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Treatments

Convalescent plasma

Guy’s and St Thomas’ NHS Foundation Trust, King’s College London, NHS Blood and Transplant and the University of Cambridge

A landmark trial is being co-led by Dr Manu Shankar-Hari, a consultant in intensive care medicine at Guy’s and St Thomas’ NHS Foundation Trust, along with experts from NHS Blood and Transplant and the University of Cambridge on a promising new blood plasma treatment for COVID-19. Known as ‘convalescent plasma’, the treatment is for patients who are severely ill with COVID-19 and involves blood plasma donations from patients who have recovered from COVID-19. This plasma is transfused into COVID-19 patients whose bodies are not producing enough of their own antibodies against the virus, to support the patients fighting the disease. The research lab run by Dr Shankar-Hari within the King’s College London School of Immunology and Microbial Sciences, is coordinating the underpinning science behind the convalescent plasma treatment.

Interleukin 7 trial

Francis Crick Institute, King’s College London, and Guy’s and St Thomas’ Hospital

Patients who are the most seriously ill with COVID-19 are also the focus of scientists from the Francis Crick Institute, King’s College London, and Guy’s and St Thomas’ Hospital who are conducting a trial to evaluate if a drug called interleukin 7, known to boost T-cell numbers, can aid patients’ recovery. The trial of this drug was prompted by the finding that those with the most severe form of the COVID-19 have extremely low numbers of immune cells called T-cells, which clear infection from the body.

Remdisivir trial

UCL and the Medical Research Council (MRC)

The first large-scale international trial to report on the use of the drug remdisivir to treat patients hospitalised with COVID-19 was co-led by UCL and the Medical Research Council (MRC). The Adaptive Covid-19 Treatment Trial (ACTT-EU/UK), is taking place in around 75 hospitals globally, with the MRC Clinical Trials Unit at UCL leading the UK and EU study. Other sites in the EU (Spain, Denmark and Germany) were co-ordinated by the University of Copenhagen. The randomised controlled trial, which has recruited more than 1,000 patients globally, aims to evaluate the safety and efficacy of the anti-viral drug remdesivir, as a treatment for COVID-19.

TRV027 trial

British Heart Foundation Centre of Excellence at Imperial College London

A new drug to prevent lung damage and blood clots in people with COVID-19 is set to be trialled in UK hospitals with support from researchers at the British Heart Foundation Centre of Excellence at Imperial College London. The drug, a molecule known as TRV027, aims to restore the balance between two hormones, angiotensin II and angiotensin 1-7, which control blood pressure and affect blood vessels, and could put a brake on many of the dangerous processes which occur in COVID-19, such as lung damage and blood clots.

OxVent ventilator

King’s College London, University of Oxford and Smith+Nephew

The OxVent group, comprising scientists, clinicians, engineers and medical technology manufacturers from King’s College London, University of Oxford and Smith+Nephew mobilised quickly to respond to COVID-19 and the anticipated needs of the NHS in treating it. They developed the OxVent ventilator to be produced at speed and scale and at significantly lower cost than alternatives. It was conceived as an open source not-for profit project.

UCL-Ventura Continuous Positive Airway Pressure (CPAP) breathing aid

UCL, UCLH, Formula One and Mercedes-AMG High Performance Powertrains

UCL, UCLH and Formula One collaborated to create the UCL-Ventura Continuous Positive Airway Pressure (CPAP) breathing aid. Developed by engineers at UCL and clinicians at UCLH working with Mercedes-AMG High Performance Powertrains, it underwent patient evaluations at UCLH and partner hospitals in London. The devices have been delivered to over 60 NHS hospitals across England, the devolved nations and crown dependencies in line with demand, and NHS staff can request the devices for their hospitals at no cost to assist management of patients during possible future surges. The designs of UCL-Ventura have been made freely available to support the global response to COVID-19 and the CPAP design licence has been downloaded by more than 1,800 teams in over 105 countries around the world, and 22 teams have begun manufacture and hospital testing of the devices.

DeVENT trial

Imperial College London and Royal Brompton & Harefield NHS Foundation Trust

Innovation has also seen the development of mechanical ventilation using AI to support patients with severe symptoms of COVID-19 through the DeVENT trial which is being co-led by Dr Brijesh Patel, Clinical Senior Lecturer at Imperial College London and Honorary Consultant at Royal Brompton & Harefield NHS Foundation Trust. Those who are most severely affected by the virus may develop a life-threatening condition, known as Acute Respiratory Distress Syndrome (ARDS), where the lungs cannot provide the body’s vital organs with enough oxygen and require mechanical ventilation. The DeVENT trial is testing a new AI device called the Beacon Care system which is connected to a ventilator to help monitor the effect mechanical ventilation is having on a patient’s lungs.

Adapting a novel antibody technology to combat COVID-19

Imperial College London

Cancer researchers at The Institute of Cancer Research (ICR) are working to develop antibodies against the virus SARS-Cov2. The project, led by Professor Terry Rabbitts, could lead to a new method of testing using an antibody ‘tetramerisation’ technology, already developed by his team. The research may also lead to a new way of treating patients with symptoms, by giving them artificial antibodies that could boost their own immune response to the virus.

ARDS treatment

King’s Heath Partners

KHP is undertaking early-phase clinical trials of treatments for COVID-19-related Acute Respiratory Distress Syndrome, known as “ARDS”, (including C5 complement inhibitors, mesenchymal stromal cells, lipid encapsulated non-steroidal anti-inflammatory drugs, inhaled heparin).

Therapeutic developments

King’s Health Partners

Research programmes on high-throughput screening of FDA/EMA-approved drugs to prevent and treat COVID-19 infection; using infection assays – pseudotypes (HIV/MLV), replication-competent isolates, reverse genetics; novel AAV gene therapy to knock-down COVID-19, using existing platform; and solation and characterisation of neutralising monoclonal antibodies from recovered patients.

Prevention and treatment for COVID-19 associated severe pneumonia

King’s Health Partners

Antibody response to produce artificial antibodies

Queen Mary University of London

Queen Mary University of London is studying the COVID-19 antibody response to produce artificial antibodies for treating severely ill patients. By collecting B cells from volunteers and amplifying their antibody genes, the team aims to build an antibody immune library which will act as a platform for an unlimited source of SARS-COV-2 specific antibodies.

COVID-19 THERAPEUTIC CLINICAL TRIAL (LIBERATE)

King’s College London / Guys and St Thomas’ NHS / SEEK

The LIBERATE trial aims to reduce the mortality of patients hospitalised with Acute Respiratory Distress Syndrome (ARDS) brought on by COVID-19. The investigational product, Flarin, is a unique lipid formulation of ibuprofen licensed in the UK and available Over The Counter (OTC) for chronic inflammatory conditions. Importantly, it also has compelling ARDS preclinical evidence. If efficacious, this inexpensive and easily administered drug has vast positive implications for COVID-19 response both in the developed setting and in Low and Middle-Income Countries (LMICs).

Convalescent blood plasma given to COVID-19 patients

Imperial College London

Convalescent plasma is the antibody-rich plasma of someone who has recovered from a virus. There is some limited evidence that patients might benefit from the use of convalescent plasma, and the clinical trials are needed to confirm whether such transfusions are safe and effective.

Patients in more than 50 hospitals in the UK, including Imperial College Healthcare NHS Trust, have received the treatment as part of the REMAP-CAP trial. As well as analysing convalescent plasma treatment, the trial will also assess other treatments such as antiviral and anti-inflammatory drugs, anti-coagulants and high doses of vitamin C for patients who have severe pneumonia as a result of COVID-19.