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Coronavirus: identifying treatments

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A range of potential treatments have been suggested for COVID-19, but it's still unclear whether any of them will turn out to be more effective than the usual standard of hospital care, which all patients receive.

Tihana Web Dr Tihana Bicanic

Our Emerging Leaders Prize-winner Dr Tihana Bicanic is Principal Investigator at St George’s University Hospital for a national trial testing some of the treatments suggested for COVID-19. The Oxford University-led RECOVERY trial has already enrolled over 5,000 patients across 160 hospital sites, randomising them to one of five different treatment arms:

- Usual standard-of-care
- Lopinavir-Ritonavir (commonly used to treat HIV)
- Low-dose Dexamethasone (a type of steroid, which is used in a range of conditions typically to reduce inflammation).
- Hydroxychloroquine (related to an anti-malarial drug)
- Azithromycin (a commonly used antibiotic)

Since the trial opened at St. George’s on 30 March, the hospital has already recruited 50 COVID-19 patients.

Tihana said: “Drawing on my experience running clinical trials in severe fungal infection, I’m supporting our team of research nurses, consultants and study investigators, who are all working across a range of medical specialties. This includes identifying suitable patients, consenting them and randomising them to one of the treatment arms.

“The RECOVERY trial is specially designed so that promising treatments can be quickly introduced as soon as they’re identified, or removed if we find they’re not working.

“We’re hoping to rapidly find some answers to what may or may not work as treatment for COVID-19. With so many sites contributing, we can arrive at these answers at remarkable speed, which is exactly what’s needed in this fast-moving pandemic.”

Tihana has also added a further arm to her AspiFlu study, which aims to reveal the proportion of patients with severe flu on intensive care that go on to develop a fungal lung infection called aspergillosis, and understand the immune mechanisms behind this complication. The study has now been expanded to include COVID-19 patients on intensive care.

The RECOVERY trial has received £2.1 million from UK Research and Innovation (UKRI) and the Department of Health and Social Care, through the National Institute for Health Research (NIHR).