SARS-CoV-2 Acute Respiratory Disease
Conditions
Keywords
Coronavirus, SARS-CoV-2, COVID-19, Intensive Care Units, Ultrasonography
Brief summary
Patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents risk to develop muscle weakness associated with prolonged period of mechanical ventilation support and hospital stay.
Detailed description
Intensive care unit (ICU) acquired muscle weakness affects both respiratory and peripheral muscles and can contribute to worsen clinical and functional outcomes. In this way, ultrasonography muscle evaluation could help to identify early alterations guiding the therapeutic planning and allowing to monitor the interventions performed. Therefore, the investigators intend to follow up mechanically ventilated patients with confirmed diagnosis of COVID-19 during ICU stay to quantify the diaphragm, parasternal intercostal, abdominals and femoral quadriceps muscles thickness assessed by ultrasonography. Additionally, functional capacity, frailty and level of physical activity will be evaluated and followed for pre-admission condition and 30, 90 and 180 days after hospital discharge .
Interventions
DIAGNOSTIC_TESTMuscle ultrasound evaluation
Muscle ultrasound evaluation will be performed in patients admitted with COVID-19 requiring invasive mechanical ventilation. The measurements of thickness and thickening fraction will occur for diaphragm, abdominal - rectus abdominis, internal oblique, external oblique and transverse abdomen - and parasternal intercostal muscles. Serial measurements of the thickness and echogenicity of the quadriceps femoris muscle will also be performed.
Sponsors
Hospital Israelita Albert Einstein
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patients admitted to ICU * having a confirmed diagnosis of COVID-19 * requiring invasive mechanical ventilation.
Exclusion criteria
* exclusive palliative care; * neuromuscular diseases; * patients who evolve with the need for lower limb amputation; * previous known diaphragm malformations and dysfunctions; * patients transferred from other institutions under invasive mechanical ventilation; * clinical conditions that make the respiratory and peripheral muscle assessment through ultrasound unfeasible.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Muscle thickness | Day 1, 5, and within 24 hours after ICU discharge. | Change in the thickness of the diaphragm and quadriceps femoris muscles. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Respiratory muscle thickness | At the end of data collection, within 24 hours after ICU discharge. | Change in the thickness of the intercostal and abdominal wall muscles. |
| Muscle thickness and functional outcomes | At the end of data collection, within 24 hours after ICU discharge. | Verify the correlation between quadriceps femoris muscle thickness change and echogenicity with functional outcomes (Barthe Index, International Physical Activities Questionnaire, and the Clinical Frailty Score). |
| Grip strength and clinical outcomes | At the end of data collection, within 24 hours after ICU discharge. | Verify the correlation between grip strength (measured by the Dynamometer Grip Strength) and clinical outcomes (Barthe Index, International Physical Activities Questionnaire, and the Clinical Frailty Score). |
| Mobility level correlation with clinical and functional outcomes | At the end of data collection, within 24 hours after ICU discharge. | Verify the correlation between mobility level (measured by the Perme Intensive Care Unit Mobility Score) with clinical and functional outcomes (Barthe Index, International Physical Activities Questionnaire, and the Clinical Frailty Score). |
Countries
Brazil
Contacts
Primary ContactRicardo K Nawa, PT MSc PhD
Backup ContactCarla L Batista, PT
Outcome results
None listed