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At the beginning of the COVID-19 pandemic, the effect it would have on our healthcare system was unknown. As a result, surgical guidelines shifted to recommend non-operative management despite uncertainty of its efficacy compared to standard operative management. Within general surgery, nowhere was this more relevant than with the management of appendicitis, the most common abdominal emergency worldwide. This novel research collaborative was set up during the COVID-19 pandemic to assess the outcomes of appendicitis patients managed with antibiotics compared to appendicectomy. Methods Without the time to obtain funding for the project, trainee-driven recruitment of sites was vital and used established trainee-led regional research networks and twitter (@Covidharem). Further backing was provided by surgical societies who published and promoted the study protocol on their platforms. The steering group used surgical networks and contacts to recruit sites who were not already involved and RedCap was used for data entry to allow for real time monitoring of data completion. Results In just twelve weeks, 471 individual collaborators were recruited from 101 sites across the United Kingdom and Ireland. The collaborative went from inception to 500 patients uploaded in 30 days. The collaborative to date has recruited nearly 3500 patients, published both the protocol and an interim analysis within 4 months, and hosted a highly successful webinar. Conclusion Quality research can be achieved in times of crisis, the key to successful projects is trainee driven and led, focussed “snapshots” that can be implemented rapidly during the dynamic environment of a crisis.

O3 Forming a novel trainee-led research collaborative during times of crisis: Lessons learned from the COVID:HAREM collaborative