COVID-19LoCTDCNCT05862896
Exploring Gas Transfer and the Utility of Dynamic Chest Radiography in Long Covid Patients
An observational study of COVID-19, run by Liverpool University Hospitals NHS Foundation Trust.
Trial summary
This study aims to identify if breathless patients with Long COVID have reduced transfer factor on pulmonary function testing and if the degree of transfer factor reduction is correlated with the symptom severity and physiological ability to exercise. 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
- How many people
- 194 participants
- Where
- No sites listed yet
- Study dates
- 1 Aug 2023to 1 Aug 2024
- 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 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Study population: A group of adults (over 18 years) with breathlessness secondary to long COVID identified in the community will be compared with a control group of age and sex matched healthy volunteers.
Who may be able to join
- Adults (over 18 years old)
- Patients with breathlessness (defined as self-reported modified Borg Scale score of 2 or more when walking on flat ground for 100 metres) that has continued or developed and persists more than 4 weeks after acute COVID 19 i.e., related to 'long COVID' (covid confirmed by photographic evidence of positive lateral flow/NHS application, EMIS records or hospital lab data).
- Able to achieve positioning for a PA chest X-ray for a 20 second period
- Able to hold their breath for at least 7 seconds
- Fluent spoken English - to ensure a comprehensive understanding of the research project and their proposed involvement
- Able to provide written informed consent
- For control group: Age, sex matched to participants identified in the affected group
Who cannot join
- Any contraindication to pulmonary function testing or DCR
- Pregnancy
- For women of childbearing age, a positive pregnancy test or refusal of pregnancy test (a negative urinary pregnancy test on the day of DCR is a requirement)
- Significant other respiratory co-morbidities as judged by study clinician
- Significant research related radiation exposure in last 12 months prior to consent (from participation in a previous studies involving radiation exposure, with a research dose constraint of 0.4 mSv)
- Unable to provide informed consent for any reason
- For the long covid arm no evidence of a positive covid-19 test
About this study
Official title: Exploring Gas Transfer and the Utility of Dynamic Chest Radiography in Long Covid Patients.
This study aims to identify if breathless patients with Long COVID have reduced transfer factor on pulmonary function testing and if the degree of transfer factor reduction is correlated with the symptom severity and physiological ability to exercise. We will also investigate whether a new type of X-ray called a dynamic chest X-ray can identify perfusion abnormalities and whether these correlate with differences in diffusion capacity measured on a pulmonary function test.
Read the detailed description
Long COVID is the term used to describe patients who present with persistent symptoms after recovering from SARS-CoV-2 infection. Patients exhibit a range of symptoms and commonly report respiratory and cardiac phenomena including breathlessness, feeling tight chested and having persistent tachycardias. Survey data suggests up to 87% of patients discharged from hospital after COVID-19 infection have ongoing symptoms 60 days after discharge, with 43% describing breathlessness. In the USA, 35% of patients treated for SARS-CoV-2 as an outpatient have ongoing symptoms, with a similar percentage of the population unable to return to their normal work. The natural history and pathophysiology of long COVID is not yet fully understood. Few studies have explored pulmonary function in post-COVID patients. There are suggestions that functional limitation is related to lung abnormalities affecting both ventilation (air flow) and perfusion (blood flow), possibly caused by micro-blood clots. Establishing a relatively cost-effective and accessible way of diagnosing these will allow clinicians to treat or signpost the patients to the correct services. This is vital at both the patient and health system level.
Full pulmonary function testing is routinely done in respiratory clinics to investigate breathlessness and diagnose conditions such as asthma, chronic obstructive pulmonary disease (COPD) and pulmonary fibrosis. It includes a measure of transfer factor, an estimate of the efficiency of the diffusion of gas from the lung into the blood stream. The lungs' ability to absorb carbon monoxide (CO) is measured as a proxy for the ability to absorb oxygen. It is hypothesised that long COVID patients with breathlessness have abnormal gas transfer due to lung tissue damage at an alveolar level and/or perfusion abnormalities such as micro clots. Dynamic X-ray is a new, innovative technology to image the thoracic cavity throughout the breathing cycle allowing assessment of pulmonary function and possibly diagnose small ventilation-perfusion abnormities. Liverpool hosts the only dynamic X-ray machine in Europe. Potential applications beyond COVID are numerous, including filling diagnostic gaps in many lung diseases where expensive lung function testing is an unrealistic possibility in the medium term.
- Conditions
- COVID-19
- Keywords
- Long COVID
- Medical subject headings
- COVID-19, Post-Acute COVID-19 Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Control | Healthy, age and sex matched controls | |
| Long Covid | Patients with breathlessness (defined as self-reported modified Borg Scale score of 2 or more when walking on flat ground for 100 metres) that has continued or developed and persists more than 4 weeks after acute COVID 19 i.e., related to 'long COVID' (covid confirmed by photographic evidence of positive lateral flow/NHS application, EMIS records or hospital lab data). |
What is being measured
The primary outcome is the main question the study is designed to answer.
Primary objective
- To establish the proportion of patients with long COVID that have abnormal transfer factor on pulmonary function testing.
