The COCOON study

The Cocoon Study is an international project which will examine blood coagulation in Covid-19 patients and its interplay with inflammation. Using advanced artificial intelligence and genomics technologies, the project will deliver enhanced thrombotic prevention strategies and a rapid diagnostic platform for personalised risk assessment. The study aims to address urgent clinical dilemmas and to develop novel solutions for existing diagnostic and therapeutic challenges.

1. What is the optimal strategy to prevent thrombosis in Covid-19?
2. Can we refine prediction of patients’ outcomes?
3. Could anti-thrombotics represent a novel therapy?

The team aims to characterise the mechanisms driving hypercoagulability in Covid-19 and determine whether current standard thrombosis prevention measures sufficiently attenuate Covid-19 hypercoagulability. Achieving these aims will address the controversy surrounding optimal dosing of anti-thrombotics in Covid-19 and will also determine if other means of thrombosis prevention (such as anti-platelet therapy) may be of benefit.

Advanced proteomic analysis of plasma samples taken from across the spectrum of severity of infection will permit the identification of novel biomarkers which will be of superior specificity in comparison to existing markers (e.g. D-dimer). This will address the current limitations in this regard. In particular, analysis of platelet releasate (PR) in Covid-19 is predicted to yield valuable data – the UCD Conway SPHERE team have previously demonstrated that the proteomic signature of the PR is highly conserved among healthy individuals but can act as a ‘barcode for disease’ in multiple pathological states.

This novel and disruptive approach to risk stratification will arm clinicians with an affordable tool to channel resources appropriately and prevent unnecessary adverse outcomes through prevention of thrombotic complications. In collaboration with their international partners, the researchers believe that their approach will rapidly shape international clinical practice.