Delirium, Encephalopathy, Intensive Care Unit Patient, Neurological Abnormality, SARS-CoV-2 Infection
Conditions
Keywords
SARS-CoV-2 infection, Intensive care unit patient, Neurological abnormalities, Delirium, Encephalopathy
Brief summary
The SARS-CoV-2 epidemic is leading to a large number of patients in intensive care units due to severe hypoxemic pneumonia. After an acute phase that may require controlled mechanical ventilation and deep sedation, removal of sedation often reveals a pathological awakening in the vast majority of patients. This encephalopathy state remains, to date and to our knowledge, unexplained. Clinical features do not appear to fully correlate with regular delirium. This encephalopathy might be explained by deep and prolonged hypoxemia, a wide use of sedation drugs, systemic inflammation or the hostile ICU environment.
Detailed description
This study is intended to investigate neurological abnormalities associated with SARS-CoV-2 infection. Complete daily neurological examinations will be routinely conducted in intensive care unit patients. Specific biological analyses will also be performed in these patients by collecting additional blood samples from an arterial or central catheter, every 2 days. These clinical and biological examinations will be continued throughout patient's stay in the intensive care unit.
Interventions
None listed
Sponsors
University Hospital, Clermont-Ferrand
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
* Age ≥ 18 years old * COVID-19 positive patient (positive RT PCR, nasopharyngeal or tracheal) * Patient admitted in an intensive care unit of the department of Anesthesia, Critical Care and Perioperative of Clermont-Ferrand University Hospital * Patient with an arterial or central catheter to perform blood samples collection
Exclusion criteria
* Patient or family member's refusal to participate * Neuropsychiatric history that may interfere with neurological evaluations in the intensive care unit * Patient not affiliated with French social security insurance * Patient under legal guardianship
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Dosage of biomarkers typically explored in intensive care unit delirium | Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every 2 days | Plasminogen activator inhibitor-1 (PAI-1), E-selectin and angiopoietin-2 |
| Dosage of neuronal injury markers | Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every 2 days | S100 β, Neuron Specific Enolase (NSE), GFAP, UCHL1, NFL |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Delirium assessment | Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days | CAM-ICU (Confusion Assessment Method - Intensive Care Unit) scale |
| Coma assessment | Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days | CRS-R (Coma Recovery Scale-Revised) |
| Pupils characteristics | Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days | Clinical observation |
| Neurological abnormalities | Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days | Electroencephalogram : epileptic activity (spikes, spike-waves) or encephalopathy activity (triphasic waves)) |
Countries
France
Contacts
Primary ContactLise Laclautre
Outcome results
None listed