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COVID-19COVENTRYNCT04373811

One-Year Quality of Life and Functional Prognosis of COVID-19 Patients in Post-ICU Setting

An observational study of COVID-19 and ICU Acquired Weakness, run by Fondation Hôpital Saint-Joseph at 3 sites in France.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The COVID-19 disease has been subject to numerous publications since its emergence. Almost 20% of people suffering from COVID-19 develop severe to critical symptoms and require hospitalization, often in Intensive Care Unit (ICU). Respiratory failure is the main reason for admission in ICU of these patients. Read more about this study

Who is it for?
Ages 18 to 100 years
Conditions the study is for
COVID-19, ICU Acquired Weakness, Weaning Failure
What is being tested?
Lung ultrasound and Muscle ultrasound
How many people
65 participants
Where
3 sitesFrance
Study dates
16 Apr 2020to 31 Dec 2023
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 100 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Patients who were initially hospitalized in ICU for COVID-19 and then admitted in a post-ICU setting for difficult weaning purpose.

Who may be able to join

  • Patient initially hospitalized in ICU for COVID-19;
  • Admitted in post-ICU setting (difficult-to-wean unit);
  • Age > 18 years old;
  • Membership of a social insurance sheme;
  • Medical prescription of early mobilization;
  • Patient or relative provides consent.

Who cannot join

  • Known pregnancy ;
  • Person subject to judicial health protection;
  • Patient under legal guardianship or curatorship;
  • Contraidication for early mobilization;
  • Decision to withhold lifesustaining treatment.

Trial locations and contacts

3 sites in 1 country.

France3 sites
  • Centre Hospitalier de Béthune

    Beuvry, Hauts-de-France, 62660

  • Hôpital Forcilles

    Férolles-Attilly, Île-de-France Region, 77150

  • APHP - Hôpital Universitaire Pitié-Salpétrière

    Paris, Île-de-France Region, 75013

Other trials in France

About this study

Official title: Quality of Life and Functional Prognosis at One Year of Patients With COVID-19 Admitted in Post-ICU Setting

The COVID-19 disease has been subject to numerous publications since its emergence. Almost 20% of people suffering from COVID-19 develop severe to critical symptoms and require hospitalization, often in Intensive Care Unit (ICU). Respiratory failure is the main reason for admission in ICU of these patients. Therapeutic strategies implemented for the management of critically-ill patients may often lead to short-term muscular and functional alterations resulting in ICU-Acquired Weakness (ICUAW). These lead to long-term disabilities expressing trough dependence and quality of life impairment of survivors.

The purpose of this study is to assess the quality of life, dependence and survival at one year in patients who survived from COVID-19 in ICU and are admitted in post-ICU setting for difficult weaning purpose.

Ancillary studies aim to assess the course of muscle function (atrophy, structural modifications), lung function (loss of aeration) and safety of early mobilization.

Read the detailed description

SARS-Cov-2, a virus causing a new infectious disease called COVID-19, has been subject to numerous publications since its emergence. Almost 20% of people infected with SARS-Cov-2 develop severe to critical symptoms and required hospitalization, often in Intensive Care Unit (ICU).

Respiratory failure is the main reason for admission in ICU of patients with COVID-19, which develop an Acute Respiratory Distress Syndrome (ARDS). Respiratory failure may be associated to liver, renal, coagulation and hemodynamic failure.

Therapeutic strategies implemented for the management of critically-ill patients with COVID-19 may often lead to short-term muscular and functional alterations resulting in ICU-Acquired Weakness (ICUAW), as studied in other ICU population.

The muscular and functional impairments of patients are associated to a longer duration of mechanical ventilation and hospital length of stay and increased mortality. Long-term impacts are also reported like dependence and quality of life impairment of survivors.

The COVID-19 pandemic currently leads to an increasing number of ICU admission in France with a high risk of settings saturation. Specialized settings for post-ICU rehabilitation are preparing to early receive difficult-to-wean patients with ICUAW after admission in ICU for severe or critical form of COVID-19.

To our best knowledge, no data is obviously available regarding at the future of these patients in terms of quality of life, dependence or survival. Moreover, no short-term data are available concerning the course of lung damages and muscle function after ICU stay. The safety of early mobilization usually delivered in patients admitted to post-ICU settings has never been assessed in patients with COVID-19.

The purpose of this study is to assess the quality of life, dependence and survival at one year in patients who survived from COVID-19 in ICU and are admitted in post-ICU setting for difficult weaning purpose.

Ancillary studies aim to assess course of muscle function (atrophy, structure modification), lung function (loss of aeration) and safety of early mobilization.

Being tested
Lung ultrasound, Muscle ultrasound
Keywords
COVID-19, ICU, ICUAW, Lung Ultrasound, Muscle Ultrasound, Quality of life, Physiotherapy, Diaphragm Ultrasound
Medical subject headings
COVID-19

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Lung ultrasoundDiagnostic test

    Lung ultrasound will be performed in 12 thorax area: anterior, lateral and posterior, each area divided in superior and inferior area, for each hemithorax.

