Aims

To understand how practices of care and patient characteristics changed over the different waves of the Covid-19 pandemic, to determine the most effective treatments available and inform care nationally and globally.

Background

The Covid-19 pandemic has affected millions of people worldwide. Although most infections are very mild, 1 in every 10 patients admitted to hospital will becoming very sick with difficulty breathing. These patients are often admitted to High Dependency (HDU) and Intensive Care Units (ICU) where their breathing is supported with high levels of oxygen, breathing support masks or they are placed on breathing machines called ventilators.

Studies suggest that by treating the lungs gently and by placing patients on their fronts, treating with steroids and drugs that reduce inflammation, it is possible to improve their chances of survival.

The UK has also had different policies to protect people from Covid-19 and reduce the chance of the disease spreading. These have included national lockdowns, shielding the most vulnerable and the tier system where different parts of the country have been subject to different restrictions.

Research

Due to variations in the waves of Covid-19 and restrictions across the country it can be difficult to determine what factors are affecting recovery.   This research will seek to answer the following questions:

Studying patients in one geographic area helps answer these questions, as all patients had the same social restrictions at the same time, and treatments were given at the same hospital by the same doctors.

This study will consider Covid-19 Intensive Care admissions at University Hospitals Birmingham NHS Foundation Trust across the pandemic, patient demographics (i.e. age, ethnicity, other health conditions), ventilation approach, treatments and whether outcomes changed for patients. Virus variants and the impact on patients’ severity of illness will also be considered.

Patient involvement

This work has been discussed extensively with patients who have survived Covid-19 and been discharged from ICU, and also families of patients who died. This group will continue discussions as the project evolves and will co-create a series of leaflets to help with intensive care discussions for patients and their families.

Approval

This project was supported unanimously by the PIONEER Data Trust Committee.

Principal investigator

Dr Dhruv Parekh, University Hospitals Birmingham NHS Foundation Trust

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