Wellcome-Wolfson Institute for Experimental Medicine Institute: against COVID-19 ^Hub

Institute directed by Professor Jose Bengoechea, Queen's University Belfast. His research focuses on boosting host defences to fight against infections caused by antibiotic resistant bacteria. He is a world leader in the fight against Klebsiella pneumoniae, one of the deadliest hospital superbugs, with mortality rates of 25-60 per cent. Klebsiella infections are typical secondary infections that occur following influenza infection. Professor Bengochea's work is currently examining the role that co-infections play in the progression of COVID19 infections to help inform the future management of the disease in these patients.

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Project: 'RECOVERY-RS Respiratory Support : Respiratory Strategies in COVID-19; CPAP, High-flow, and standard care'

Summary: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged at the end of 2019 as a new coronavirus, resulting in a current global pandemic of respiratory illness, Coronavirus Disease 2019 (COVID-19). This illness can cause serious breathing difficulties and it is important to provide ventilatory (lung or respiratory system) methods to support the patient to breathe. Deciding which form of ventilatory support for patients with COVID-19 is the most effective is critical to ensure the best therapy is given to patients and to protect vital UK critical care resources and NHS organisations. The trial will also have the potential to provide information on the global ventilation practice for patients with COVID-19. This trial will look at three different approaches to providing ventilatory support to patients suspected or confirmed COVID-19, all of which are currently in use in clinical practice at present; High Flow Nasal Oxygen (HFNO), Continuous Positive Airway Pressure (CPAP), and standard care involving regular oxygen therapy. The project will see which is more effective in relation to survival of patients and intubation (tube inserted in to patient's throat to help them breathe). There is currently little evidence to support the use of HFNO or CPAP compared to standard care in patients with COVID-19. This trial will also look at other important outcomes in patients whilst they are in hospital such as how long it takes to intubate a patient, time to death, survival in critical care and hospital stay and length of critical care and hospital stay up until 30 days or hospital discharge, whichever comes later.

The trial is a multi-centre randomised controlled trial taking place in 40 hospital sites in the UK with the aim to recruit 4,002 patients. The trial will take place over a period of 18 months.

This project is a collaborative study between Queen’s University Belfast, the University of Warwick and Wellcome-Wolfson Institute that is testing the efficacy of non-invasive interventions at an earlier stage in disease progression as an effective alternative to using ventilators for COVID-19 patients. (NIHR funded; Danny McAuley, Wellcome-Wolfson Institute For Experimental Medicine).