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Landscape of urgent UK-wide research in COVID-19.

ISARIC4C is one the UK-wide NIHR Urgent Public Health Priority studies for hospitalised patients with COVID-19:


Any hospitalised patient

  • ISARIC Clinical Characterisation Protocol (CCP) Tier 0 (CO-CIN)

    Data collection, no consent

    COVID19 Clinical Information Network (DHSC-funded). Near real-time analysis and reporting of the clinical characteristics of patients admitted to hospital with SARS-CoV-2 infection, to inform the research and public health responses. To achieve this we need clincal research nurses and administrators to gather data from clinical notes and enter it into a simple online database.

  • ISARIC Clinical Characterisation Protocol (CCP) Tiers 1/2 (4C)

    Sample collection, consent needed

    COVID19 Clinical Characterisation Consortium (MRC-funded). Obtaining research samples. Either one sample set at recruitment, or 4 sample sets on Day 1, 3, and 9 and (if possible) another set 28 days after discharge. Aims to understand transmission, pathogenesis, and prognosis. To achieve this we need PPE-trained research nurses to obtain consent, and samples of pathogen shedding sites and blood.

Adaptive platform drug trial, consent needed

Randomised Evaluation of COVID-19 Therapy (MRC/DHSC-funded). Trial of widely available, high-priority interventions, among confirmed COVID19 cases requiring hospital admission, to determine effect on death or requirement for invasive ventilation. Interventions will be added and removed over time as needed. Given the unprecedented impact COVID 19 will have on the health of the population, even small clinical benefits may be of significant benefit. Designed to give individual patients the best chance of getting an effective therapy. To do this we need GCP-trained research nurses to support front-line clinical staff recruiting patients.

Adaptive platform trial of supportive care interventions, consent waived

RECOVERY-RS is a multi-centre, pragmatic clinical trial evaluating the use of CPAP and / or high flow nasal oxygenation to prevent intubation and reduce mortality. Uncertainty about the effectiveness of CPAP / HFNO in COVID-19 have led to conflicting guidance on the use of these interventions. Recruits patients with acute respiratory impairment (FiO2 >0.4 and SpO2 < 94%). Sites may choose to enrol in one or both arms of the trial (CPAP versus standard care, HFNO versus standard care or CPAP versus HFNO versus standard care). Sites are encouraged to contact the co-ordinating centre at [email protected] to log their interest in participation.


Patients in Critical Care

Genetic study, consent needed

Genetics Of Mortality In Critical Care (MRC/DHSC/FEAT/ICS/Wellcome-funded). UK-wide ICU study to identify variants underlying genetic susceptibility to critical illness with coronavirus, which may help identify new targets for treatment and mechanisms of disease. This study was funded in 2014 and was recruiting across the UK before the pandemic hit.

Bayesian adaptive platform trial, consent needed

A Randomised, Embedded, Multi-factorial, Adaptive Platform Trial for Community-Acquired Pneumonia. This is a global platform trial in critical care with multiple arms and domains to test a variety of therapeutic interventions in critically-ill patients.