Dr Jonathan Underwood
MRC-NIHR Clinical Academic Research Partnership Fellow
- underwoodj7@cardiff.ac.uk
- +44 (0)29 2074 6718
- A1 corridor, Main Hospital Building, University Hospital of Wales, Heath Park, Cardiff, CF14 4XN
Overview
I am a consultant physician specialising in acute medicine and infectious diseases based at the University Hospital of Wales. I completed a PhD at Imperial College London in 2017 where I studied cognitive impairment in treated HIV-disease. My main research interest is understanding the neurological sequelae of infections.
I have recently been awarded an MRC-NIHR Clinical Academic Research Partnership grant to study blood-brain barrier dysfunction and cognitive outcomes following bloodstream infection. This work is in partnership with Prof Neil Harrison based at CUBRIC and the SAIL Databank at Swansea University and Public Health Wales.
Due to the current COVID-19 pandemic I am currently back working clinically full-time. Additionally, I am the PI for several COVID-19 randomised controlled trials of immunotherapy.
Biography
Honours and awards
- Highly commended poster award – British HIV Association, April 2019
- Best research presentation – HIV CNS UK meeting, March 2018
- Highly commended poster award – British HIV Association, April 2017
- Margaret Johnson prize for best oral research presentation – British HIV Association, April 2016
- Gordon M Holmes prize (for Medicine finals) – July 2005
- Distinction in Clinical Practice (finals) – July 2005
- Honours in Clinical Pharmacology and Medicine (finals) – July 2005
Committees and reviewing
- Executive Comittee - British HIV Association (BHIVA)
- Education and Scientific Subcommittee - British HIV Association (BHIVA)
- Governance group - COVID-19 Therapeutics Advice & Support Group (CTAG)
- Antiviral subgroup - COVID-19 Therapeutics Advice & Support Group (CTAG)
Publications
2023
- Nightingale, S. et al. 2023. Cognitive impairment in people living with HIV: consensus recommendations for a new approach. Nature Reviews Neurology 19(7), pp. 424-433. (10.1038/s41582-023-00813-2)
- Evans, A. et al. 2023. Real-world effectiveness of molnupiravir, nirmatrelvir-ritonavir, and sotrovimab on preventing hospital admission among higher-risk patients with COVID-19 in Wales: a retrospective cohort study. Journal of Infection 86(4), pp. 352-360. (10.1016/j.jinf.2023.02.012)
- Ambati, S. et al. 2023. Resolution of persistent SARS-CoV-2 infection with prolonged intravenous remdesivir and vaccination in a patient post CAR-T. International Journal of Hematology (10.1007/s12185-022-03518-2)
2022
- Keir, H. R. et al. 2022. Dipeptidyl peptidase-1 inhibition in patients hospitalised with COVID-19: a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial. The Lancet Respiratory Medicine 10(12), pp. 1119-1128. (10.1016/S2213-2600(22)00261-2)
- Nightingale, S. et al. 2022. Cognitive impairment in people with HIV: consensus recommendations for a new approach. The Lancet HIV 9, pp. e815-e817. (10.1016/S2352-3018(22)00267-3)
- Carter, B. L. and Underwood, J. 2022. Sepsis and the brain: a review for acute and general physicians. Clinical Medicine 22(5), pp. 392-395. (10.7861/clinmed.2022-0346)
- Cooksey, R., Underwood, J., Brophy, S., Atkinson, M., Kennedy, J. and Choy, E. 2022. Shielding reduced incidence of COVID-19 in patients with inflammatory arthritis but vulnerability is associated with increased mortality. Rheumatology 61(SI2), pp. SI120-SI128., article number: keac283. (10.1093/rheumatology/keac283)
- Ponsford, M. J. et al. 2022. Examining the utility of extended laboratory panel testing in the emergency department for risk stratification of patients with COVID-19: a single-centre retrospective service evaluation. Journal of Clinical Pathology 75(4), pp. 255-262. (10.1136/jclinpath-2020-207157)
- Alagaratnam, J. et al. 2022. Correlation between cerebrospinal fluid and plasma neurofilament light protein in treated HIV infection: results from the COBRA study. Journal of Neurovirology (JNV) 28, pp. 54-63. (10.1007/s13365-021-01026-3)
- Brown, L. K. et al. 2022. Treatment of chronic or relapsing COVID-19 in immunodeficiency. Journal of Allergy and Clinical Immunology 149(2), pp. 557-561. (10.1016/j.jaci.2021.10.031)
- Wood, C. H., Underwood, J., Davies, C. and Taylor, P. N. 2022. Patient characteristics and variables influencing acute medical flow. Acute Medicine Journal 21(4), pp. 165-208. (10.52964/AMJA.0920)
2021
- De Francesco, D. et al. 2021. Correlation between computerised and standard cognitive testing in people with HIV and HIV-negative individuals. AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV 33(10), pp. 1296-1307. (10.1080/09540121.2020.1865518)
