Study of COVID-19 Prognostic Factors in Hospitalized Patients

COVID-19 Clinical Trial

Official title:

Study of COVID-19 Prognostic Factors in Hospitalized Patients

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05102708
• Other study ID #: IIBSP-COV-2021-75
• Status: Completed
• Start date: November 25, 2021
• Est. completion date: May 28, 2022

Study information

• Verified date: August 2022
• Source: Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Severe COVID-19 prognostic factors have been studied worldwide throughout the pandemic, but there is considerable variability. Therefore, the investigators will summarize the identified prognostic factors in the international literature and will conduct a retrospective cohort study to identify the prognostic factors of severe COVID-19 in hospitalized patients of the Hospital de la Santa Creu i Sant Pau in Barcelona (Spain) between March 2020 and February 2021, compare them with those mentioned in the international literature and establish those most adequate to our population.

Description:

Background: Spain is one of the European countries most affected by the SARS-CoV-2 pandemic, with a fatality rate of 2.2%. Faced with the significant number of patients requiring intensive care, the number of beds increased considerably in the span of 11 months to respond to the situation. There is still no drug treatment or specific prognostic factors for COVID-19 that allow its proper management.

Objective: To study the prognostic factors of severity due to COVID-19 in hospitalized patients at Hospital de la Santa Creu i Sant Pau, and their comparison with the prognostic factors identified in the literature review.

Methods: In a first phase, the published studies will be reviewed to identify the existing prognostic factors through various platforms (MEDLINE, EMBASE, Cochrane). A retrospective cohort study will subsequently be carried out to determine the patients' characteristics and to identify the prognostic factors of severity. Patients over 18 years of age, diagnosed with COVID-19 and hospitalized between March 01, 2020 and February 28, 2021 will be included. A descriptive analysis of the cohort will firstly be performed, followed by an analysis of the possible prognostic factors through bivariate tests and multivariate analyzes. The occurrence of admission to intensive care, mortality, and hospital stay > 30 days will be calculated with logistic regression (p <0.05, a = 0.05, 95% confidence interval). Finally, the prognostic factors identified in the literature review will be compared with those determined in the cohort.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 3725
• Est. completion date: May 28, 2022
• Est. primary completion date: December 31, 2021
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Equal or older than 18 years old

• Hospitalized between March 1st, 2020, and February 28th, 2021.

• Be diagnosed with COVID-19 disease

Exclusion Criteria:

• Underaged patients

• > 16h stay in the Emergency Unit

Related Conditions & MeSH terms

• COVID-19

Intervention

Other:
• Prognostic factors of severe COVID-19
prognostic factors: patients´ epidemiological characteristics (such as age, sex), comorbidities, length of hospitalization, critical care admission, treatments received, laboratory results, vital signs.

Locations

Country	Name	City	State
Spain	Hospital de la Santa Creu i Sant Pau	Barcelona

Sponsors (1)

Lead Sponsor	Collaborator
Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau

Country where clinical trial is conducted

Spain, 

References & Publications (20)

Cavalcanti AB, Zampieri FG, Rosa RG, Azevedo LCP, Veiga VC, Avezum A, Damiani LP, Marcadenti A, Kawano-Dourado L, Lisboa T, Junqueira DLM, de Barros E Silva PGM, Tramujas L, Abreu-Silva EO, Laranjeira LN, Soares AT, Echenique LS, Pereira AJ, Freitas FGR, Gebara OCE, Dantas VCS, Furtado RHM, Milan EP, Golin NA, Cardoso FF, Maia IS, Hoffmann Filho CR, Kormann APM, Amazonas RB, Bocchi de Oliveira MF, Serpa-Neto A, Falavigna M, Lopes RD, Machado FR, Berwanger O; Coalition Covid-19 Brazil I Investigators. Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19. N Engl J Med. 2020 Nov 19;383(21):2041-2052. doi: 10.1056/NEJMoa2019014. Epub 2020 Jul 23. Erratum in: N Engl J Med. 2020 Nov 19;383(21):e119. — View Citation

Cevik M, Tate M, Lloyd O, Maraolo AE, Schafers J, Ho A. SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta-analysis. Lancet Microbe. 2021 Jan;2(1):e13-e22. doi: 10.1016/S2666-5247(20)30172-5. Epub 2020 Nov 19. — View Citation

