Eastern patients play vital role in practice-changing COVID-19 study

Patients, NHS trusts and local research teams at hospitals across the Eastern region 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.

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%.

The REMAP-CAP trial is being delivered at four NHS Foundation Trusts across East Anglia: Cambridge University Hospitals (CUH), East Suffolk and North Essex, James Paget University Hospitals and Norfolk and Norwich University Hospitals (NNUH), and at many other trusts across the country.

Dr Charlotte Summers, Principal Investigator for the REMAP-CAP trial at Cambridge University Hospitals and Critical Care Lead for the NIHR Clinical Research Network Eastern, said:

“This result from REMAP-CAP provides further support for the finding from the RECOVERY trial, suggesting that steroids improve survival for critically ill people with COVID-19. The breakthroughs we have made so far are testament to NHS teams unwavering determination to improve the outcomes of our patients by offering them the opportunity to participate in research.

“There are still more questions to be answered in relation to COVID-19, but with our country's unique NIHR community, along with those who participate in research, we're in the best possible position to succeed."

Deirdre Fottrell-Gould, Clinical Research Nurse working on the REMAP-CAP trial at NNUH, said:

“We are delighted to see another vital step forward taken in finding proven treatments for patients with COVID-19. These findings demonstrate how necessary research is and how grateful we are to our participants who have helped us evidence this."

NHS chief executive, Sir Simon Stevens said: “One of the distinctive benefits of having our NHS is that we've been able to mobilise quickly and at scale to help researchers test and develop proven coronavirus treatments. Just as we did with dexamethasone, the NHS will now take immediate action to ensure that patients who could benefit from treatment with hydrocortisone do so, adding a further weapon in the armoury in the worldwide fight against Covid-19.”