Development of a research protocol for the evaluation of the risk of nosocomial transmission of SARS-CoV-2: NOSO-COR






Bangladesh, Brazil, Ivory Coast, France, Guinea, Madagascar, Mali




In progress


Coronavirus disease 2019 (COVID-19) has rapidly reached epidemic proportions internationally and destabilized some of the most robust healthcare systems.

Beyond the emergency of diagnosing COVID-19 cases, it is important to provide solutions to identify and reduce transmission risks in hospitals. It has been shown that SARS-CoV-2, like SARS-CoV-1 in 2003, is characterized by a particularly high rate of hospital-acquired infections. In response to this finding, the Mérieux Foundation, in collaboration with Prof. Philippe Vanhems, an epidemiologist at the Hospices Civils de Lyon (France), has developed a research protocol to assess the risk of nosocomial transmission of SARS-CoV-2: the NOSO-COR project.


This is a prospective, non-interventional hospital-based study which aim is to describe and document COVID-19 cases nosocomial transmissions in hospitals and describe hospital infection prevention and control practices and policies.

The main objectives of this project are:

  • Conduct a skills mapping in hospitals to identify interventions needed to limit nosocomial infection cases;
  • Develop an epidemiological study for a better knowledge of the transmission chains and the impact of infection prevention and control measures in hospitals, in order to identify the determining risk factors for these cases;
  • Propose solutions to identify and reduce the risks of transmission in hospitals.


This study is implemented in the following countries:

  • Bangladesh
  • Brazil
  • Ivory Coast *
  • Guinea *
  • Lebanon
  • Madagascar *
  • Mali *

In addition, this protocol is currently being proposed to 8 university hospitals in France, with a view to sharing results and experiences.

The Mérieux Foundation manages the implementation of the research protocol in the countries, particularly in the research laboratories that are members of the GABRIEL network, and the Hospices Civils de Lyon are responsible for the implementation in the French university hospitals. Prof. Jianwey Wang, from the Christophe Mérieux Laboratory in Bejin, acts as scientific advisor.

* in collaboration with Africa CDC and with the support of the Bill & Melinda Gates Foundation


Deploying an international research project in the context of a global health crisis requires long and complex processes. Despite the closure of borders, the lockdown in many countries and the lack of personal protective equipment, it was necessary to launch the protocol before the epidemic gained ground. The teams involved redoubled their efforts and were able to count on the incredible mobilization and support of local partners to sustain the project and ensure its implementation despite the difficult context, as of March 2020.

  • The study has been registered on the website under the identifier NCT04290780.
  • The project has been approved by the ethics committee in France and by the national ethics committees of the partner countries.
  • Centralized data management has been implemented.
  • Most sites are in the final stages of recruitment and are entering the study closure phase, which includes data sharing and preservation.

The NOSO-COR project has also been involved in building capacity in several countries to access COVID-19 diagnostics and to implement clinical research studies. 


  • Comparison of the Clinical Features of SARS-CoV-2, Other Coronavirus and Influenza Infections in Infants Less Than 1-Year-Old Vanhems, Philippe MD, PhD; Endtz, Hubert MD; Dananché, Cédric DrPharm, PhD; Komurian-Pradel, Florence PhD ; Sanchez Picot, Valentina, DVM; For the Pneumonia Study members* The Pediatric Infectious Disease Journal: July 2020 – Volume 39 – Issue 7 – p e157-e158
  • Protocol for a prospective, observational, hospital-based multicentre study of nosocomial SARS-CoV-2 transmission: NOSO-COR Project. Mitra Saadatian-Elahi, Valentina Picot, Laetitia Hénaff, Florence K Pradel, Vanessa Escuret, Cédric Dananché, Christelle Elias, Hubert P Endtz, Philippe Vanhems, BMJ Open 2020;10:e039088. doi:10.1136/bmjopen-2020-039088


Financial :

  • Bill & Melinda Gates Foundation
  • Fondation AnBer
  • Exceptional sponsorship from bioMérieux dividends


  • Hospices Civils de Lyon, France
  • Institut National d’Hygiène Publique et Treichville University Hospital à Abidjan, Côte d’Ivoire
  • Treichville University Hospital (CHU) Abidjan, Cte d’Ivoire
  • Institut national de Santé Publique et CHU de Conakry, Guinée
  • Centre Hospitalier Universitaire (CHU), Conakry, Guinée
  • Centre d’Infectiologie Charles Mérieux à l’Université d’Ankatso à Antananarivo, Madagascar
  • Hôpital de Befelatanana, Madagascar
  • Hôpital de Andohatapenaka, Madagascar
  • Hôpital de Anosiala, Madagascar
  • Centre d’infectiologie Charles Mérieux de Bamako, Mali
  • Hôpital Universitaire Point G, Mali
  • Hôpital de Mali, Mali
  • iccdr,b, Bangladesh
  • Mugda Medical College Hospital, Dhaka, Bangladesh
  • Khulna Medical College Hospital, Khulna, Bangladesh
  • Chittagong Medical College Hospital, Chittagong, Bangladesh