Measured: 12 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 May 2023
- Study start1 Aug 2023 (estimated)
- Primary completion1 Aug 2024 (estimated)
- Study completion1 Aug 2024 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for COVID-19Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Case-control
- Time perspective
- Prospective
- Enrolment
- 194 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Liverpool University Hospitals NHS Foundation Trust
- Sponsor type
- Other government
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05862896
- Sponsor's protocol ID
- LHS0056
- Acronym
- LoCTDC
- Status last verified
- May 2023
- First submitted
- 16 May 2023
- Last updated
- 17 May 2023
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 17 May 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Exploring Gas Transfer and the Utility of Dynamic Chest Radiography in Long Covid Patients.
- ClinicalTrials.gov ID
- NCT05862896
- Acronym / sponsor ID
- LoCTDC / LHS0056
- Conditions
- COVID-19
- Keywords
- Long COVID
- Study type
- Observational
- Recruitment status
- Unknown status
- Enrolment
- 194 participants (estimated)
- Lead sponsor
- Liverpool University Hospitals NHS Foundation TrustOther government
- Study start
- 1 Aug 2023 (estimated)
- Primary completion
- 1 Aug 2024 (estimated)
- Study completion
- 1 Aug 2024 (estimated)
- First posted
- 17 May 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to identify if breathless patients with Long COVID have reduced transfer factor on pulmonary function testing and if the degree of transfer factor reduction is correlated with the symptom severity and physiological ability to exercise. We will also investigate whether a new type of X-ray called a dynamic chest X-ray can identify perfusion abnormalities and whether these correlate with differences in diffusion capacity measured on a pulmonary function test.
Detailed description
Long COVID is the term used to describe patients who present with persistent symptoms after recovering from SARS-CoV-2 infection. Patients exhibit a range of symptoms and commonly report respiratory and cardiac phenomena including breathlessness, feeling tight chested and having persistent tachycardias. Survey data suggests up to 87% of patients discharged from hospital after COVID-19 infection have ongoing symptoms 60 days after discharge, with 43% describing breathlessness. In the USA, 35% of patients treated for SARS-CoV-2 as an outpatient have ongoing symptoms, with a similar percentage of the population unable to return to their normal work. The natural history and pathophysiology of long COVID is not yet fully understood. Few studies have explored pulmonary function in post-COVID patients. There are suggestions that functional limitation is related to lung abnormalities affecting both ventilation (air flow) and perfusion (blood flow), possibly caused by micro-blood clots. Establishing a relatively cost-effective and accessible way of diagnosing these will allow clinicians to treat or signpost the patients to the correct services. This is vital at both the patient and health system level.
Full pulmonary function testing is routinely done in respiratory clinics to investigate breathlessness and diagnose conditions such as asthma, chronic obstructive pulmonary disease (COPD) and pulmonary fibrosis. It includes a measure of transfer factor, an estimate of the efficiency of the diffusion of gas from the lung into the blood stream. The lungs' ability to absorb carbon monoxide (CO) is measured as a proxy for the ability to absorb oxygen. It is hypothesised that long COVID patients with breathlessness have abnormal gas transfer due to lung tissue damage at an alveolar level and/or perfusion abnormalities such as micro clots. Dynamic X-ray is a new, innovative technology to image the thoracic cavity throughout the breathing cycle allowing assessment of pulmonary function and possibly diagnose small ventilation-perfusion abnormities. Liverpool hosts the only dynamic X-ray machine in Europe. Potential applications beyond COVID are numerous, including filling diagnostic gaps in many lung diseases where expensive lung function testing is an unrealistic possibility in the medium term.
Study design
- Observational model
- Case-control
- Time perspective
- Prospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Control | – | –Healthy, age and sex matched controls |
| Long Covid | – | –Patients with breathlessness (defined as self-reported modified Borg Scale score of 2 or more when walking on flat ground for 100 metres) that has continued or developed and persists more than 4 weeks after acute COVID 19 i.e., related to 'long COVID' (covid confirmed by photographic evidence of positive lateral flow/NHS application, EMIS records or hospital lab data). |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
- Study population
- A group of adults (over 18 years) with breathlessness secondary to long COVID identified in the community will be compared with a control group of age and sex matched healthy volunteers.
Key inclusion criteria (7 listed)
- Adults (over 18 years old)
- Patients with breathlessness (defined as self-reported modified Borg Scale score of 2 or more when walking on flat ground for 100 metres) that has continued or developed and persists more than 4 weeks after acute COVID 19 i.e., related to 'long COVID' (covid confirmed by photographic evidence of positive lateral flow/NHS application, EMIS records or hospital lab data).
- Able to achieve positioning for a PA chest X-ray for a 20 second period
- Able to hold their breath for at least 7 seconds
- Fluent spoken English - to ensure a comprehensive understanding of the research project and their proposed involvement
Key exclusion criteria (7 listed)
- Any contraindication to pulmonary function testing or DCR
- Pregnancy
- For women of childbearing age, a positive pregnancy test or refusal of pregnancy test (a negative urinary pregnancy test on the day of DCR is a requirement)
- Significant other respiratory co-morbidities as judged by study clinician
- Significant research related radiation exposure in last 12 months prior to consent (from participation in a previous studies involving radiation exposure, with a research dose constraint of 0.4 mSv)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Primary objective
Time frame: 12 months
1) To establish the proportion of patients with long COVID that have abnormal transfer factor on pulmonary function testing.
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 May 2023.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
An observational study of COVID-19, run by Liverpool University Hospitals NHS Foundation Trust.
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 7 inclusion and 7 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 17 May 2023. Status can change between updates, so confirm with the study contact before making plans.
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?
Primary objective (time frame: 12 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 17 May 2023; AzTrials last refreshed its copy on 7 Nov 2026.