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COVID-19ASCCOVID19NCT04936503

Support for the Resumption of Training of High-level Athletes Post-epidemic COVID-19

A study testing Resting electrocardiogram, Stress test and Cardiac echocardiography in people with COVID-19 and Myocarditis, run by University Hospital, Bordeaux at 21 sites in France.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

As of March 2020, COVID-19 has become a global pandemic, halting athletic competition worldwide. Reports from China show a high prevalence of cardiac involvement in patients with severe SARS-CoV-2 infection. These cardiac forms were found to be closely associated with adverse outcomes. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
COVID-19, Myocarditis
What is being tested?
Resting electrocardiogram, Stress test and Cardiac echocardiography
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
984 participants
Where
21 sitesFrance
Study dates
18 Jun 2020to 2 Mar 2021
Phase
Interventional
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 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • High level athlete,
  • Of both sexes and age ≥ 18 years,
  • Affiliated to or beneficiary of a social security system,
  • Free, informed, written consent signed by the participant and the investigating physician (no later than the day of inclusion and before any examination required by the research),
  • Effective method of contraception for women with childbearing capacity.

Who cannot join

  • Minor,
  • History of ventricular arrhythmia, myocarditis, identified coronary artery disease or documented myocardial fibrosis,
  • Pregnant or breastfeeding women,
  • Person unable to give informed consent,
  • Person deprived of liberty by judicial or administrative decision,
  • Adults subject to a legal protection measure (guardianship, curator, safeguard of justice).
Show all 12Show fewer
  • Specific exclusion criteria for the MRI component (Contraindications):
  • Subject with an implantable pacemaker or defibrillator, intraocular metallic foreign body, intracranial metallic clip, pre 6000 Starr-Edwards type cardiac valve prosthesis, or biomedical device such as insulin pump or neurostimulator,
  • Hypersensitivity to gadolinium or to one of the excipients of the contrast product used,
  • Claustrophobic subjects or those unable to remain in an immobile lying position for 30 minutes,
  • Renal insufficiency with creatinine clearance of less than 30 ml/min,
  • A patient whose shoulder width does not allow installation in the MRI machine.

Trial locations and contacts

21 sites in 1 country.

21 sites in 1 country

France21 sites
  • Training center Soyaux Angoulême XV Rugby

    Angoulême, 16000

  • Training Center Stade Aurillacois

    Aurillac, 15000

  • Aviron Bayonnais Rugby Pro Training Center

    Bayonne, 64104

  • Union Bordeaux-Bègles training center

    Bègles, 33130

  • Biarritz Olympique Pays Basque training center

    Biarritz, 64200

  • Bordeaux University Hospital - CRB medical office - Hôpital du Tondu

    Bordeaux, 33076

  • Bordeaux University Hospital - Service UDH - Hôpital Pellegrin

    Bordeaux, 33076

  • CABCL Rugby Training Center

    Brive-la-Gaillarde, 19100

  • US Carcassonne Rugby training center

    Carcassonne, 11000

  • Union Sportive Colomiers Rugby training center

    Colomiers, 31770

  • FC Grenoble Rugby training center

    Grenoble, 38100

  • Stade Rochelais Rugby training center

    La Rochelle, 17000

  • Racing92 training center

    Le Plessis-Robinson, 92350

  • AS Montauban Rugby training center

    Montauban, 82000

  • US Nevers Rugby training center

    Nevers, 58000

  • Stade Français training center

    Paris, 75016

  • Section Paloise Rugby training center

    Pau, 64000

  • USAP Training Center

    Perpignan, 66000

  • Training center Valence Romans Drôme Rugby

    Romans-sur-Isère, 26100

  • Castres Olympique training center

    Saïx, 81710

  • Stade Toulousain Rugby training center

    Toulouse, 31200

Other trials in France

About this study

As of March 2020, COVID-19 has become a global pandemic, halting athletic competition worldwide.

Reports from China show a high prevalence of cardiac involvement in patients with severe SARS-CoV-2 infection. These cardiac forms were found to be closely associated with adverse outcomes. The use of Magnetic resonance Imaging (MRI) had allowed to show that cardiac dysfunction could be mediated by myocardial inflammation (i.e. myocarditis). The direct implication of the virus was demonstrated with Severe Acute Respiratory Syndrome (SARS)-CoV-2 being detected on myocardial biopsies in a patient with severe heart failure.

Read more

The experience with other viruses causing acute myocarditis shows that there is a high rate of undetected injuries. Indeed, although severe heart failure can be present at the acute stage, acute viral myocarditis is most commonly pauci or asymptomatic, but still leaving occult myocardial scars visible on MRI, and exposing to higher risks of ventricular arrhythmia and sudden cardiac death over the long term.

