Very soon after the COVID-19 pandemic began, the research community recognized that people who have certain underlying heart, lung, and blood diseases and conditions are at higher risk for serious health problems from infection with SARS-CoV-2, the virus that causes COVID-19. In addition, research quickly showed that COVID-19 can have potentially life-threatening effects on the heart, lungs, blood, and blood vessels.

The NHLBI’s multi-pronged research strategy aims to better our understanding of the risk of serious illness from COVID-19 and to identify therapies that will slow or halt disease progression and speed recovery. 

COVID-19 can have severe effects on the heart, lungs, and blood

How COVID-19 affects the heart
Heart inflammation, heart failure, and arrhythmias
How COVID-19 affects the lungs
Acute Respiratory Distress Syndrome (ARDS), Acute Respiratory Failure
How COVID-19 affects the blood
COVID-19 associated coagulopathy (CAC)

Those with underlying health conditions, such as chronic lung disease, cardiovascular disease, diabetes mellitus, and sickle cell disease, appear to be at higher risk for severe COVID-19–associated disease.

Research strategy goals

The NHLBI has designed an adaptive, responsive research strategy with short- and-long-term goals. These goals include:

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Understand how COVID-19 causes organ dysfunction and damage, and identify potential treatments
Test host-directed interventions and provide an evidence base for clinical practice
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Promote blood safety, sero-surveillance, and new blood-derived therapeutics
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Conduct longitudinal/cohort studies to understand natural history and risk factors
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Test behavioral, social, and community-based interventions
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Provide data and biospecimen resource

NHLBI's rapid response

NHLBI’s research response to the COVID-19 crisis has been a rapid, collaborative, and strategic effort.

February 2020

  • The scientific community began to recognize the systemic and multi-organ nature of COVID-19, including the extensive involvement of the heart, lung, and blood systems.
  • By February, the NHLBI formed a COVID-19 response team. The NHLBI immediately began developing a research strategy, which included a process to solicit, review, and fund an initial set of clinical trials to evaluate therapies for people who become ill from COVID-19.

March 2020

  • Congress passed the Coronavirus Aid, Relief, and Economic Security (CARES) Act, authorizing $103.4 million for the NHLBI to conduct and fund COVID-19 research.
  • On March 17, the NHLBI put out our first COVID-19 notice of special interest (NOSI), which called for investigators with active NHLBI grants to propose COVID-related research ranging from preclinical to clinical studies.

April 2020

June 2020

  • Based on an interim analysis, the NHLBI halted the ORCHID clinical trial. The trial found that while the drug hydroxychloroquine did not cause harm, it was not beneficial to hospitalized patients with COVID-19.
  • The NHLBI launched the Collaborating Network of Networks for Evaluating COVID-19 and Therapeutic Strategies (CONNECTS). The goal of CONNECTS is to build on NHLBI’s existing clinical research networks across the nation and around the world to better understand the risk of severe illness from COVID-19 and to identify therapies that will slow or halt the disease progression and speed recovery. 
  • As part of CONNECTS, the NHLBI launched ACTIV-4 Antithrombotics, a series of adaptive clinical trials evaluating the safety and effectiveness of varying doses of blood thinners to treat adults diagnosed with COVID-19. The trials involve several categories of patients — those who do not need hospitalization, those currently hospitalized, and those discharged after hospitalization for moderate to severe disease.

September 2020

October 2020

February 2021

March  2021

  • The NHLBI halted the trial of COVID-19 convalescent plasma in patients with mild to moderate symptoms, after the study found that the treatment is safe but provides no significant benefit to these patients. Read the final results of the study.
  • The NHLBI, as part of a trans-NIH effort, announced a research initiative to understand how SARS-CoV-2 affects children, called Collaboration to Assess Risk and Identify Long-term Outcomes for Children with COVID (CARING for Children with COVID). The research program funds studies, including the NHLBI’s MUSIC study, to find out why some children are at greater risk for infection than others, why symptoms vary among children who are infected, why some children have more severe illness than others (like multisystem inflammatory syndrome in children, or MIS-C), and what the long-term outcomes are for children who have become infected with SARS-CoV-2.

April 2021

May 2021

  • NHLBI Director Dr. Gary Gibbons and NIMHD Director Dr. Eliseo Perez-Stable were announced as finalists for the 2021 Samuel J. Heyman Service to America Medals (Sammies) in the COVID-19 Response category.

NHLBI director Dr. Gary Gibbons and Eliseo Perez-Stable

June 2021

July 2021

  • Researchers discovered a pathway that may explain why some children and adolescents develop MIS-C. A clinical trial funded in part by the NHLBI is now underway using the medicine larazotide, which is in late-stage clinical trials for celiac disease.

August 2021

  • Results from a worldwide NHLBI clinical trial found full-dose blood thinners are effective at treating people who are hospitalized with moderate COVID-19, but not those who are seriously ill and require intensive care. Read the news release.

Visit our 2021 report on the impact of COVID-19 on heart, lung, and blood systems to learn more about our research response strategy and COVID-19 research efforts.

September 2021

  • The NIH awarded nearly $470 million to support research as part of the RECOVER initiative, which is co-chaired by the NHLBI, to better understand the long-term effects of SARS-CoV-2 infection.

What’s Next

We continue to develop new initiatives and funding opportunities, and share our findings as part of our ongoing research response strategy.

A Collaborative Effort

A visual demonstrating the collaborative efforts of the COVID-19 research response, including HHS collaborations and trans-NIH efforts.

NHLBI COVID-19 research response

Teams helping to design and implement the COVID response span subject areas such as preclinical studies, clinical trials, longitudinal cohort studies, community-based interventions, data mining and resources, and communications.

  • Pre-clinical Studies 
  • Clinical Trials 
  • Longitudinal/Cohort Studies 
  • Data Mining and Resources 
  • Communication 
  • Community-based Interventions 
  • Community-engaged Research 

The NHLBI is working with NIH and HHS in collaboration to end the pandemic. 

Trans-NIH efforts

Much of NHLBI staff are part of trans-NIH efforts that include community-based interventions to work with vulnerable populations, data coordination, and collaboration with industry. 

HHS collaborations

At an HHS level, the NHLBI works closely with our government partners, including the FDA and CDC, and participates in working groups, such as the medical countermeasures and clinical working group. We engage in an exchange of information with patient groups to learn about their needs. The information they share helps us set our research agenda. 

  • HHS Clinical Working Group 
  • HHS MCM Working Group