EU Science Hub

CIAO – Modelling the Pathogenesis of COVID 19 using the Adverse Outcome Pathway Framework

The CIAO (Modelling the Pathogenesis of COVID‑19 using the Adverse Outcome Pathway Framework) initiative addresses a pressing issue in COVID‑19 research: Making sense of the overwhelming flood of information that is produced and published every day.

CIAO collects relevant knowledge currently available on COVID‑19, organises it in a coherent fashion, and makes it publicly available to the scientific community, such as researchers and clinicians.

CIAO aims to act as a point of reference for anyone with a scientific background who wants to get a quick, but fact-based overview of what happens when SARS‑CoV‑2 infects the human organism. In a roundabout way, via better informing the research community, CIAO will ultimately also increasingly impact health-care and policy decisions.

Focusing on the mechanistic aspect of the collected COVID‑19 knowledge will help with our understanding of the causal relationships between the individual stages of the disease, as well as the factors that influence – in a good or a bad way – the ultimate clinical outcome.

How can CIAO help the COVID‑19 research community?

CIAO curates and consolidates relevant COVID‑19 knowledge stemming from various disciplines and specialists, and presents it in a way that is understandable and usable by a wide range of scientists from different research domains.

Starting from this interdisciplinary overview, CIAO zooms into more specialised knowledge by summarising the available information and pointing to relevant third party sources.

Making sense of the available knowledge will help researchers or medical professionals dealing with COVID-19 to make recognisable progress:

  • raising awareness of knowledge gaps to point out additional research needs,
  • highlighting the repurposing potential of suitable existing drugs, or
  • identifying relevant biomarkers of the disease progression

are examples of where CIAO will be of great value for public health and policy decision makers.

The Adverse Outcome Pathway (AOP) framework

In order to achieve this, the CIAO project makes use of Adverse Outcome Pathways (AOPs), which are part of a well-established knowledge collection, management, and dissemination framework.

In general, every AOP describes a series of events occurring in an organism, causing an adverse outcome like a disease or death, and the concept originally developed in the toxicology area is now repurposed in COVID‑19 research.

The AOP framework is steered at OECD level, and the JRC is an important player in its further development.

AOPs and CIAO project

Applying the AOP approach, we are depicting how COVID‑19 develops from the very first interaction of the SARS‑CoV‑2 virus with the organism over a series of key events finally leading to one or several of the well-known COVID‑19-related adverse outcomes, with respiratory failure being the most prominent one of many.

Assembling an AOP does not necessarily mean producing new knowledge. It mostly consists of finding, curating and integrating relevant knowledge, leaving out misleading or superfluous information.

This addresses a practical but formidable problem with COVID‑19 research: the high number of publications out there makes it challenging to identify quality information, extract the 'signal from the noise', and make the 'good stuff' available to all. This is where the AOP framework can help.

Join the CIAO community!

COVID‑19 is a complex disease. Creating a network of AOPs fully describing COVID‑19 is equally complex.

We therefore apply the “crowdsourcing” approach, which means we continuously welcome collaborators who want to join the effort and help the community by:

  • reviewing the available published research material
  • assessing its quality and relevance
  • weighing its importance
  • extracting the relevant knowledge and
  • finally incorporating it into the growing AOP network

The CIAO community currently consists of more than 50 enthusiastic partners coming from a wide variety of complementary fields of expertise. If you are willing to contribute to the project and join the community, contact us!

Want to know more?

If you want to know more about CIAO, its current scientific outputs and how you can apply them to your domain of activity, or how to join the CIAO community, please visit the dedicated project web site:

Don't miss the CIAO webinar on 7 September! Find out more on how to participate: