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Establishing a COVID-19 Prospective Cohort for Identification of Secondary HLH

Conditions
COVID
Registration Number
NCT04347460
Lead Sponsor
Technical University of Munich
Brief Summary

SARS-CoV2 has become a pandemic disease putting an enormous burden on health care systems around the world. A considerable amount of patients require intensive care treatment for Covid-19 associated pneumonia. At this point there is no specific treatment, apart from supportive intensive care treatment protocols for severe COVID-19 disease.The latest reports describe massive hyperinflammation in some of the severe COVID-19 patients, which is not a typical finding in virus associated pneumonia. The H-score and the modified HLH 2004 score offer diagnostic tools, that help establishing the diagnosis of HLH. Even more important is the expert clinical judgment to establish the diagnosis of sHLH.

Detailed Description

SARS-CoV2 has become a pandemic disease putting an enormous burden on health care systems around the world. The course of disease is relatively mild in most of the patients, but there is a considerable amount of patients that require intensive care treatment for Covid-19 associated pneumonia. At this point there is no specific treatment, apart from supportive intensive care treatment protocols for severe COVID-19 disease.The latest reports describe massive hyperinflammation in some of the severe COVID-19 patients. The H-score and the modified HLH 2004 score offer diagnostic tools, that helps establishing the diagnosis of HLH. Moreover expert clinical judgment is key to establish a diagnosis of sHLH. Still, so far no systematic analysis has been carried out answering the question as to whether or not these patients suffer from secondary HLH and could potentially benefit from immunomodulatory drugs.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Age > 17a
  • diagnosis of SARS CoV 2 by PCR testing
  • Hospitalized due to clinical severity of the disease
  • written and informed consent or consent of the family
  • GFR<30 is not an exclusion criterion
Exclusion Criteria
  • not fulfilling the inclusion criteria
  • missing written and informed consent

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Presence of sHLH as determined by expert chart review by two independent reviewersin the first week after admission to the ICU

blinded chart review by a hematooncologist and a rheumatologist having expert experience in HLH diagnosis and treatment

Determine the incidence of patients fulfilling modified 2004 HLH diagnostic criteria (Ferritin > 10000 μg/L) in Covid 19 viral infectionin the week after admission to the ICU

Calculate modified 2004 HLH diagnostic criteria in all study participants

Determine the incidence of patients fulfilling HLH criteria in Covid 19 viral infectionin the first week after admission to the ICU

Calculate HScore in all recruited patients

Characterization and incidence of the hyper-inflammatory state in COVID-19assessed within 15 days post ICU-admission

characterized by sIL-2, Ferritin, Il-6, CRP, PCT and aberrant cellular activation (differential blood count and immunophenotypic analysis)

Secondary Outcome Measures
NameTimeMethod
all cause mortality assesed on day 29assesed on study day 29

vital status of patients will be assesed by clinical records or phone calls to patients or relatives or other hospitals involved in the care of the patient

immunophenotpyein the first days after admission to the ICU

characterize immune cell populations

all cause mortality assesed on day 15assesed on study day 15

vital status of patients will be assesed by clinical records or phone calls to patient or relatives or other hospitals involved in the care of the patient

Trial Locations

Locations (1)

Department of nephrology, Klinikum rechts der Isar

🇩🇪

München, Bavaria, Germany

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