Existing research raises concern about the accuracy and use of current triage tools used to predict adverse outcomes in pandemics. The PRIEST study will evaluate current triage methods used to determine if a patient with suspected COVID-19 is to be admitted to hospital or not and whether or not they should be admitted to ICU/HDU. Based on the information collected from this study, two new triage tools will be created. The first will include clinical characteristics alone, and will be used in the community setting to determine if a full hospital assessment is required. The second would be used in emergency departments to determine if hospital admission is required and will include presenting clinical characteristics and investigations (ECG , chest X-ray and blood results). These new triage tools will be evaluated based upon ability to predict adverse outcomes; patient death or requirement for cardiac, renal or respiratory support.
Honorary Professor of Emergency Medicine & Clinical Director of the Emergency Department
People who develop an Acute Kidney Injury (AKI) often have a poor prognosis and many go on to develop chronic kidney disease (CKD). The recognition that AKI and CKD are linked is recent and the molecular pathways that control the transition from acute injury to chronic disease are not well defined. Currently there are no specific treatments that reduce the risk of progressing to CKD after AKI.
Preliminary investigations (not yet published) suggest that AKI causes sustained activation of the endothelin (ET) system to the long-term detriment of renal and systemic haemodynamic function. These pilot data form the basis of our project that seeks to determine whether the ET system is active in patients with AKI and, thus, represents a potential target for therapeutic intervention.
KRAKIL aims to recruit altogether 100 patients from across the emergency department, acute medical unit and inpatient wards at the Royal Infirmary. 50 of which with AKI’s and 50 matched controls with normal kidney function. We will monitor their bloods and urine for 90 days and compare the data from between the two groups.
ISARIC/WHO Clinical Characterisation Protocol for Severe Emerging Infections in the UK (CCP-UK)