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Published on: 28 May 2020
Chesterfield Royal Hospital Foundation Trust is proud to be in the first 10 hospitals country wide who are taking part in one of the convalescent plasma trials which will help to go on to provide a better outcome for coronavirus patients.
Since the end of March the 15 strong research team at the Royal has worked alongside international and national research teams, and with our clinical teams, on studies including the ‘RECOVERY’ trial – looking at five existing drug treatments which could also reduce mortality rates or symptoms of Covid -19 in hospitalised patients.
Another arm was introduced to that trial, looking at whether plasma taken from patients who have had COVID- 19, and have recovered, contains antibodies which will help patients in hospital with COVID-19 fight the infection and recover more quickly.
Yesterday (26.05.2020) saw the beginning of the plasma arm of the RECOVERY trial at Chesterfield– with REMAP – CAP, another trial looking specifically at drug treatments and plasma in Intensive Care patients, currently in set-up.
These are both national trials – with 11,000 patients throughout the UK participating already in the RECOVERY trial. Over 100 local patients have signed up for this whilst hospitalized with COVID in Chesterfield and going forward, patients will all have a 50/50 randomised chance of receiving convalescent plasma, as well as one of the various trial drugs or usual care. In terms of the newest addition to RECOVERY – tens of patients locally will receive the convalescent plasma once they have begun to sign up from today.
Data collected from these trials will go to The University of Oxford who are running the trial – and our patients will add to the collective evidence base so that in future patients will benefit.
Dr Nick Spittle is a Consultant Intensivist at Chesterfield Royal Hospital and is Clinical Lead for the RECOVERY trial. He has first-hand experience of both COVID-19 and the trial, having signed up for them himself whilst a patient. He said:” I was in hospital for 10 days, despite being relatively young and fit, and the illness was awful - the less well patients have it lots harder!
“Our motivation for wanting to be involved is tohelp prove what treatments are definitely of benefit in COVID-19. At the minute we don’t have any proven treatments to decrease mortality. We’re keen to try and reduce mortality, and plasma is one of the hopes as it’s been shown in smaller studies of other viral illnesses that it can help reduce mortality. So the hope is that by doing a bigger study that if it is of benefit we will decrease the number of deaths in the future and also reduce the number of patients becoming sick enough to need admission to ICU –
“There’s some evidence globally that suggests it does help patients to recover. We now need to collect a large evidence base. A large clinical trial, such as RECOVERYremoves as much bias as possible to say whether the convalescent plasma really works or not”
“Patients are identified through being hospitalized with COVID-19 or a strong clinical suspicion of COVID- 19 and, after a full explanation, are asked if they give consent to go ahead with the trial. They will have the opportunity to be randomized for a drug trial or the plasma trial. It’s their choice and we do have patients who refuse after explaining and we respect that.
“It’s so important for Chesterfield Royal Hospital to be involved - all hospitals throughout the UK are seeing patients with COVID-19 and there are different patient groups in each; different levels of co-morbidity, or fitness backgrounds and what we want to know if that treatment is applicable to our typical patient groups ,so having input from hospitals throughout the country will be beneficial and mean that we are giving treatment with confidence”
It’s been a real team effort; the National Health Service Blood Transfusion Service (NHSBT) backed this – and created a programme to collect blood samples from patients who have recovered from COVID – 19 .
The convalescent plasma comes from patients hospitalised with a more serious version of COVID -19 as they will have generated the most antibodies in their own blood .The plasma is harvested 28 days from recovery as this is when the antibody response is optimum, with units of blood taken the normal way - with red blood cells the taken out and given back to the donor. The plasma - like a thick yellow fluid – is then tested to measure the antibody levels, the trial will see patients only given the plasma which has the highest 25% of antibodies in order to maximize the benefit to the patient. Plasma is matched to blood groups- plasma donors will come from a wide range of patient groups - gender or ethnic.
Tom Spencer, Research and Development Lead is incredibly proud of the research team:” It’s great that Chesterfield Royal Hospital has been selected as it allows us a another option to give to patients in this area which is a fantastic thing. For us as a Trust to be involved, having had teams across the hospital working together to make it happen, it’s been excellent! The patients and their families have supported us incredibly well too. At times of a pandemic it is never more vital to get involved in researchIt allows us to put our name against the national response. It is great that people ask about research, and get involved when they come into the hospital. It’s fantastic for us and our patients to be offered these innovative therapies early.
“We are getting more people talking about research – currently more than every its part of clinical care and the ultimate goal is to enable it to be seen that way.
“Our overriding consideration will always be patients’ safety, we know it’s a scary time anyway if you are in hospital with COVID- 19 so it’s about introducing the therapies in as safe a way as possible”
Dr Jon Cort, Deputy Medical Director at Chesterfield Royal Hospital and Deputy Chair of the National Blood Transfusion Committee is especially pleased to see the trial taking place here:” Chesterfield Royal Hospital is exceptionally proud to be one of the first hospitals in the United Kingdom to be able to offer Convalescent Plasma as part of the national trials as a treatment within research trials in the attempt to better treat Covid-19. Our Research Department has worked tirelessly to be able to make this happen and help the population that we serve. Chesterfield Royal Hospital appreciates the need to be involved in both national and international trials in order to try and find effective treatments in our battle to reduce the harm caused by Covid-19. We as an NHS Trust embrace all research into reducing the harm from Covid-19 and are proud to take our part in these challenging times.”