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COVID-19 Research

Working closely with our clinical colleagues the RBCH research team is delivering high priority COVID-19 studies below. In doing so we are contributing to the national and international effort to diagnose, treat and ultimately prevent the disease. The evidence gained will be used to inform treatment decisions and benefit patients in the immediate future.

These studies have been designed such to integrate with each other and such that data can be pooled with others around the world. Doing so helps to identify trends faster, gives greater confidence to any conclusions and enables insights that may not be identified in smaller studies. This emerging evidence is being fed back rapidly to improve practice.

A range of potential treatments, previously used in other indications, have been suggested for COVID-19 but nobody knows if any of them will turn out to be more effective in helping people recover than the usual standard of hospital care which all patients will receive. As put by the Chief Medical Officers of the UK, 'While it is for every individual clinician to make prescribing decisions [...] Use of treatments outside of a trial, where participation was possible, is a wasted opportunity to create information that will benefit others.'. The following 2 trials will collect this vital data.

  • RECOVERY - Randomised Evaluation of COVID-19 Therapy. Eligible patients are randomly allocated between several treatment arms, each to be given in addition to the usual standard of care in the hospitals.

  • REMAP-CAP - a Randomized, Embedded, Multifactorial Adaptive Platform trial for Community-Acquired Pneumonia. This is a critical care study running in 12 countries worldwide and created with the treat of an event such as this in mind. It uses an innovative trial design to efficiently evaluate multiple interventions simultaneously.

Both trials are constantly reviewing the investigational treatments available. Please visit their websites for the most up to date details.

The following observational studies collect information from the hospital records of patients admitted with COVID-19 to answer the urgent questions. In order to obtain as much information as possible, and ensure the whole patient population is represented, data is collected for all patients unless they choose to opt out.

  • ISARIC/WHO-CCP UK - ISARIC/WHO Clinical Characterisation Protocol for Severe Emerging Infections in the UK. This originated in 2013, the time of the SARS-CoV pandemic. It is part of an international collaboration (ISARIC/WHO-CCP) designed to collect information on severe emerging infections. The study was activated by the CMO in January 2020 in response to COVID-19 and has been collecting data and samples since the first cases were reported in the UK. At RBCH we are contributing to the COVID19 Clinical Information Network (CO-CIN), the data collection tier.

  • PRIEST - Pandemic Respiratory Infection Emergency System Triage study –This study was designed in preparation for a potential pandemic, allowing data to be collected from the early phases of the pandemic. The baseline characteristics and outcomes of patients with suspected COVID-19 using the emergency care system (999 or ED) are being used evaluate current triage methods used to determine whether a patient with suspected coronavirus should be admitted to hospital, and if so to intensive care. It is intended that the results will be used to update triage guidelines as the pandemic continues.

  • GENOMICC - Genetics Of Mortality In Critical Care – How susceptible we are to COVID-19 is likely to be partly down to our genes, as in other infections. Finding these genes has the potential to help prioritise treatments. This global study collects DNA samples from the critically ill and is now focusing on COVID-19, with the particular aim to include all patients requiring invasive mechanical ventilation in the UK.

In addition to these priorities we are part of the UK Coronavirus Monitoring Project. Patients with cancer potentially have greater susceptibility to COVID-19 and more serious complications of the disease. This could be both due to the cancer itself and treatment, with differences between different cancer types. Doctors and patients are having to make difficult decisions regarding their condition including whether or not to treat and if so what treatment and how it is given. It is important that these are informed by the best available evidence. UKCCMP aims 'to collect identify and learn from every case of COVID-19' and provide 'live' updates.