Thames Valley NHS patients contribute key data to practice-changing COVID-19 study
Patients, NHS trusts and local research teams in Thames Valley have contributed important data to new global research which shows that corticosteroids can significantly improve outcomes for severely ill patients with COVID-19.
The research papers published in the Journal of the American Medical Association (JAMA) today reinforce evidence that these inexpensive and widely available drugs improve outcomes for the most critically ill patients with the disease. One paper suggests the risk of death can be reduced by up to 20%.
The papers include findings from the National Institute for Health Research (NIHR) supported REMAP-CAP study, which is being conducted across 15 countries around the world and led in the UK from the NIHR Imperial Biomedical Research Centre.
Working closely together to help deliver rapid recruitment, NHS trusts and the NIHR’s Clinical Research Network (NIHR CRN) and research institutes from the devolved nations helped recruit 71% of all global study participants from right across the UK. This included 10 patients recruited at Oxford’s John Radcliffe Hospital, run by Oxford University Hospitals NHS Foundation Trust and two patients at Royal Berkshire NHS Foundation Trust.
The results from the REMAP-CAP trial show a high probability that among critically ill patients with COVID-19, treatment with a seven-day course of hydrocortisone improved outcomes such as survival and more rapid recovery, compared with no hydrocortisone treatment.
An additional paper, co-ordinated by the World Health Organisation (WHO) and led by researchers at the University of Bristol and the NIHR’s Bristol Biomedical Research Centre, provides a meta-analysis (evidence summary) of global steroid use across seven randomised controlled trials (RCTs) in 12 countries spanning five continents. It also included data drawn from REMAP-CAP and the NIHR-funded RECOVERY trial, which has already shown that the steroid dexamethasone can be successfully used in treatment of moderate to severe Covid-19. It concludes that corticosteroids can reduce the risk of death in the most ill patients by up to 20%.
Dr Matt Rowland, the principal investigator for the study at the John Radcliffe Hospital, said: “We’re proud to have participated in the REMAP-CAP study to help improve outcomes in the most critically unwell patients with COVID. This once again shows the benefit of the collaborative approach to COVID research we’ve seen across the UK.”
Professor Jonathan Van-Tam, Deputy Chief Medical Officer said: “These findings offer further evidence that corticosteroids can be an important part of COVID-19 treatment for severe patients. Both the REMAP-CAP and the Bristol University papers show the important work that has been done here in the UK by researchers in making further major contributions towards the international evidence. It is impressive to see so many UK participants willing to take part in studies, and able to volunteer due to the rapid recruitment response of the NIHR’s Clinical Research Network. Research such as this, will make the difference in controlling this virus.”
Anthony Gordon, Professor of Anaesthesia and Critical Care at Imperial College London and the study’s Chief Investigator, said: “The UK has been able to deliver so well in this study because of the joined up research processes that we have in this country. The NIHR provides infrastructure support to ensure research can be delivered efficiently throughout the whole NHS. This system is the envy of our international colleagues.”