CDDFT Studies during COVID
The work undertaken by the research team at County Durham &
Darlington NHS Foundation Trust, in response to the Covid-19
pandemic, has been recognised with an award by the regional
Around 1,000 patients admitted to Darlington Memorial Hospital
and University Hospital of North Durham with suspected or confirmed
COVID-19 have been recruited onto COVID-19 trials, contributing to
the national and international search for treatments.
James Limb, Director of Research and Innovation, said, "Our
research nurses and other members of our teams worked with those
caring for patients with COVID-19 across our sites, ensuring
patients were asked to participate when it was appropriate,
ensuring they had all the information they needed and making
participation as easy and straightforward as possible.
"We continue to recruit patients to the RECOVERY trial, the huge
national trial which has identified the only drug so far known to
improve survival in hospitalised patients - dexamethasone. The
trial continues to investigate three possible treatments, including
using antibodies from patients who have recovered from
"On top of RECOVERY, we're also part of the ISARIC-CCP trial of
all COVID-positive patients admitted to hospital, CA-COVID, which
is looking into the common problem of blood clots which we see in
the disease, and PAN-COVID, which looks at women who have COVID-19
symptoms in pregnancy.
"Recruiting over 1,000 patients to these trials makes the Trust
a significant contributor, which has been recognised by the North
East and North Cumbria Local Research Network, which has made the
"We're enormously grateful to our patients and their families
for supporting this vital research, helping us better understand
this new virus and finding ways to combat it.
"As we head into autumn, as part of the Durham Tees Valley
Research Alliance - our partnership with North and South Tees NHS
Foundation Trusts, we'll be busy working on antibody and vaccine
"I'm proud that our hardworking research team has been
recognised by our regional Research Network, we're all excited to
be playing such an important part in helping to find the answers to
fight this disease."
There are a number of vaccines being identified and
safety-tested at the moment, but only large scale studies can give
researchers the information needed about how effective they are.
The National Institute for Health Research (NIHR) is working with
the NHS to recruit half a million people onto the NHS COVID-19
vaccine research registry by October. Those who volunteer and sign
up will be contacted by researchers to take part in COVID-19
vaccine research in the coming months.
Researchers are looking for people from all backgrounds, ages
and parts of the UK, with or without existing health conditions, to
take part in vaccine studies. Without volunteers, we can't find out
which vaccines are going to be effective. Our region currently has
the lowest rate for signing up for vaccine trials. By taking
part, you could help researchers find vaccines to protect us all
more quickly - which in turn could help the NHS and save lives. To
find out more, or register, go to the following website: https://bepartofresearch.nihr.ac.uk/vaccine-studies/
Published 2nd September 2020
During this pandemic #TeamCDDFT
has been very proactive in initiating work to understand more about
this virus and its impact. This supports the Trust's ambition
and reputation has a forward-thinking organisation with a strong
Research focus. Below is a summary of some of this important
County Durham and Darlington NHS
Foundation Trust is part of the new Durham Tees Valley Research
Alliance along with South Tees and North Tees NHS Foundation
Trusts, and has been recruiting patients for the national COVID-19
research trial which has made a major breakthrough in the fight
against the virus.
Almost 100 patients cared for by
CDDFT agreed to take part in the RECOVERY study, a national
clinical trial aiming to identify treatments that may be beneficial
for people hospitalised with suspected or confirmed COVID-19.
Across the Alliance, nearly 500 patients from the region have
entered the study.
James Limb, Director of Research
and Innovation, explains, "Three months ago,
there were no known treatments for COVID-19. The RECOVERY Trial,
led by Oxford University and set up in record time at the start of
the pandemic, is testing seven potential treatments and, thanks to
the willingness of patients recruited to the study and the work of
our teams, we've been contributing vital data. Nationally, nearly
12000 patients are part of the trial."
"It was recently announced that
the trial has identified a clear survival benefit to giving a daily
dose of a drug called dexamethasone to any patient ill enough with
COVID-19 to need oxygen or ventilation."
"The significance of this result
is enormous - dexamethasone is inexpensive, well-tolerated, easily
available, and it is the first drug anywhere to show an improvement
in survival for COVID patients. The actual results show a one third
reduction in deaths in patients ill enough to be on a ventilator,
and a one fifth reduction in those needing oxygen."
"Moving forward dexamethasone
should become a standard part of the care given to patients with or
suspected of having Covid-19.
"Taking part in clinical
research trials takes a great deal of commitment from clinicians,
research nurses, patients, their families and those caring for the
patient. That said, it's so important for patients to consider
taking part in research so we can discover better treatments, and
in doing so, they can benefit from treatments before they become
more widely available.
"Whilst all hospitalised
COVID-19 patients should be considered for dexamethasone, the
RECOVERY trial is continuing to test other potential treatments for
COVID including convalescent plasma from survivors, and
tocilizumab, a drug which alters the immune response. Another six
COVID-19 trials are also underway in our hospitals, as well as a
range of trials for other conditions. We encourage all patients to
take part in research - their help plays an important part in
improving medical care.
The research team, despite
supporting the frontline, have continued to research activity
particularly in relation to COVID 19. The trust has
taken part in 7 other trials recruiting over 1000
Review of nosocomial
(hospital acquired) infection
The IPC team conducted a review
of all patients that had a positive test result 5 days or more
after admission which would be suggestive of acquiring the
infection during the stay. During the period from 13 April to
18 May there were 494 positive cases. Of these 18% (92) were
post 5 days. Those cases that were post 15 days are most
likely to have acquired the infection in hospital, the trust
identified that 8% (40) patients with a positive result fell into
this category. This compares to 15% nationally.
An incidental finding from this review is that 45% of the patients
that were positive post 5 days had been admitted following a
fall. Further work is being undertaken to understand the
implications for how we manage these patients.
ED UHND review of
patients with a positive test result
An initial study was undertaken
in April 2020 to understand how well the clinical teams were
identifying patients with COVID 19, at this time only symptomatic
patients were being swabbed. This was followed up with a
repeat of the data collection in May when swabbing of all
non-elective patients was introduced nationally. The initial
study found that the clinical team were successfully recognising
symptomatic patients with 85% successfully streamed and 95%
correctly admitted to RED AMU. However in the second study, only
68% were correctly streamed and 75% correctly admitted. This
reduction reflects the patients that are not presenting with
classic symptoms but are testing positive after swabbing. A
proportion of these patients came from care homes and were
presenting as generally unwell. This review made a number of
recommendations on how patients should be managed to ensure the
risk of transmission to other patients is minimised.
ENT review - olfactory
and taste disorders
This study was initiated as the
ENT team acknowledged the growing body of international evidence as
well as anecdotal reports locally and nationally that patients with
COVID 19 were reporting a loss of taste and/or smell. The
team contacted 63 patients and 14 staff that had a positive result
to understand their presenting symptoms. 43% of this cohort
reported these symptoms. It was found that the group with
these symptoms were generally younger and fitter than those that
did not. The recommendation of this study was
that these symptoms should be considered as indicators of COVID 19
on triage. This coincided with the change in national
guidance to include these symptoms.
Published 30th June
'As I was very, very nervous, I must have been the worst patient
ever and they were brilliant with me and I can't thank them enough
- could you please pass on my sincere thanks.'
Patient, Hysteroscopy Unit, Chester-le-Street Community