Although athletes are younger and have fewer comorbidities than the general population and therefore are at lower risk for severe disease or death, there is a critical and urgent need to assess the prevalence of occult scars in the population of high-level athletes returning to training after the SARS-CoV-2 pandemia.

Being tested
Resting electrocardiogram, Stress test, Cardiac echocardiography, Cardiac rhythm monitoring, Questionnaire
Keywords
myocardial scars, MRI, Ventricular arrhythmia, Sudden cardiac death, High-level athletes
Medical subject headings
COVID-19, Myocarditis, Death, Sudden, Cardiac

What participants receive

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

  • Resting electrocardiogramDiagnostic test

    An ECG at rest is performed for all participants at Day 0. A centralized reading is performed by one of the 6 expert cardiologists participating in the research.

  • Stress testDiagnostic test

    In case of positive COVID-19 serology and/or positive COVID-19 RT-PCR and/or new ECG abnormality and/or positive questionnaire, a stress test is performed.

  • Cardiac echocardiographyDiagnostic test

    In case of positive COVID-19 serology and/or positive COVID-19 RT-PCR and/or new ECG abnormality and/or positive questionnaire, a Cardiac echocardiography is performed.

  • Cardiac rhythm monitoringDiagnostic test

    In case of positive COVID-19 serology and/or positive COVID-19 RT-PCR and/or new ECG abnormality and/or positive questionnaire, a Cardiac rhythm monitoring is performed.

  • QuestionnaireOther

    To determine the rhythmic risk of athletes

  • Injected Cardiac MRIDevice

    High resolution MRIs is performed on 200 athletes :

    • 100 athletes without rhythmic abnormalities (50 individuals with positive COVID-19 status and 50 individuals with negative COVID-19 status)
    • 100 athletes with rhythmic abnormalities (50 individuals with positive COVID-19 status and 50 individuals with negative COVID-19 status)
  • Blood sampling for biobankBiological

    For all athletes included at the D0 inclusion visit, a centralized COVID-19 serology is performed to search for biomarkers associated with the occurrence of myocardial fibrosis: analysis of genetic determinants in relation to cardiac damage.

    For athletes who have performed MRI: Search for biomarkers associated with the occurrence of myocardial fibrosis: analyses of low-grade inflammation markers (cytokine assay and fibrosis markers).

Study groups in NCT04936503
Study groupRoleWhat they receive
High-level athletesExperimentalHigh level athletes are rugby players, intervention unit agents of the National Police, sports students. Definition of a COVID-19 positive subject : Any subject whose serology is positive (IgM and/or IgG) and/or the Reverse Transcription Polymerase Chain Reaction (RT-PCR) result is positive and/or the questionnaire is positive and/or a new electrocardiogram (ECG) abnormality. The COVID-19 negative subjects do not meet the definition of COVID-19 positive subjects.
Receives: Diagnostic Test: Resting electrocardiogram; Diagnostic Test: Stress test; Diagnostic Test: Cardiac echocardiography; Diagnostic Test: Cardiac rhythm monitoring; Other: Questionnaire; Device: Injected Cardiac MRI; Biological: Blood sampling for biobank

What is being measured

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

  1. Presence of rhythmic risk markers bye the questionnaire

    Questionnaire looking for heart palpitations, chest pain/pressure and shortness of breath.

    Measured: Day 0

  2. Evaluation by resting ECG of rhythmic risk marker : repolarization disorders

    Presence or absence of repolarization disorders

    Measured: Day 0

  3. Evaluation by resting ECG of rhythmic risk marker : inverted T waves

    Presence or absence of inverted T waves

    Measured: Day 0

  4. Evaluation by resting ECG of rhythmic risk marker : ST segment abnormalities

    Presence or absence of ST segment abnormalities

    Measured: Day 0

  5. Evaluation by resting ECG of rhythmic risk marker : QRS fragmentation

    Presence or absence of QRS fragmentation

    Measured: Day 0

  6. Evaluation by resting ECG of rhythmic risk marker : ventricular extrasystoles (VES)

    Presence or absence of VES. Ventricular extrasystoles especially with short coupling (<300ms), falling on the T wave, width > 160ms, complex forms (repetitive, several morphologies, instantaneous cycle >200bpm)

    Measured: Day 0

  7. Evaluation by resting ECG of rhythmic risk marker : ventricular tachycardia (VT)

    Presence or absence of VT.

    Measured: Day 0

  8. Presence of rhythmic risk markers bye the stress test

    VES, especially with short coupling (<300ms), falling on the T wave, width > 160ms, complex shapes (repetitive, several morphologies, instantaneous cycle >200bpm), ventricular tachycardias (VT). The analysis focus on the exercise period, and the recovery period. Ventricular arrhythmias will be quantified.

    Measured: Day 0

  9. Presence of rhythmic risk markers bye ECG holter

    VES, especially with short coupling (<300ms), falling on the T wave, width > 160ms, complex shapes (repetitive, multiple morphologies, instantaneous cycle >200bpm), ventricular tachycardias (VTs). Ventricular arrhythmias are quantified.

