ARDC Research Link Australia

ORCID Profile
Orcid icon. 0000-0002-6899-8319

Current Organisations
King's College London , University of Algarve , Interdisciplinary Centre for the Study of Human Performance , Royal College of Physicians , Kings College Hospital NHS Foundation Trust , Guys & St Thomas Hospital NHS Foundation Trust

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Publications

Publication

Safety and efficacy of tenecteplase in patients with wake-up stroke assessed by non-contrast CT (TWIST): a multicentre, open-label, randomised controlled trial

Publisher: Elsevier BV

Date: 02-2023

DOI: 10.1016/S1474-4422(22)00484-7

Publication

COVID-19-related acute kidney injury; incidence, risk factors and outcomes in a large UK cohort

Publisher: Springer Science and Business Media LLC

Date: 11-2021

DOI: 10.1186/S12882-021-02557-X

Abstract: Acute kidney injury (AKI) is common among patients hospitalised with COVID-19 and associated with worse prognosis. The aim of this study was to investigate the epidemiology, risk factors and outcomes of AKI in patients with COVID-19 in a large UK tertiary centre. We analysed data of consecutive adults admitted with a laboratory-confirmed diagnosis of COVID-19 across two sites of a hospital in London, UK, from 1st January to 13th May 2020. Of the 1248 inpatients included, 487 (39%) experienced AKI (51% stage 1, 13% stage 2, and 36% stage 3). The weekly AKI incidence rate gradually increased to peak at week 5 (3.12 cases/100 patient-days), before reducing to its nadir (0.83 cases/100 patient-days) at the end the study period (week 10). Among AKI survivors, 84.0% had recovered renal function to pre-admission levels before discharge and none required on-going renal replacement therapy (RRT). Pre-existing renal impairment [odds ratio (OR) 3.05, 95%CI 2.24–4,18 p 0.0001], and inpatient diuretic use (OR 1.79, 95%CI 1.27–2.53 p 0.005) were independently associated with a higher risk for AKI. AKI was a strong predictor of 30-day mortality with an increasing risk across AKI stages [adjusted hazard ratio (HR) 1.59 (95%CI 1.19–2.13) for stage 1 p 0.005, 2.71(95%CI 1.82–4.05) p 0.001for stage 2 and 2.99 (95%CI 2.17–4.11) p 0.001for stage 3]. One third of AKI3 survivors (30.7%), had newly established renal impairment at 3 to 6 months. This large UK cohort demonstrated a high AKI incidence and was associated with increased mortality even at stage 1. Inpatient diuretic use was linked to a higher AKI risk. One third of survivors with AKI3 exhibited newly established renal impairment already at 3–6 months.

Publication

An ecological dynamics conceptualisation of physical ‘education’: Where we have been and where we could go next

Publisher: Informa UK Limited

Date: 02-03-2021

DOI: 10.1080/17408989.2021.1886271

Publication

Outcomes of COVID-19 infection in patients treated with Clozapine

Publisher: Cold Spring Harbor Laboratory

Date: 19-04-2021

DOI: 10.1101/2021.04.13.21255384

Abstract: Clozapine, an antipsychotic, is associated with increased susceptibility to infection with COVID-19, compared to other antipsychotics. To investigate associations between clozapine treatment and increased risk of adverse outcomes of COVID-19, namely COVID-related hospitalisation and intensive care treatment, and death, among patients taking antipsychotics with schizophrenia-spectrum disorders. Using data from South London and Maudsley NHS Foundation Trust (SLAM) clinical records, via the Clinical Record Interactive Search system, we identified 157 in iduals who had an ICD-10 diagnosis of schizophrenia-spectrum disorders, were taking antipsychotics at the time of the COVID-19 pandemic in the UK, and had a laboratory-confirmed COVID-19 infection. The following health outcomes were measured: COVID-related hospitalisation, COVID-related intensive care treatment death. We tested associations between clozapine treatment and each outcome using logistic regression models, adjusting for gender, age, ethnicity, neighbourhood deprivation, obesity, smoking status, diabetes, asthma, bronchitis and hypertension using propensity scores. In the 157 in iduals who developed COVID while on antipsychotics, there were 44 COVID-related hospitalisations, 13 COVID-related intensive care treatments and 13 deaths of any cause during the follow-up period. In the unadjusted analysis, there was no significant association between clozapine and any of the outcomes and there remained no associations following adjusting for the confounding variables. In our s le of patients with COVID-19 and schizophrenia-spectrum disorders, we found no evidence that clozapine treatment puts patients at increased risk of hospitalisation, intensive care treatment or death, compared to any other antipsychotic treatment. However, further research should be considered in larger s les to confirm this. RDH has received research funding from Roche, Pfizer, Janssen, and Lundbeck. DFF has received research funding from Janssen and Lundbeck. JHM has received research funding from Lundbeck. JTT has received research funding from Bristol-Meyers-Squibb. RS declares research support in the last 36 months from Janssen, GSK and Takeda. The research was conducted under ethical approval reference 18/SC/0372 from Oxfordshire Research Ethics Committee C.

Publication