UCD School of Medicine Research Team Demonstrate transmission of the virus among patients and healthcare workers in the hospital.

A team of researchers at UCD and St Vincent’s University Hospital, D4 investigated the virus isolated from patients who acquired COVID-19 in hospital during the first wave of the pandemic in March and April 2020 in Ireland. In turn, the research team clearly demonstrated the transmission of the virus among patients and healthcare workers in the hospital.

The researchers employed the most advanced sequencing technologies to characterise 52 complete genomes (samples) of SARS-CoV-2 isolated from patients and healthcare workers and taking advantage of the mutation rate of the virus, they revealed also the time-dependent relation of the viruses isolated in different wards. This study was published on 19th Sept in the journal Clinical Infectious Diseases and provides evidence that COVID-19 transmission can occur from pre-symptomatic or asymptomatic HCWs to patients.

Speaking about the findings from the study, Lead Author, Prof Kirsten Shaffer, Clinical Professor, UCD School of Medicine and Consultant Microbiologist, SVUH said “During the first wave of the COVID-19 pandemic in March and April 2020 in Ireland, outbreaks of the virus in healthcare institutions posed a significant problem. So in this study we used genome sequencing of the SARS-CoV-2 genome to learn about the transmission routes of the virus in hospital-acquired cases of COVID-19 and to decide on the appropriate infection control measures to prevent this from happening.”

“Viral genome sequencing identified previously unknown transmission routes and provides evidence that SARS-CoV-2 transmission can occur from pre-symptomatic or asymptomatic HCWs to patients generally by close contact or droplet rather than aerosol” continued Prof Shaffer.

The study also highlighted that the following interventions are required;

  • Comprehensive screening of HCWs for COVID-19 symptoms
  • PCR testing (to detect the presence of the virus, rather than the presence of the body's immune response, or antibodies) of asymptomatic HCWs upon identification of hospital acquired cases
  • Implementation of universal use of surgical masks for all clinical care is indicated to prevent and break the chain of viral transmission
  • Close collaboration between guidance bodies and frontline Infection Prevention and Control (IPC) experts for developing control measures in an emergency pandemic situation caused by a virus with undefined modes of transmission

Also speaking on the findings from the study, joint Lead Author, Dr Guerrino Macori, Research Scientist/ Bioinformatician, UCD said “Whole Genome Sequencing allowed us to have a clear picture of the genetic material of the virus and to describe the route of transmission. We have been using these cutting edge approaches to study food-borne outbreaks caused both by bacteria (for example Salmonella and enterotoxigenic Staphylococcus aureus) and also viruses such as Hepatitis A Virus and Norovirus with the aim of promptly identifying the cause of infection and guarantee public health.”

The UCD School of Medicine, founded in 1854, is one of the Ireland’s leading medical schools. At undergraduate level, we offer programmes in medicine, radiography, Biomedical Health & Life Sciences (BHLS) and physiology and at graduate level, we offer up to 40 programmes for healthcare professionals including hospital doctors, GPs, radiographers, forensic scientists and mental health professionals and for managers and administrators working in healthcare settings. All of our undergraduate and graduate programmes are delivered by specialist staff across an extensive network of academic and clinical locations. Our student populational also comprises more than 60 nationalities, and international students now account for one-third of the total undergraduate student cohort. This diversity is one of the defining features of life at UCD, and one that enriches the student experience by delivering a truly international campus.

Research, science and a commitment to enquiry and discovery inform every aspect of the School's mission. Our 100 investigators generate approximately €15 million in annual research income and have grants under management worth more than €85 million. Our undergraduate students are always encouraged to immerse themselves in structured medical research throughout their studies. This approach is consistent with our desire to shape not just world-class healthcare professionals, but also scientific innovators, who will advance the boundaries of medical understanding and contribute to the development of new approaches to treatment and care to benefit patients.

To set up an interview please contact Jane Curtin, Marketing and Communications Manager, UCD School of Medicine. Tel.: 087 938 0779


JAMA published paper on a global trial which demonstrates that delivering intravenous hydrocortisone, a corticosteroid, improves recovery and survival for critically ill COVID-19 patients

A paper was published today in The Journal of the American Medical Association (JAMA) on a global trial which demonstrates that delivering intravenous hydrocortisone, a corticosteroid, improves recovery and survival for critically ill COVID-19 patients.

The findings were made through the “Randomised Embedded Multifactorial Adaptive Platform Community Acquired Pneumonia” (REMAP-CAP) trial and are reported today in the JAMA as part of a four-article package. The World Health Organisation is updating its COVID-19 treatment guidance as a result. Between March and June, the REMAP-CAP corticosteroid trial randomized 403 adult COVID-19 patients admitted to an intensive care unit to receive the steroid hydrocortisone or no steroids at all. The trial found a 93% probability that giving patients a seven-day intravenous course of hydrocortisone would result in better outcomes than not giving the steroid. The results were consistent across age, race and sex.

The Health Research Board helped fund the Irish arm of this trial which was set up by a group of intensive care specialists from around the world in response to the H1N1 pandemic in 2009. It is led in Ireland by Professor Alistair Nichol, SVUH and University College Dublin. Irish hospitals and patients participated in this important trial. Irish hospitals and patients participated in this important trial.

According to Prof Nichol, an author of the paper, 'The REMAP CAP Trial was designed to be able to quickly recruit patients in response to emerging pandemics such as COVID-19. So, in March 2020 ​our team of​ investigators began randomising patients with COVID-19 to alternative hydrocortisone dosing strategies and compared their outcomes with patients who received no corticosteroid.

The study involved 384 adult participants globally, and the research found a 93 per cent probability that giving this common steroid to patients improved their recovery and survival.

These results build on the success of existing evidence that dexamethasone, another corticosteroid, also improves outcomes for COVID 19 patients, confirming​ ​that this class of anti-inflammatory drugs can make a real difference in the fight against COVID-19.

Data from REMAP-CAP also contributed by combining data with other corticosteroid trials to confirm these results. ​Overall, this is an important extension of current knowledge that gives clinicians an alternative corticosteroid to use in case of shortages in availability of dexamethasone'.

Dr Mairead O'Driscoll, Chief Executive at the HRB added,

'This rapid response to address critical cases of COVID-19 is possible because of a long term investment by the Health Research Board in the Irish Critical Care Clinical Trials Network based at the UCD Clinical Research Centre, and in clinic research facilities and infrastructures across in Ireland. Since 2007, the HRB has invested more than €160 million in Ireland's clinical research ecosystem. It is good to see that by having this infrastructure in place, we can help deliver such timely and relevant outcomes for patients’.

 

To set up an interview please contact Stephen Pigott, Marketing and Communications Manager, UCD School of Medicine. Tel.: 087 646 2128