- Bousfield, R. et al. 2021. A retrospective cohort study of bacterial native vertebral osteomyelitis and its management in the UK. Clinical Infection in Practice 12, article number: 100101. (10.1016/j.clinpr.2021.100101)
- Hinks, T. S. C. et al. 2021. Azithromycin versus standard care in patients with mild-to-moderate COVID-19 (ATOMIC2): an open-label, randomised trial. The Lancet Respiratory Medicine 9(10), pp. 1130-1140. (10.1016/S2213-2600(21)00263-0)
- Alagaratnam, J. et al. 2021. No evidence of neuronal damage as measured by neurofilament light chain in a HIV cure study utilising a kick-and-kill approach. Journal of Virus Eradication 7(3), article number: 100056. (10.1016/j.jve.2021.100056)
- Calcagno, A. et al. 2021. Associations between plasma nucleoside reverse transcriptase inhibitors concentrations and cognitive function in people with HIV. PLoS ONE 16(7), article number: e0253861. (10.1371/journal.pone.0253861)
- Alagaratnam, J. et al. 2021. Correlation between CSF and blood neurofilament light chain protein: a systematic review and meta-analysis. BMJ Open Neurology 3, article number: e000143. (10.1136/bmjno-2021-000143)
2020
- Horby, P. et al. 2020. Effect of hydroxychloroquine in hospitalized patients with Covid-19. New England Journal of Medicine 383(21), pp. 2030-2040. (10.1056/NEJMoa2022926)
- Toniolo, S. et al. 2020. Changes in functional connectivity in people with HIV switching antiretroviral therapy.. Journal of Neurovirology (JNV) 26, pp. 754-763. (10.1007/s13365-020-00853-0)
- Gupta, S., Parker, J., Smits, S., Underwood, J. and Dolwani, S. 2020. Persistent viral shedding of SARS‐CoV‐2 in faeces – a rapid review. Colorectal Disease 22(6), pp. 611-620. (10.1111/codi.15138)
2019
- Underwood, J. et al. 2019. Validation of a novel multivariate method of defining HIV-associated cognitive impairment. Open Forum Infectious Diseases 6(6), pp. ofz198., article number: ofz19. (10.1093/ofid/ofz198)
- Haddow, L. J. et al. 2019. Magnetic resonance imaging of cerebral small vessel disease in men living with HIV and HIV-negative men aged 50 and above. AIDS Research and Human Retroviruses 35(5), pp. 453-460. (10.1089/aid.2018.0249)
- Dhillon, S. et al. 2019. Level of agreement between frequently used cardiovascular risk calculators in people living with HIV. HIV Medicine 20(5), pp. 347-352. (10.1111/hiv.12731)
- De Francesco, D. et al. 2019. Cognitive function, depressive symptoms and syphilis in HIV-positive and HIV-negative individuals. International Journal of STD and AIDS 30(5), pp. 440-446. (10.1177/0956462418817612)
- Underwood, J. et al. 2019. Antiretroviral central nervous system toxicity. Presented at: The 25th Annual Conference of the British HIV Association (BHIVA), Bournemouth, 2-5 April 2019, Vol. 20. Vol. 55. Wiley pp. 36., (10.1111/hiv.12739)
- De Francesco, D. et al. 2019. Depression, lifestyle factors and cognitive function in people living with HIV and comparable HIV-negative controls. HIV Medicine 20(4), pp. 274-285. (10.1111/hiv.12714)
- Underwood, J., Marks, M., Collins, S., Logan, S. and Pollara, G. 2019. Intravenous catheter-related adverse events exceed drug-related adverse events in outpatient parenteral antimicrobial therapy. Journal of Antimicrobial Chemotherapy 74(3), pp. 787-790. (10.1093/jac/dky474)
- De Francesco, D. et al. 2019. Do people living with HIV experience greater age advancement than their HIV-negative counterparts?. AIDS 33(2), pp. 259-268. (10.1097/QAD.0000000000002063)
2018
- Underwood, J., Cole, J. H., Leech, R., Sharp, D. J. and Winston, A. 2018. Multivariate pattern analysis of volumetric neuroimaging data and its relationship with cognitive function in treated HIV disease. JAIDS Journal of Acquired Immune Deficiency Syndromes 78(4), pp. 429-436. (10.1097/QAI.0000000000001687)
- Cole, J. et al. 2018. No evidence for accelerated ageing-related brain pathology in treated HIV: longitudinal neuroimaging results from the Comorbidity in Relation to AIDS (COBRA) project.. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 66(12), pp. 1899–1909. (10.1093/cid/cix1124)
- Underwood, J., De Francesco, D., Leech, R., Sabin, C. A. and Winston, A. 2018. Medicalising normality? Using a simulated dataset to assess the performance of different diagnostic criteria of HIV-associated cognitive impairment. PLoS ONE 13(4), article number: e0194760. (10.1371/journal.pone.0194760)
- van Zoest, R. et al. 2018. Structural brain abnormalities in successfully treated HIV infection: Associations with disease and cerebrospinal fluid biomarkers. Journal of Infectious Diseases 217(1), pp. 69 - 81. (10.1093/infdis/jix553)