    Lung Ultrasound Score (lung aeration) will be recorded using a convex probe with a transverse view. Presence of pleural thickening and subpleural consolidations will be recorded.

  • Muscle ultrasoundDiagnostic test

    Diaphragm ultrasound will be performed using intercostal view with a linear probe at the zone of apposition for assessing diaphragm thickness and thickening and subcostal anterior view with convex probe to assess diaphragm excursion.

    Thickness of vastus intermedius, rectus femori and tibialis anterior will be measured using ultrasound linear probe. Cross-sectionnal area and echogeneicity of rectus femori and tibialis anterior will be measured using ultrasound linear probe. Penation angle of rectus femori will be assessed using ultrasound linear probe.

Study groups in NCT04373811
Study groupRoleWhat they receive
Principal cohortQuality of life, autonomy and survival will be assessed at one year on 50 patients. Safety of early mobilization in post-ICU setting and Medical Reasearch Council (MRC) sum score will be assessed during hospitalization.
Lung cohortLung Ultrasound will be carried out on the first 38 patients of the principal cohort.
Receives: Diagnostic Test: Lung ultrasound
Muscle cohortMuscle Ultrasound will be carried out on the first 27 patients of the principal cohort.
Receives: Diagnostic Test: Muscle ultrasound

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mean in quality of life score at one year on the Short Form Health Survey (SF-36)

    Quality of life will be assessed using Short Form Health Survey (SF-36) through a phone call at one year. SF-36 score range from 0 to 100, 100 indicating a better quality of life.

    Measured: 1 year

Secondary outcomes (10)
  1. Mean in autonomy score on the Activities Daily Living (ADL) scale

    Autonomy will be assessed using Activities Daily Living (ADL) scale through a phone call at one year and six months.

    ADL scale range from 0 to 6, 6 indicating a better autonomy in activities daily living.

    Measured: At enrollement and 1 year

  2. Survival rate

    Survival will be assessed using the death registry query and phone call for vital status recording at six months and one year. Survival rate will be expressed as a survival function using Kaplan Meier method.

    Measured: 1 year

  3. Change from baseline in lung ultrasound aeration score

    Lung aeration will be assessed using the Lung Ultrasound Score (LUS). Patient is in semi-recumbent position (30°). Lung ultrasound will be performed in 12 thorax area: anterior, lateral and posterior, each area divided in superior and inferior area, for each hemithorax.

    Lung Ultrasound Score will be recorded using a convex probe with a transverse view.

    For each thorax area a subscore is calculated: 0 = normal profil; 1 = multiple and well-defined B-lines; 2 = confluent B-lines; 3 = lung consolidation.

    Sum of this subscores allows calculation of the total score out of 60. Presence of pleural thickening and subpleural consolidations will be also recorded.

    Measured: Day of enrollement, day 14, day 21, day 28 and day 35 from initial admission in ICU

  4. Change from baseline in diaphragm ultrasound thickness and excursion

    Diaphragm Ultrasound will be used to assess diaphragm thickness and excursion. Patient is in semi-recumbent position (30°). Diaphragm thickness will be performed using intercostal view with a linear probe at the zone of apposition for assessing diaphragm thickness. M-Mode will be used to measure diaphragm thickness at inspiratory time (maximal inspiration) and expiratory time (maximal expiration).

    Diaphragm excursion will be measured using a subcostal anterior view with convex probe. Excursion measurement is performed in M-mode as the distance between end-inspiration and end-expiration.

    Three measures of both DTF and excursion will performed and the better will be kept.

    Measured: Day of enrollement, day 14, day 21, day 28 and day 35 from initial admission in ICU

  5. Mean change from baseline in ultrasound muscle thickness

    Muscle ultrasound measurements will be performed using a linear probe with a transverse view.

    Thickness (cm) of vastus intermedius, rectus femori and tibialis anterior will be measured.

    Measured: Day of enrollement, day 14, day 21, day 28 and day 35 from initial admission in ICU

  6. Mean change from baseline in ultrasound muscle cross-sectionnal area

    Muscle ultrasound measurements will be performed using a linear probe with a transverse view.

    Cross-sectionnal area (CSA) (cm^2) of rectus femori and tibialis anterior will be measured.

    Measured: Day of enrollement, day 14, day 21, day 28 and day 35 from initial admission in ICU

  7. Mean change from baseline in ultrasound muscle echogeneicity

    Muscle ultrasound measurements will be performed using a linear probe with a transverse view.

    Echogeneicity (0 to 255) of rectus femori and tibialis anterior will be measured using Image J software. Penation angle of rectus femori will be assessed.

    is used to measure muscle thicknesses, CSA and echogeneicity. Longitudinal view is used to measure angle of pennation.

