From the lab to the NHS frontline

When the coronavirus hit, BHF Clinical Training Fellow Dr Ricky Vaja swapped his lab coat for scrubs and returned to the NHS frontline. He tells us about his experience and what he’s learned.



In an operating room, a surgeon has the privilege of holding someone’s heart in their hand and seeing the effect of disease. In a lab, a scientist can understand the processes that lead to that disease. I see research as the bridge between the two, and so I always knew I wanted to pause my surgical training and embark on a PhD.

Shedding light on a well-known drug

I wanted to study something that could help a lot of people so - with BHF funding - began examining the link between ibuprofen and heart attacks. Ibuprofen is one of the most commonly used drugs, so understanding why some people are more likely to have a heart attack with long-term ibuprofen use has the potential to benefit a huge number of people.

By the time Covid-19 reached the UK, I had been gathering blood samples as part of my research and was preparing to run a clinical trial. I was really enjoying the process and felt we were making progress. We had already made some really exciting discoveries. Working with researchers at the University of Dundee, we found hints that taking statins may reduce the risks that accompany long-term ibuprofen use. We were hoping to find out if this is true in the general population with more studies.
“When the coronavirus infection hit, this was all put on hold”
We had to stop our clinical trial, lab work ground to a halt, and as a clinician I wanted to answer the call to return to the frontline. I chose to move out of my family home, to keep them safe while they shielded. Not only was my professional life being turned upside down, but I was separated from my family and had to adapt to living in a hotel, too.

Keeping hearts beating

I worked in the intensive care unit at the Royal Brompton Hospital. We had a specialist heart-lung bypass machine there, so were often treating younger people who had Covid-19 or those who had the most severe complications. Being on the frontline again was hard, but it was easy to see how important it was for us to be there.

As the pandemic progressed, my surgical skills were needed. While I felt out of my comfort zone initially, I had lots of support and quickly got used to the operating room again. Lots of heart surgeries had been postponed due to the pandemic, so we were kept busy catching up with the waiting list.

From lab bench to bedside

Throughout, I never stopped working on my research, no matter how busy we were. I have also been part of a group looking into how delays in routine surgery due to the pandemic have impacted heart surgery risk. Questions like this, along with ongoing important dialogue on the cardiovascular consequence of the coronavirus infection, have shown me there is a clear need for ongoing research.

Early on in the pandemic, there were concerns about the use of ibuprofen. Given our lab’s expertise and my own insight into clinical research, we were in a fantastic position to review all the studies linking the drug and the virus. We found that taking ibuprofen didn’t seem to be linked to the severity of Covid-19. This was great news during the pandemic, but also highlighted gaps that show just how important our research is, and our work has been accepted for publication. But it’s worth noting that paracetamol is the first choice of medicine to treat a fever caused by any infection and is the best choice to treat Covid-19 symptoms.

I was also fortunate that my first year as a BHF training fellow gave me the skills needed to examine the link between those most at risk from Covid-19 and the molecules the virus uses to enter heart and blood vessel cells. While I was back in the clinic, I used my spare time to examine this in a computer-based project with others in my team and Imperial College London bioinformaticians. We could do this because the data were publicly available, and we have since made our own data publicly available too, and hope to publish our findings soon.
“It’s really easy to collaborate with people; everyone is really happy to get on board”
My team and our collaborators are now building on these findings by studying how actual blood vessel cells become infected with the virus. This could help us understand more about who is at increased risk of developing more severe complications of Covid-19, and why.

Clear vision for the future

Returning to the frontline has not only meant I could help those who needed it most, but also presented new opportunities for research into subjects I may never have got involved in. I think I’ll come back to the lab with a lot of experience, confidence in my ability to adapt, and a whole new set of research questions.

The fact that the BHF supported clinicians and researchers to divert their efforts to frontline care and Covid-19 research while our usual research was paused also made a real difference.

The time I’ve spent out of the lab and back in the hospital has confirmed my ambition to straddle research and surgery. After my PhD, I hope to apply for a BHF intermediate fellowship. This would allow me to carry on with life saving work in the operating theatre while also searching for vital answers in the lab. What could be better?

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