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020 Feb 15;395(10223):507-513. doi: 10.1016/S0140-6736(20)30211-7. Epub 2020 Jan 30. — View Citation

Chocron R, Galand V, Cellier J, Gendron N, Pommier T, Bory O, Khider L, Trimaille A, Goudot G, Weizman O, Alsac JM, Geneste L, Schmeltz A, Panagides V, Philippe A, Marsou W, Ben Abdallah I, Deney A, El Batti S, Attou S, Juvin P, Delmotte T, Messas E, Pezel T, Planquette B, Duceau B, Gaussem P, Sutter W, Sanchez O, Waldman V, Diehl JL, Mirault T, Bonnet G, Cohen A, Smadja DM; Critical COVID-19 France Investigators. Anticoagulation Before Hospitalization Is a Potential Protective Factor for COVID-19: Insight From a French Multicenter Cohort Study. J Am Heart Assoc. 2021 Apr 20;10(8):e018624. doi: 10.1161/JAHA.120.018624. Epub 2021 Feb 8. — View Citation

Chu DK, Akl EA, Duda S, Solo K, Yaacoub S, Schünemann HJ; COVID-19 Systematic Urgent Review Group Effort (SURGE) study authors. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet. 2020 Jun 27;395(10242):1973-1987. doi: 10.1016/S0140-6736(20)31142-9. Epub 2020 Jun 1. — View Citation

Elavarasi A, Prasad M, Seth T, Sahoo RK, Madan K, Nischal N, Soneja M, Sharma A, Maulik SK, Shalimar, Garg P. Chloroquine and Hydroxychloroquine for the Treatment of COVID-19: a Systematic Review and Meta-analysis. J Gen Intern Med. 2020 Nov;35(11):3308-3314. doi: 10.1007/s11606-020-06146-w. Epub 2020 Sep 3. Review. — View Citation

Hatmi ZN. A Systematic Review of Systematic Reviews on the COVID-19 Pandemic. SN Compr Clin Med. 2021;3(2):419-436. doi: 10.1007/s42399-021-00749-y. Epub 2021 Jan 26. Review. — View Citation

Jain V, Yuan JM. Predictive symptoms and comorbidities for severe COVID-19 and intensive care unit admission: a systematic review and meta-analysis. Int J Public Health. 2020 Jun;65(5):533-546. doi: 10.1007/s00038-020-01390-7. Epub 2020 May 25. — View Citation

Kronbichler A, Kresse D, Yoon S, Lee KH, Effenberger M, Shin JI. Asymptomatic patients as a source of COVID-19 infections: A systematic review and meta-analysis. Int J Infect Dis. 2020 Sep;98:180-186. doi: 10.1016/j.ijid.2020.06.052. Epub 2020 Jun 17. — View Citation

Lazarus G, Audrey J, Wangsaputra VK, Tamara A, Tahapary DL. High admission blood glucose independently predicts poor prognosis in COVID-19 patients: A systematic review and dose-response meta-analysis. Diabetes Res Clin Pract. 2021 Jan;171:108561. doi: 10.1016/j.diabres.2020.108561. Epub 2020 Dec 9. — View Citation

Martha JW, Wibowo A, Pranata R. Hypocalcemia is associated with severe COVID-19: A systematic review and meta-analysis. Diabetes Metab Syndr. 2021 Jan-Feb;15(1):337-342. doi: 10.1016/j.dsx.2021.01.003. Epub 2021 Jan 18. — View Citation

Martha JW, Wibowo A, Pranata R. Prognostic value of elevated lactate dehydrogenase in patients with COVID-19: a systematic review and meta-analysis. Postgrad Med J. 2022 Jun;98(1160):422-427. doi: 10.1136/postgradmedj-2020-139542. Epub 2021 Jan 15. — View Citation

Moreno G, Carbonell R, Bodí M, Rodríguez A. [Systematic review of the prognostic utility of D-dimer, disseminated intravascular coagulation, and anticoagulant therapy in COVID-19 critically ill patients]. Med Intensiva (Engl Ed). 2021 Jan-Feb;45(1):42-55. doi: 10.1016/j.medin.2020.06.006. Epub 2020 Jun 17. English, Spanish. — View Citation

