Treating COVID-19 patients with oxygen therapy can be important because the disease is primarily a respiratory illness. Improvements in oxygen therapy mean better morbidity and mortality outcomes. A new research study has been launched by experts at University Hospitals Birmingham NHS Foundation Trust (UHB) and University of Warwick, supported by the Health Foundation, UK. It will find factors that influence how well oxygen is used across hospital wards where treatments take place. Evidence in other medical conditions shows that over-oxygenation can have negative health outcomes. Furthermore, this over-use would reduce the amount available for treating other patients.

“…It is important to understand and optimise practices, including prescribing of oxygen, for Covid-19 patients, in order to improve outcomes for hospitalised patients...”

Professor Alice Turner – Respiratory Medicine, UHB Trusts.

Optimal use of oxygen is vital for treating COVID-19 patients, most of whom can be managed in normal wards, as well as the minority that progress to intensive care units. Professor Alice Turner (UHB) who is co-lead on the project said: “Oxygen is a drug, and optimising prescribing is critical in a range of medical conditions, of which Covid-19 may be one…”

Data collected from four hospitals in the trust will be analysed to describe patients receiving oxygen therapy and assess how well it is prescribed. The results of our study will enable better understanding of staff-patient dynamic in hospital environments where considerable pressure is being experienced on a daily basis. Specifically, recommendations will be made to the Health Foundation concerning potential behavioural interventions. The aim is to improve treatment and to reduce mortality rates and morbidity related disease complications in the fight against the pandemic. Future behavioural interventions based on the current study will likely involve changes to hospital environments that guide cost-effective use of oxygen and improves health outcomes for a sustainable health system.

This research is supported by the national Health Foundation, UK, University of Warwick and University Hospitals Birmingham NHS Foundation Trust. Project PI, Prof Ivo Vlaev, and a number of researchers are supported by NIHR ARC West Midlands.

It has been widely reported that A&E attendance across the UK has decreased since the COVID-19 lockdown came into effect, with newspapers suggesting that this is especially the case for patients with heart attacks or strokes. Writing in the Lancet, Lumley-Holmes, et al. looked at callout figures across the West Midlands for these two conditions, and found that there was no significant change associated with lockdown. There was no evidence suggesting that people were reluctant to ring for an ambulance when they experienced heart attack or stroke symptoms.

Read more: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31031-X/fulltext

Lumley-Holmes J, Brake S, Docherty M, Lilford R, Watson S. Emergency ambulance services for heart attack and stroke during UK's COVID-19 lockdown. Lancet. 2020; 395: e93-4.

Corresponding author Richard Lilford. Richard Lilford is supported by the National Institute of Health Research (NIHR) Applied Research Collaboration West Midlands (ARC WM). Views expressed are not necessarily those of the National Health Service, the NIHR, or the Department of Health and Social Care.

Two fully funded, full time, three-year PhD studentships are available in Warwick Medical School from September 2020. These include fees and monthly stipend based on the Research Councils recommended rate – for details see: https://www.ukri.org/skills/funding-for-research-training/ .The studentships are part of the NIHR Applied Research Collaboration West Midlands (ARC WM).

The Margaret Peters Centre was launched at the Institute for Translational Medicine, University Birmingham on 13th November 2019. This virtual centre is an initiative between NIHR ARC West Midlands and University Hospitals Birmingham NHS Foundation Trust. The centre will seek to bridge the gap between the routine analysis and processing of data in hospitals, and the interesting questions that exist in clinical and academic teams. It will do so by bringing together the expertise of managers, clinicians and academics with questions that can be answered through the analysis of available data. The centre aims to conduct research using both local and national hospital datasets through health informaticians based within the Trust.