KGH staff helping four major Covid-19 research trials

Staff at Kettering General Hospital are helping four major research studies into Covid-19 to help make the world a safer place.

The hospital - which is also the top-recruiting trust in the country in a Covid-19 sniffer dog trial - is playing a vital role in studies around the world.

Research into Covid-19 is crucial to help find the most effective treatments for it and to better understand the development of the pandemic.

KGH staff are helping studies into recovery from the illness, a global health study to better understand it, a study into Covid patients in intensive care units and an inflammatory bowel disease Covid impact study.

Interim director of research and development, Dr Ajay Verma, said: “We have had a great response to our efforts to support the very important international research into this terrible illness.

“Patients and their families, our doctors, nurses and support staff, have all been involved in work which could impact on many lives in the future. I particularly wanted to thank my consultant colleagues who have overseen recruitment to the studies at KGH (known as principal investigators). Their leadership enables recruitment to these studies in the large numbers we have seen.

“I must also thank our team of research nurses, who support the recruitment into studies by ensuring all the information required is recorded for analysis.”

KGH has a team of 12 research nurses and practitioners and two research and development staff who help find, set-up and support the logistics of their involvement in research trials.

Senior research nurse Sue Coburn said: “I think it has been amazing the way doctors, nurses, patients, and staff from across the trust have worked together to support a better understanding of this new illness.

“Our teams have been very dynamic and enthusiastic in their involvement and our patients too have demonstrated that they really want to do their bit to find solutions to all the problems that Covid-19 has brought with it.”

Recovery – the world’s largest ever research study

It's the world’s largest ever research study, running within the UK with more than 120,000 patients taking part. At KGH the trial is being led by respiratory consultant Dr Nasir Siddique and it is comparing potential treatments for patients with Covid-19.

They are the steroid dexamethasone, malarial drug hydroxychloroquine and HIV antiviral drugs lopinavar-ritonavir.

KGH has recruited nearly 100 patients across the hospital to support the trial, developed by the University of Oxford.

The trial has shown dexamethasone, a steroid that calms down inflammation in the body, to reduce the risk of death by a third for patients on ventilators. This same study has shown hydroxychloroquine, which received global attention, was ineffective at treating Covid-19.

Dr Siddique said: “The trial was open to all adult inpatients over the age of 18 who were documented as Covid-19 positive.

“Patients joining the trial were allocated a drug at random by the computer and received - or did not receive - one of the drugs so that their impact can be assessed without bias. All patients received our full support – whatever group they were in.”

Helping the most sick – Covid study in intensive care units

The hospital is also taking part in an international study specifically designed for patients in intensive care units. These patients are some of the most poorly and the trial has been designed to offer them a variety of different treatments all at once.

One of the treatments being tested is convalescent plasma - blood plasma taken from patients who have recovered from Covid-19 and have antibodies in their blood to fight the virus.

This study in KGH has been led by consultant intensivist Dr Dhinesh Sundaran.

Dr Sundaran said: “This is an adaptive trial in which multiple interventions can be tested simultaneously. So, not only can we know the effectiveness of different treatment options, we can also evaluate the interactions between them.

“There are various hurdles in recruiting patients in intensive care units like consent, a time limit to enter the trial, and availability of interventions at each site. We are thankful for the support of our research and pharmacy teams, nurses and junior doctors, at a time when we were very busy with critically ill patients during the pandemic.”

Global study to help better understanding of Covid-19

Isaric4c is a global health study collecting data on all Covid-19 patients to enable a better understanding of the virus.

It looks at the disease process, risk factors for severe illness, transmission dynamics and susceptibility factors and should also help inform the development of treatments.

At KGH it is being led by A&E consultant Dr Adrian Ierina and the research team is busy uploading information on nearly 400 cases so far.

Dr Ierina said: “This is an observation study tracking cases as they happened and on into the future so that we can learn valuable lessons about Covid-19.

“It provides a literal fountain of knowledge about the illness and is being built on every day. Patients have helped us by consenting to take part after having had a positive swab test at

the front door of urgent care.

“We have been looking at their symptoms, risk factors, and how they have responded to different treatments. It is research that has very quickly brought benefits by enabling us to better tailor treatments to patients.”

The data collected by KGH feeds directly to the World Health Organisation (WHO) and Government’s Covid-19 Clinical Information Network (CO-CIN), which is a SAGE sub-group.

Supporting national inflammatory bowel disease Covid-19 impact study

KGH is also making a significant contribution to a national study to determine the impact of Covid-19 on patients with inflammatory bowel disease (IBD).

Gastroenterology registrars Dr Farhad Peerally, Dr Amjad Ali and Dr Solange Serna are working on a large national registry study and under the supervision of Dr Verma they have been one of the highest contributors nationally to this study with at least 145 participants so far.

The study aims to describe adaptations in treatment for patients with flare-ups of IBD during the pandemic, including those who also suffer from Covid-19.

The findings will be used to identify any predictors of outcomes in patients with IBD who also suffer from Covid-19 symptoms and will help determine patients' progress when adaptations to treatments are made for them.

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