, Shamil; Turner, Grace; Aiyegbusi, Olalekan Lee; Subramanian, Anuradhaa; Hughes, Sarah E; Flanagan, Sarah; Nirantharakumar, Krishnarajah; Davies, Elin Haf; Frost, Chris; Key considerations for digital decentralised clinical trials from a feasibility study assessing pacing interventions for Long COVID. Scientific Reports. 14, 22083 (2024).

2025

  • McMullan, Christel; Haroon, Shamil; Turner, Grace; Aiyegbusi, Olalekan; Hughes, Sarah; Flanagan, Sarah; Subramanian, Anuradhaa; Nirantharakumar, Krish; Davies, Elin; Frost, Chris; Views and experience of non-hospitalised individuals with Long COVID of using pacing interventions: a mixed methods study. Scientific Reports.15, 14467 (2025).