ARDS, Coronavirus, Infection Viral, Pneumonia
Conditions
Keywords
critical care, biology of infectious agent
Brief summary
Coronavirus 2019 (COVID-19) is a respiratory tropism virus transmitted through droplets emitted into the environment of infected persons. The symptoms can be extremely varied and the course can range from spontaneous healing without sequelae to death. Currently, the diagnosis of certainty for resuscitation patients (by definition severe) is based on searching for a fragment of virus genetic material within the epithelial cells of the respiratory tree, up and/or down, by PCR. It is to be expected that the epidemic peak will make it difficult (if not impossible) to respect the stereotypical path that is currently in place, due to the lack of space in the specific unit. This will require optimization of care pathways and use of the specific sectors. It is therefore necessary to define the simple criteria, available from the moment patients are admitted, to predict the result of the COVID-19 PCR.
Interventions
None listed
Sponsors
University Hospital, Lille
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All patient admitted in ICU Lille Hospital and hospitalized in the unit Emergent Biological Risk (REB) before a suspicion of infection with COVID-19 * Clinical infectious syndrome: fever (\>38°C) or hypothermia ( 36°C), chill, fever at home * a severe respiratory table defined by: * Oxygen demand \> 3 L/min in the presence of significant comorbidity (pregnancy, chronic respiratory disease, chronic heart disease, hemopathy, cirrhosis) or \> 6 L/min in the absence of comorbidity * or a respiratory rate \> 30 cycles per minute * the need for mechanical, invasive or non-invasive ventilation * the need for humidified high-flow oxygen therapy
Exclusion criteria
* Patient already included in study for first stay * Cirrhosis CHILD C * Major surgery in the last 7 days Minor patient * Patient under guardianship or curatorship * Refusal to participate * No social security coverage.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Correlation between nasal and deep PCR positivity for Covid-19 patients performed and all predictors for Covid-19 patients performed within 24 hours of admission to ICU | within 24 hours of admission to ICU |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Coinfections | during ICU stay, up to 28 days | Assessment of viral, bacterial, fungal and parasitic rate in confirmed and unconfirmed patients for COVID-19 |
| Respiratory dysfunction requiring mechanical ventilation | during ICU stay, up to 28 days | it will be reported the evolution of respiratory dysfunction in patients infected with COVID-19 admitted to ICU during their stay and requiring mechanical ventilation (during, Pao2/FIO2 ratio,,features of artificial ventilation features of extra-bodied respiratory assistance) |
| Sequential Organ Failure Assessment (SOFA) Score | during ICU stay, up to 28 days | the SOFA assessment is used to track a person's risk status during stay in the Intensive Care Unit (ICU). The score is based on six different scores, one each for the respiratory, cardiovascular, hepatic, coagulation, renal, and neurological systems. Each organ system is assigned a point value from 0 (normal) to 4 (high degree of dysfunction/failure). |
| SAPS II score | at admission | APS II was designed to measure the severity of disease for patients admitted to Intensive care units 24 hours after admission to the ICU, the measurement has been completed and resulted in an integer point score between 0 and 163 and a predicted mortality between 0% and 100%. |
| Disseminated Intravascular Coagulation (DIC) score | during ICU stay, up to 28 days | The DIC Score was developed by the The International Society of Thrombosis and Haemostasis (ISTH.) The DIC score calculator accounts of the following four parameters.Each of the four parameters evaluated above have values that are weighted with a number of points varying from 0 to 3. By summing the points given to the choices, a final result between 0 and 8 is obtained |
| Number of days on vasopressive amines | during ICU stay, up to 28 days | — |
| Occurrence of an event of venous or arterial thromboembolic disease | during ICU stay, up to 28 days | — |
| Impact of Event Scale - revised (IES-R) | at 9 months +/- 3 months after ICU stay | 22-item self-report measure that assesses subjective distress caused by traumatic events Items are rated on a 5-point scale ranging from 0 (not at all) to 4 (extremely). The IES-R yields a total score (ranging from 0 to 88) Measuring the long-term impact of confirmed COVID-19 infection |
| Number of patients alive after ICU stay less than 28 days will be tracked | At 28 day | — |
| Short Form 36 | at 9 months +/- 3 months after ICU stay | measuring the long-term impact of confirmed COVID-19 infection. assessment of quality of life according to 8 areas: physical activity (and related limitations), body pain, perception of one's own health, mental health (and related limitations), social life and vitality. |
| Hospital anxiety and depression scale (HADS) | at 9 months +/- 3 months after ICU stay | The scale allows to detect anxiety and depression using 14 items rated from 0-3. Measuring the long-term impact of confirmed COVID-19 infection |
| Post-traumatic stress disorder Checklist version DSM-5 (PSL-5) | at 9 months +/- 3 months after ICU stay | Question the stressful experience or event, followed by 20 multiple-choice questions. Measuring the long-term impact of confirmed COVID-19 infection |
| Modified Medical Research Council (MMRC) Dyspnea Scale | at 9 months +/- 3 months after ICU stay | The mMRC Dyspnea Scale stratifies severity of dyspnea in respiratory diseases Measuring the long-term impact of confirmed COVID-19 infection |
| Correlation between number of patient deaths and all predictors for Covid-19 including anamnestic, clinical, biological, radiological parameters | until day 28 after admission of ICU | — |
| Viral clearance | through study completion, an average of 28 days | Evolution of viral clearance in nasal and depp PCR during ICU |
| Number of days with extra renal treatment (ERA) | during ICU stay, up to 28 days | — |
Countries
France
Outcome results
None listed