Ventilation system in use by patient

NCA plays key role in fight against Covid-19 pandemic

Research has been crucial to the global effort against Covid-19 and Northern Care Alliance (NCA) has taken a leading role in work to identify possible treatments and vaccines.

More than 11,000 patients, volunteers and NHS staff have taken part in Covid-19 research at NCA since March 2020. Nearly 9,000 of those have been involved in NHS priority research – known as urgent public health studies – which are improving care, identifying treatments and developing vaccines and other prevention measures.

That makes NCA the sixth highest recruiter to these studies in England.

Professor Phil Kalra

Professor Phil Kalra

NCA’s Director of Research, Professor Phil Kalra, said: “We are very grateful for the support of our patients and their families and our volunteers at such a difficult time.

“Through the local, national and international research efforts, we already have much better information about how to treat coronavirus and therefore potentially save thousands of lives. We’re proud to have been involved in the study that identified a widely used steroid, dexamethasone, as being able to help those in hospital with respiratory complications.

“We also recognise the vital importance of preventing infection and it has been heart-warming to have so many people come forward from our communities to take part in studies into potential vaccines and antibody treatments.”

As well as supporting more than 20 studies classed as urgent public health or approved by the Department of Health and Social Care (see panel), we have also initiated research locally and created new sample collections to support trials.

These include a Covid-19 sub-collection as part of the NCA Research Collection, which is collecting blood samples from infected patients to help identify early on those who are going to become severely unwell so they can be taken to intensive care units in good time. Samples have also been collected from patients in the Salford Kidney Study and the B-Cell stroke study.

Professor Kalra added: “While many restrictions have now been lifted and we have some effective treatments and preventative vaccines, we know that the dangers of coronavirus will be with us for years to come. Having these sample collections will allow us to support vital research long-term.”

Volunteer being vaccinated

Vaccine studies

Public health experts estimate the Covid-19 vaccination programme in England has so far prevented nearly 100,000 deaths and around 25 million infections.

But despite the successful NHS vaccine roll-out, more vaccines are needed both now and in the future as the virus mutates.

Since November 2020, NCA has recruited around 700 volunteers to vaccine studies with a major programme of research in a community setting – Oldham Leisure Centre.

Led by Director of Research Professor Phil Kalra, Assistant Director of Nursing for R&I Vikki O’Loughlin and Vaccine Trials Team Lead Rachel Newport, and supported by departments across NCA, the team set up a research centre inside the sports hall for each phase of the studies. This ensured volunteers were able to visit a convenient and well-planned venue without adding to pressures on our hospital sites.

The Novavax study reported excellent safety and effectiveness results this spring and Valneva’s results are expected to be reported before the end of the year.

The team have also been involved in the successful trial of AstraZeneca’s long-acting antibody combination as a preventative measure against Covid for those who may need an alternative to a vaccine, such as those who are immunosuppressed because of certain diseases or are taking drugs to suppress their immune reactions. Nearly 100 people took part in this study through the NCA, again attending appointments at the leisure centre.

Treatment studies

The NCA is proud to have been involved in the study which has arguably had the largest impact on Covid treatment – RECOVERY.

This urgent public health study is the largest randomised controlled trial of potential Covid-19 treatments in the world. There have been more than 45,000 participants globally and the study has identified several treatments that improve survival, as well as ruling out other potential treatments that have been shown to be ineffective.

Notably, it found that dexamethasone, a low-cost steroid, reduced deaths by one-third in ventilated patients and by one fifth in other patients receiving oxygen only, and that tocilizumab – a drug used to treat rheumatoid arthritis – significantly reduced deaths in all patient sub-groups. It has also demonstrated that an investigational antibody combination developed by Regeneron reduces the risk of death when given to patients hospitalised with severe Covid-19 who have not mounted a natural antibody response of their own. This treatment uses a combination of two monoclonal antibodies that bind specifically to two different sites on the coronavirus spike protein, neutralising the ability of the virus to infect cells.

Nearly 800 NCA patients have taken part in the study.

Additionally, the research team at Fairfield General Hospital in Bury recruited the first UK patient to the RECOVERY-RS study, the largest global non-invasive respiratory support trial for Covid-19. This study is comparing the effectiveness of three ventilation methods, including continuous positive airway pressure (CPAP) devices developed through a partnership between UCL in London and car racing experts at Mercedes AMG HPP.

The landmark trial found that participants who received CPAP were less likely to require invasive mechanical ventilation but that there was no benefit from high flow nasal oxygenation (HFNO) over standard oxygen therapy.

Based on this evidence, the authors say CPAP should be considered for hospitalised patients with Covid-19 needing increasing oxygen – reducing the need for invasive ventilation and relieving pressure on intensive care services.

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