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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04388657
Other study ID # 2020-A00
Secondary ID
Status Recruiting
Phase
First received
Last updated
Start date May 1, 2020
Est. completion date September 1, 2020

Study information

Verified date April 2020
Source Ramsay Générale de Santé
Contact JEAN F OUDET
Phone +33683346567
Email jf.oudet@ecten.eu
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

Coronavirus 2 (SARS-CoV2) has been identified as the pathogen responsible for severe acute respiratory syndrome associated with severe inflammatory syndrome and pneumonia (COVID-19).

Haemostasis abnormalities have been shown to be associated with a poor prognosis in these patients with this pneumonia. In a Chinese series of 183 patients, the hemostasis balance including thrombin time, fibrinogenemia, fibrin degradation products and antithrombin III were within normal limits. Only the D-Dimer assay was positive in the whole cohort with an average rate of 0.66 µg / mL (normal <50 µg / mL). These hemostasis parameters were abnormal mainly in patients who died during their management; the levels of D-dimers and fibrin degradation products were significantly higher while the antithrombin III was reduced. The findings on the particular elevation of D-dimers in deceased patients as well as the significant increase in thrombin time were also reported in another series. Higher numbers of pulmonary embolisms have been reported in patients with severe form of SARS-COV2 (data in press).

This research is based on the hypothesis that the existence of deep vein thrombosis (DVT) could make it possible to screen patients at risk of pulmonary embolism and to set up a curative anticoagulation.

The main objective is to describe the prevalence of deep vein thrombosis in patients hospitalized in intensive care for acute respiratory failure linked to documented SARS-COV2 pneumonia, within 24 hours of their admission.


Description:

Coronavirus 2 (SARS-CoV2) has been identified as the pathogen responsible for severe acute respiratory syndrome associated with severe inflammatory syndrome and pneumonia (COVID-19).

Described at the end of 2019 in China, the pandemic sees the number of patients increasing worldwide, Europe being still in the ascending phase of the epidemic and the American continent at the very beginning of it.

Haemostasis abnormalities have been shown to be associated with a poor prognosis in these patients with this pneumonia. In a Chinese series of 183 patients, the hemostasis balance including thrombin time, fibrinogenemia, fibrin degradation products and antithrombin III were within normal limits. Only the D-Dimer assay was positive in the whole cohort with an average rate of 0.66 µg / mL (normal <50 µg / mL). These hemostasis parameters were abnormal mainly in patients who died during their management; the levels of D-dimers and fibrin degradation products were significantly higher while the antithrombin III was reduced. The findings on the particular elevation of D-dimers in deceased patients as well as the significant increase in thrombin time were also reported in another series. Higher numbers of pulmonary embolisms have been reported in patients with severe form of SARS-COV2 (data in press).

This research is based on the hypothesis that the existence of deep vein thrombosis (DVT) could make it possible to screen patients at risk of pulmonary embolism and to set up a curative anticoagulation. This is all the more important since the occurrence of a pulmonary embolism can clearly worsen the right ventricular failure possibly observed during mechanical ventilation in these patients.

Cohort study, non-interventional, multicentric, prospective, non-comparative, longitudinal.

The main objective of the research is to describe the prevalence of deep vein thrombosis in patients hospitalized in intensive care for acute respiratory failure linked to documented SARS-COV2 pneumonia, within 24 hours of their admission.

The secondary objectives of the research are:

- Identify the factors associated with the existence of deep vein thrombosis

- Describe the relationship between the inflammatory status of patients on admission and the existence of DVT during follow-up.

- Describe the relationship between the results of the hemostasis assessment and the existence of deep vein thrombosis during follow-up.

- Describe the relationship between a right ventricular failure or dysfunction during follow-up and the existence of DVT.

- Describe the relationship between mortality and the existence of DVT, within 28 days of the patient's admission to intensive care or intensive care. Describe the lung parenchyma if a CT scan is performed


Recruitment information / eligibility

Status Recruiting
Enrollment 100
Est. completion date September 1, 2020
Est. primary completion date September 1, 2020
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria:

- Patient, male or female, over 18 years of age with no upper age limit.

- Patient admitted to intensive care or intensive care for pneumonia linked to SARS-COV2 (diagnosed on positive PCR or chest CT and anamnesis)

- Affiliated patient or beneficiary of a social security scheme

- Patient having been informed and not objecting to the use of their data in the context of this research.

Exclusion Criteria:

- Pregnant, lactating or parturient woman

- Protected patient: adult under guardianship, curatorship or other legal protection, deprived of liberty by judicial or administrative decision.

Study Design


Intervention

Diagnostic Test:
Echo-Doppler
Utrasound Doppler of the lower limbs

Locations

Country Name City State
France Hôpital Ambroise Paré Boulogne-Billancourt IDF
France Hôpital Privé Jacques Cartier Massy IDF
France Centre Cardiologique du Nord Saint-Denis IDF

Sponsors (2)

Lead Sponsor Collaborator
Ramsay Générale de Santé Hôpital Privé Jacques Cartier, service réanimation Dr Bougouin

Country where clinical trial is conducted

France, 

Outcome

Type Measure Description Time frame Safety issue
Primary percentage of patients with one or more DVTs. The primary outcome measure will be the percentage of patients with one or more DVTs from a lower extremity ultrasound scan. 28 days
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