Nugroho J, Wardhana A, Maghfirah I, Mulia EPB, Rachmi DA, A'yun MQ, Septianda I. Relationship of D-dimer with severity and mortality in SARS-CoV-2 patients : A meta-analysis. Int J Lab Hematol. 2021 Feb;43(1):110-115. doi: 10.1111/ijlh.13336. Epub 2020 Sep 15. — View Citation

Nussbaumer-Streit B, Mayr V, Dobrescu AI, Chapman A, Persad E, Klerings I, Wagner G, Siebert U, Christof C, Zachariah C, Gartlehner G. Quarantine alone or in combination with other public health measures to control COVID-19: a rapid review. Cochrane Database Syst Rev. 2020 Apr 8;4:CD013574. doi: 10.1002/14651858.CD013574. Update in: Cochrane Database Syst Rev. 2020 Sep 15;9:CD013574. — View Citation

Piechotta V, Chai KL, Valk SJ, Doree C, Monsef I, Wood EM, Lamikanra A, Kimber C, McQuilten Z, So-Osman C, Estcourt LJ, Skoetz N. Convalescent plasma or hyperimmune immunoglobulin for people with COVID-19: a living systematic review. Cochrane Database Syst Rev. 2020 Jul 10;7:CD013600. doi: 10.1002/14651858.CD013600.pub2. Update in: Cochrane Database Syst Rev. 2020 Oct 12;10:CD013600. — View Citation

Reddy RK, Charles WN, Sklavounos A, Dutt A, Seed PT, Khajuria A. The effect of smoking on COVID-19 severity: A systematic review and meta-analysis. J Med Virol. 2021 Feb;93(2):1045-1056. doi: 10.1002/jmv.26389. Epub 2020 Aug 13. — View Citation

Thachil J, Tang N, Gando S, Falanga A, Cattaneo M, Levi M, Clark C, Iba T. ISTH interim guidance on recognition and management of coagulopathy in COVID-19. J Thromb Haemost. 2020 May;18(5):1023-1026. doi: 10.1111/jth.14810. Epub 2020 Apr 27. — View Citation

Wang Y, Tian H, Zhang L, Zhang M, Guo D, Wu W, Zhang X, Kan GL, Jia L, Huo D, Liu B, Wang X, Sun Y, Wang Q, Yang P, MacIntyre CR. Reduction of secondary transmission of SARS-CoV-2 in households by face mask use, disinfection and social distancing: a cohort study in Beijing, China. BMJ Glob Health. 2020 May;5(5). pii: e002794. doi: 10.1136/bmjgh-2020-002794. — View Citation

Zhou Y, Yang Q, Chi J, Dong B, Lv W, Shen L, Wang Y. Comorbidities and the risk of severe or fatal outcomes associated with coronavirus disease 2019: A systematic review and meta-analysis. Int J Infect Dis. 2020 Oct;99:47-56. doi: 10.1016/j.ijid.2020.07.029. Epub 2020 Jul 25. — View Citation

* Note: There are 20 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	All cause mortality	All cause mortality of COVID-19 inpatients	one year
Primary	Critical care admission	Critical care admission of COVID-19 inpatients	one year
Primary	Length of stay	length of hospital stay equal or longer than 30 days	one year
Primary	30-day all cause mortality	30-day all cause mortality of COVID-19 inpatients	one year

External Links

•   A risk score to predict admission to the intensive care unit in patients with Covid-19: the ABC-GOALS score
•   Actualización de la situación epidemiológica de las variantes de SARS-CoV-2 de preocupación (VOC) e interés (VOI) en salud pública en España
•   COVID-19 - UpToDate
•   COVID-19: timeline of WHO action
•   Crónica Global article
•   Digital Economy article
•   European Centre for Disease Prevention and Control (ECDC) COVID-19 situation update for the EU/EEA
•   European Centre for Disease Prevention and Control (ECDC) COVID-19 situation update worldwide
•   Generalitat de Catalunya COVID-19 Data
•   Generalitat de Catalunya COVID-19 Data
•   John Hopkins Coronavirus Resource Center
•   John Hopkins Coronavirus Resource Center - Mortality Analyses
•   Opening address by the WHO Director-General at the press conference on COVID-19 held on March 11, 2020
•   Public Health Agency of Barcelona - COVID-19 Data
•   WHO Coronavirus (COVID-19) Dashboard
•   WHO Corticosteroids for COVID-19
•   World Health Organization
•   World Health Organization - COVID-19 Weekly Epidemiological Update