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Hospital’s top researchers say ground-breaking trials may find treatment ‘by end of year’

PUBLISHED: 16:37 30 April 2020 | UPDATED: 16:37 30 April 2020

A multi-disciplinary team of consultants, critical care staff and research nurses at the James Paget University Hospital which are hoped to put us in a stronger position for treatment

A multi-disciplinary team of consultants, critical care staff and research nurses at the James Paget University Hospital which are hoped to put us in a stronger position for treatment "by the end of the year". Photo: JPUH

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A Norfolk hospital has signed up its first 50 patients for a national trial into drugs which may find a treatment for coronavirus ‘by the end of the year’.

The James Paget University Hospital (JPUH) in Gorleston is taking part in the NHS National Institute of Health Research’s (NIHR) ‘RECOVERY’ trial into four drugs that are being studied to see if they help treat patients diagnosed with Covid-19.

The 50 patients are among more than 8,000 nationally taking part in the trial, funded by NIHR as one of a growing number of COVID-19 studies taking place to help future treatment of Covid-19 patients.

Alongside exploring which medications may help fight off the disease, the hospital began a second trial last week, exploring how respiratory machines can be used most effectively – called the ‘RECOVERY RS’ trial.

Patients in this trial randomly receive either standard care, high flow oxygen or the use of CPAP machines which typically support patients with sleep apnoea - a condition where airways become blocked while unconscious.

Unlike traditional ventilators, CPAP machines do not require patients to be sedated or placed in intensive care units, and have a much lower associated mortality rate than ventilators (of which up to 50pc of Covid-19 patients who are given them pass away).

JPUH is currently the only hospital in the East of England to participate in this trial, due to its “extensive expertise” with the use of CPAP machines already showing “favourable results” over the past month for treating breathing difficulties in suspected Covid-19 patients.

A multi-disciplinary team of consultants, critical care staff and research nurses led by Professor Ben Burton are behind the hospital’s RECOVERY trials, which are coordinated by researchers from Oxford University’s Nuffield Department of Population Health and the University of Warwick.

Dr Venkat Mahadevan, a respiratory and sleep specialist at JPUH said: “Research changes lives for the better, and it is only through research that we can develop better care and treatments. I am confident that by the end of the year, we will be in a much stronger position in knowing which treatments work and hopefully we will have a vaccine.”

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Dr Mahadevan explained “there are currently no specific medications for treating Covid-19, just supportive ones, as the virus causes overwhelming infection that can variably affect the lungs and subsequently other body organs.”

As part of the RECOVERY trial, JPUH are researching four key drugs, including ones that typically treat malaria and HIV, to see how they may help fight Covid-19.

He said: “One arm of the study is to give a type of steroid called Dexamethasone which is believed to be helpful in reducing inflammation - a part of what makes coronavirus so deadly and sometimes fatal.”

Researchers believe these steroids help manage overreactions of the body’s immune system called Cytokine Storms, but other medications may show promise.

Dr Mahadevan said: “The other arm of the study is to look at drugs such as Lopinavir-Ritonavir, traditionally an anti HIV medication, Hydroxychloroquine, an anti-malarial drug, and Tocilizumab, a drug that typically treats inflammatory arthritis.”

Tocilizumab has shown ‘significant promise’ in severe Covid-19 cases, according to international clinical studies, but Dr Mahadevan says “it is too soon to speculate on which of the drugs has the best promise. The picture will become clearer in the weeks and months ahead.”

“I think the message is for people not to be bogged down by this virus but to be mentally strong,” Dr Mahadevan said. “We can tackle this together.”

As of Tuesday, April 28, the James Paget only had 42 inpatients confirmed to have coronavirus, with 146 patients safely discharged, while 82pc of all patients are being treated for other non-coronavirus conditions.

“We were a few weeks behind London, so we had some time to prepare a comprehensive response to the pandemic at the JPUH. A lot more patients have gone home safely, rather than the ones who sadly passed away,” Dr Mahadevan said.

On behalf of the hospital, Dr Mahadevan thanked those who have donated PPE and other essential items, stating: “Doctors and nurses here have mostly had what they need, available when they need it. Staff and patient morale is generally good.”


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