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Research Studies

 

CDDFT Studies during COVID 19

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 research network.

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 COVID-19.

"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 award.

"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 trials.

"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 work:

RECOVERY Trial

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.

 

Other Research trials:

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 participants.

Research Studies

 

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 2020

 

'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 Hospital