    Measured: Day 0

  10. Presence of rhythmic risk markers bye ECG monitoring during games and trainings

    In case of moderate arrhythmia on stress test and/or Holter ECG, ECG monitoring during training sessions and matches is carried out with analysis of the tracings collected, in search of more sustained arrhythmia, particularly at the ventricular level.

    Measured: Day 0

  11. Presence of rhythmic risk markers by pharmacological tests and/or electrophysiological exploration

    If the risk is perceived as very high, pharmacological tests (Isuprel®) and/or electrophysiological exploration may be performed during hospitalization, in search of dangerous rhythm disorders, particularly at the ventricular level.

    Measured: Day 0

Secondary outcomes (5)
  1. Presence of myocardial fibrosis by injected MRI

    In order to compare the prevalence of myocardial fibrosis between COVID-19 positive and COVID-19 negative individuals in high level athletes with or without rhythmic risk, a high resolution MRI is performed. The examinations is performed on 1.5 or 3T MRI systems equipped with specific antennas for cardiology. The sequence used to detect occult scars is a late enhancement sequence performed at least 15 minutes after injection of gadolinium salts, using a free-breathing 3D method, for a minimum spatial resolution of 2.5x1.25x1.25mm. The images are reviewed by a core lab at the Bordeaux University Hospital. The presence or absence of myocardial fibrosis is evaluated.

    Measured: Month 3

  2. Presence of transmural localization of myocardial fibrosis by injected MRI

    In order to compare the prevalence of myocardial fibrosis between COVID-19 positive and COVID-19 negative individuals in high level athletes with or without rhythmic risk, a high resolution MRI is performed. The examinations is performed on 1.5 or 3T MRI systems equipped with specific antennas for cardiology. The sequence used to detect occult scars is a late enhancement sequence performed at least 15 minutes after injection of gadolinium salts, using a free-breathing 3D method, for a minimum spatial resolution of 2.5x1.25x1.25mm. The images are reviewed by a core lab at the Bordeaux University Hospital. The presence or absence of transmural localization is evaluated.

    Measured: Month 3

  3. Measurement of cardiac scar size by injected MRI

    In order to compare the prevalence of myocardial fibrosis between COVID-19 positive and COVID-19 negative individuals in high level athletes with or without rhythmic risk, a high resolution MRI is performed. The examinations is performed on 1.5 or 3T MRI systems equipped with specific antennas for cardiology. The sequence used to detect occult scars is a late enhancement sequence performed at least 15 minutes after injection of gadolinium salts, using a free-breathing 3D method, for a minimum spatial resolution of 2.5x1.25x1.25mm. The images are reviewed by a core lab at the Bordeaux University Hospital. The size of scars is measured in milliliters (mL).

    Measured: Month 3

  4. Search for constitutional genetic biomarkers

    identification by sequencing of genetic variants that could have an impact on the occurrence of a severe form in individuals infected with SARS-CoV-2.

    Measured: Month 5

  5. Research of inflammation markers

    Th1/Th2/activation/inflammation/apoptosis markers are measured in sera by a Luminex test allowing the detection of 10 analytes with a commercial kit according to the manufacturer's instructions

    Measured: Month 5

Timeline

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

  1. First posted23 Jun 2021
  2. Study start18 Jun 2020
  3. Primary completion2 Mar 2021
  4. Study completion2 Mar 2021

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
984 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04936503
Sponsor's protocol ID
CHUBX 2020/16
Acronym
ASCCOVID19
Status last verified
Jun 2021
First submitted
2 Jun 2021
Last updated
23 Jun 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Chevalier L, Cochet H, Mahida S, S SB, Benard A, Cariou T, Sridi-Cheniti S, Benhenda S, Doutreleau S, Cade S, Guerard S, Guy JM, Trimoulet P, Picard S, Dusfour B, Pouzet A, Roseng S, Franchi M, Jais P, Pellegrin I; ASCCOVID Investigators. Resuming Training in High-Level Athletes After Mild COVID-19 Infection: A Multicenter Prospective Study (ASCCOVID-19). Sports Med Open. 2022 Jun 25;8(1):83. doi: 10.1186/s40798-022-00469-0.

    PubMed 35751748

Questions about this trial

What is this clinical trial studying?

A study testing Resting electrocardiogram, Stress test and Cardiac echocardiography in people with COVID-19 and Myocarditis, run by University Hospital, Bordeaux at 21 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 5 inclusion and 12 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: finished, as of the sponsor's last update on 23 Jun 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 21 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Presence of rhythmic risk markers bye the questionnaire (time frame: Day 0). The study lists 11 primary outcomes in all. 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 NCT04936503, which also lists 1 linked publication.

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 23 Jun 2021.

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