- Ferretti, F., Mora-Peris, B., Underwood, J., Waldman, A., Everitt, A. and Winston, A. 2018. Cognitive impairment in a clinical setting.. Journal of acquired immune deficiency syndromes (1999) 77(1), pp. e10 - e13. (10.1097/qai.0000000000001547)
2017
- Underwood, J. et al. 2017. Gray and white matter abnormalities in treated human immunodeficiency virus disease and their relationship to cognitive function.. Clinical Infectious Diseases 65(3), pp. 422-432. (10.1093/cid/cix301)
- Booiman, T. et al. 2017. High cellular monocyte activation in people living with human immunodeficiency virus on combination antiretroviral therapy and lifestyle-matched controls is associated with greater inflammation in cerebrospinal fluid. Open Forum Infectious Diseases 4(3), pp. -., article number: ofx108. (10.1093/ofid/ofx108)
- Underwood, J. et al. 2017. Associations between cognitive impairment and patient-reported measures of physical/mental functioning in older people living with HIV. HIV Medicine 18(5), pp. 363-369. (10.1111/hiv.12434)
- Cole, J. et al. 2017. Increased brain-predicted aging in treated HIV disease. Neurology 88(14), pp. 1349-1357. (10.1212/WNL.0000000000003790)
2016
- Underwood, J. and Winston, A. 2016. Guidelines for evaluation and management of cognitive disorders in HIV-positive individuals. Current HIV/AIDS Reports 13(5), pp. 235--240. (10.1007/s11904-016-0324-x)
- Mora-Peris, B., Stevens, E., Ferretti, F., Underwood, J., Taylor, S. and Winston, A. 2016. Evolution of changes in cognitive function after the initiation of antiretroviral therapy. AIDS Research and Therapy 13(1), article number: 20. (10.1186/s12981-016-0104-0)
- Scott, J., Underwood, J., Garvey, L. J., Mora-Peris, B. and Winston, A. 2016. A comparison of two post-processing analysis methods to quantify cerebral metabolites measured via proton magnetic resonance spectroscopy in HIV disease. The British Journal of Radiology 89(1060), article number: 20150979. (10.1259/bjr.20150979)
- Winston, A. and Underwood, J. 2016. Plasma biomarkers of HIV-associated cognitive disease. EBioMedicine 3, pp. 12--13. (10.1016/j.ebiom.2015.11.052)
- Francesco, D. D. et al. 2016. Defining cognitive impairment in people-living-with-HIV: the POPPY study. BMC Infectious Diseases 16(1), article number: 617. (10.1186/s12879-016-1970-8)
2015
- Underwood, J. 2015. Cognitive deficits persist in the combination antiretroviral era: Preliminary results from the Co-morBidity in Relation to AIDS (COBRA) collaboration London cohort. Experimental Gerontology 68, pp. 104. (10.1016/j.exger.2015.01.038)
- Underwood, J., Robertson, K. R. and Winston, A. 2015. Could antiretroviral neurotoxicity play a role in the pathogenesis of cognitive impairment in treated HIV disease?. AIDS 29(3), pp. 253-261. (10.1097/QAD.0000000000000538)
- Winston, A. and Underwood, J. 2015. Emerging concepts on the use of antiretroviral therapy in older adults living with HIV infection. Current Opinion in Infectious Diseases 28(1), pp. 17--22. (10.1097/qco.0000000000000117)
2014
- Underwood, J. 2014. Bone, joint, and soft tissue infections. In: Brent, A., Davidson, R. and Seale, A. eds. Oxford Handbook of Tropical Medicine. Oxford University Press, pp. 638--655., (10.1093/med/9780199692569.003.0015)
2013
- Underwood, J. 2013. Don't forget the embalming fluid for treating recurrent infections... BMJ 346, pp. -., article number: f3933. (10.1136/bmj.f3933)
2011
- Underwood, J., Klein, J. and Newsholme, W. 2011. Escherichia coli bacteraemia: How preventable is it?. Journal of Hospital Infection 79(4), pp. 364-365. (10.1016/j.jhin.2011.07.005)
2006
- Cowie, M., Komajda, M., Murray-Thomas, T., Underwood, J. and Ticho, B. 2006. Prevalence and impact of worsening renal function in patients hospitalized with decompensated heart failure: Results of the prospective outcomes study in heart failure (POSH). European Heart Journal 27(10), pp. 1216-1222. (10.1093/eurheartj/ehi859)
Teaching
I currently provide educational and clinical supervision to ACCS and infectious diseases trainees.
I also supervise student SSC projects and teach clinical skills to undergraduates.
Primarily using neuropsychological testing and neuroimaging, I studied cognitive impairment in treated HIV-disease during my PhD at Imperial College London.
I have recently been awarded an MRC-NIHR Clinical Academic Research Partnership grant to study blood-brain barrier dysfunction and cognitive outcomes following bloodstream infection. This work is in partnership with Prof Neil Harrison based at CUBRIC and the SAIL Databank at Swansea University and Public Health Wales.