    Measured: Day of enrollement, day 14, day 21, day 28 and day 35 from initial admission in ICU

  8. Mean change from baseline in ultrasound muscle pennation

    Muscle ultrasound measurements will be performed using a linear probe with a longitudinal view.

    Penation angle (°) of rectus femori will be assessed.

    Measured: Day of enrollement, day 14, day 21, day 28 and day 35 from initial admission in ICU

  9. Mean change from baseline in Medical Research Council (MRC) sum score

    MRC sum score evaluates strength in three muscle groups of all four limbs. A score between 0 and 5 is assigned to each of them, which renders a maximum total score of 60.

    Measured: Day of enrollement, day 14, day 21, day 28 and day 35 from initial admission in ICU

  10. Prevalence of adverse outcomes during early mobilization

    Number of adverse outcomes during early mobilization of patients will recorded at each mobilization session. Prevalence of adverse outcomes is expressed as the number of adverse outcomes divided by the number of early mobilization sessions.

    Measured: From date of enrollement up to 30 days (date of estimated post-ICU discharge)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 May 2020
  2. Study start16 Apr 2020
  3. Primary completion13 Jul 2021
  4. Study completion31 Dec 2023 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
65 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04373811
Sponsor's protocol ID
COVENTRY
Acronym
COVENTRY
Status last verified
Apr 2023
First submitted
26 Apr 2020
Last updated
27 Apr 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The data that support the findings of this study will be openly available in "figshare".

Publications

  • Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020 Apr 7;323(13):1239-1242. doi: 10.1001/jama.2020.2648. No abstract available.

    PubMed 32091533
  • Murthy S, Gomersall CD, Fowler RA. Care for Critically Ill Patients With COVID-19. JAMA. 2020 Apr 21;323(15):1499-1500. doi: 10.1001/jama.2020.3633. No abstract available.

    PubMed 32159735
  • Kress JP, Hall JB. ICU-acquired weakness and recovery from critical illness. N Engl J Med. 2014 Apr 24;370(17):1626-35. doi: 10.1056/NEJMra1209390. No abstract available.

    PubMed 24758618
  • Herridge MS, Moss M, Hough CL, Hopkins RO, Rice TW, Bienvenu OJ, Azoulay E. Recovery and outcomes after the acute respiratory distress syndrome (ARDS) in patients and their family caregivers. Intensive Care Med. 2016 May;42(5):725-738. doi: 10.1007/s00134-016-4321-8. Epub 2016 Mar 30.

    PubMed 27025938
  • Bouhemad B, Liu ZH, Arbelot C, Zhang M, Ferarri F, Le-Guen M, Girard M, Lu Q, Rouby JJ. Ultrasound assessment of antibiotic-induced pulmonary reaeration in ventilator-associated pneumonia. Crit Care Med. 2010 Jan;38(1):84-92. doi: 10.1097/CCM.0b013e3181b08cdb.

    PubMed 19633538
  • Peng QY, Wang XT, Zhang LN; Chinese Critical Care Ultrasound Study Group (CCUSG). Findings of lung ultrasonography of novel corona virus pneumonia during the 2019-2020 epidemic. Intensive Care Med. 2020 May;46(5):849-850. doi: 10.1007/s00134-020-05996-6. Epub 2020 Mar 12. No abstract available.

    PubMed 32166346
  • Parry SM, El-Ansary D, Cartwright MS, Sarwal A, Berney S, Koopman R, Annoni R, Puthucheary Z, Gordon IR, Morris PE, Denehy L. Ultrasonography in the intensive care setting can be used to detect changes in the quality and quantity of muscle and is related to muscle strength and function. J Crit Care. 2015 Oct;30(5):1151.e9-14. doi: 10.1016/j.jcrc.2015.05.024. Epub 2015 Jun 3.

    PubMed 26211979
  • Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473-83.

    PubMed 1593914
  • KATZ S, FORD AB, MOSKOWITZ RW, JACKSON BA, JAFFE MW. STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. JAMA. 1963 Sep 21;185:914-9. doi: 10.1001/jama.1963.03060120024016. No abstract available.

    PubMed 14044222
  • Flaatten H, Kvale R. Survival and quality of life 12 years after ICU. A comparison with the general Norwegian population. Intensive Care Med. 2001 Jun;27(6):1005-11. doi: 10.1007/s001340100960.

    PubMed 11497132
  • Cartwright MS, Kwayisi G, Griffin LP, Sarwal A, Walker FO, Harris JM, Berry MJ, Chahal PS, Morris PE. Quantitative neuromuscular ultrasound in the intensive care unit. Muscle Nerve. 2013 Feb;47(2):255-9. doi: 10.1002/mus.23525. Epub 2012 Oct 5.

    PubMed 23041986

Questions about this trial

What is this clinical trial studying?

An observational study of COVID-19 and ICU Acquired Weakness, run by Fondation Hôpital Saint-Joseph at 3 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 27 Apr 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mean in quality of life score at one year on the Short Form Health Survey (SF-36) (time frame: 1 year). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04373811, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Apr 2023.

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