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French Cohort of COVID-19 Patients With Post-intensive Care Syndrome

Recruiting
Conditions
Covid19
Interventions
Behavioral: Post-intensive Care unit syndrome
Other: Spatiotemporal measurements of walking
Registration Number
NCT04590170
Lead Sponsor
Assistance Publique - Hôpitaux de Paris
Brief Summary

The purpose of this study is to describe post-intensive care syndrome (PICS) of patients surviving to coronavirus disease 2019 (COVID19) and their rehabilitation and recovery process from hospital to home return

Detailed Description

The novel coronavirus, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the COVID-19 emerged in December 2019 and was declared pandemic in March 2020.

Although the majority of reported COVID-19 cases are mild, approximatively 5% of patients require a stay in intensive care unit, with mechanical ventilation.

Post intensive care syndrome (PICS) consists of physical, cognitive and psychological dysfunctions.

Little is known about the rate and clinical presentations of PCIS among patients surviving to COVID-19.

The objective of this study is to describe the clinical manifestations of PCIS in COVID-19 patients, and their rehabilitation process until home return.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
200
Inclusion Criteria

Not provided

Exclusion Criteria
  • Inability to give consent

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Patients with Covid19 infectionPost-intensive Care unit syndromePatients with Covid19 infection
Control groupSpatiotemporal measurements of walkingAsymptomatic group
Primary Outcome Measures
NameTimeMethod
Change on physical Impairment : coughBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/No - Patients group

Change on cognitive Impairment: DeliriumBetween 10 days and 1 month after ICU's discharge

Yes/no - Patients group

Change on cognitive Impairment: CooperationBetween 10 days and 1 month after ICU's discharge

Yes/no - Patients group

Change on physical Impairment : dyspneaBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/No - Patients group

Change on physical Impairment : respiratory rateBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Number of breaths/per minute. - Patients group

Change on cognitive Impairment: Vigilance (RASS)Between 10 days and 1 month after ICU's discharge

Used to measure the agitation or sedation level of a person. Range -5 to +4 - Patients group

Change on cognitive Impairment: AgitationBetween 10 days and 1 month after ICU's discharge

Yes/no - Patients group

Change on physical Impairment : Peripheral capillary oxygen saturation (SpO2) on activityBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

measured by pulse oximetry, which provides an indirect measurement of arterial oxygenation (SaO2) based on the differential absorption of light by oxygenated and deoxygenated blood during pulsatile blood flow during activity - Patients group

Change on cognitive Impairment: CommunicationBetween 10 days and 1 month after ICU's discharge

Yes/no - Patients group

Change on physical Impairment : respiratory rate on activityBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

respiratory rate breathing rate on activity - Patients group

Change on physical Impairment autonomy for walkingBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/no - Patients group

Change on physical Impairment : soresBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/no Localisation

* Patients group

Change on psychological Impairment: InsomniaBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/no - Patients group

Change on psychological Impairment : ApathyBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/no - Patients group

Change on psychological Impairment : siderationBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/no - Patients group

Change on cognitive Impairment: temporo-spatial disorientationBetween 10 days and 1 month after ICU's discharge

Yes/no - Patients group

Change on physical Impairment : ventilation modeBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Tracheotomy/ ambient air / OXYGEN THERAPY Other - Patients group

Change on physical Impairment : Peripheral capillary oxygen saturation (SpO2) at restBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

measured by pulse oximetry, which provides an indirect measurement of arterial oxygenation (SaO2) based on the differential absorption of light by oxygenated and deoxygenated blood during pulsatile blood flow - Patients group

Change on physical Impairment : stability of the trunk in sitingBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/no - Patients group

Change on Imagery cerebralBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

date and result if applicable - Patients group

Change on physical Impairment Medical Research Council (MRC-SS MRC Sum score)Between 10 days and 1 month and 3 months and 6 months after ICU's discharge

assess muscle strength from Grade 5 (normal) to Grade 0 (no visible contraction).

MRC-SS score was defined as the sum of MRC scores from six muscles in the upper and lower limbs on both sides so that the score ranged from 60 (normal) to 0 (quadriplegic).

* Patients group

Change on physical Impairment five times sit to stand testBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

The score is the amount of time (to the nearest decimal in seconds) it takes a patient to transfer from a seated to a standing position and back to sitting five times without use of arms, Equipment • Standard height chair (43-45 cm, 17-18 inches) with a backrest. If the patient cannot perform five stands to complete the test without use of arms, a score of 0 seconds should be documented.

* Patients group

Change on cognitive Impairment The Montreal Cognitive Assessment (MoCA)Between 10 days and 1 month and 3 months and 6 months after ICU's discharge

Designed as a rapid screening instrument for mild cognitive dysfunction. It assesses different cognitive domains: attention and concentration, executive functions, memory, language, visuoconstruction skills, conceptual thinking, calculations, and orientation. Range 0 -30 higher is better

* Patients group

Change on cognitive Impairment : Introduction of neurolepticBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/no - Patients group

Change on physical Impairment : electrocardiogram at restBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

electrocardiogram at rest - Patients group

Change on physical Impairment: numeric verbal scales of painBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

self-evaluation numeric verbal scales of pain ranges (0-10) lesser is better

Change on physical Impairment : stiffness or pain involving jointsBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/No small joints (wrists, fingers, toes) and large joints (shoulders, elbows, hips, knees, ankles)

* Patients group

Cognitive Impairment Frontal Assessment Battery (FAB)Between 10 days and 1 month and 3 months and 6 months after ICU's discharge

Total score is from a maximum of 18, higher scores indicating better performance.

* Patients group

Change on psychological Impairment : anxietyBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/no - Patients group

Change on physical Impairment: Modified Borg scale dyspnea score.Between 10 days and 1 month and 3 months and 6 months after ICU's discharge

Verbal and numerical scale that asks you to rate the difficulty of your breathing Patients are asked to tick the boxes that reflect their dyspnea perception best range 0-10 lesser is better - Patients group

Change on physical Impairment : orthostatic hypotensionBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/no drop in blood pressure that occurs when moving from a laying down (supine) position to a standing (upright) position. - Patients group

Change on psychological Impairment : sadnessBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/no - Patients group

assess type of psychiatric treatmentBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Type - Patients group

Change on physical impairment : numeric verbal scales of fatigueBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

self-evaluation numeric verbal scales of fatigue - Patients group ranges (0-10) lesser is better

Change on physical Impairment : autonomy for bed-chair transfersBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/no - Patients group

Change on physical Impairment neurologic examBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

motor or sensory deficits involving the upper and the lower limbs (yes/no) Anosmia Yes/no taste loss Yes/no

* Patients group

Change on psychological Impairment : DespairBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/no - Patients group

Change on psychological Impairment : CulpabilityBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/no - Patients group

Change on psychological Impairment : psychiatric or psychologic careBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/no - Patients group

Change on psychological Impairment : Posttraumatic Stress Disorder Checklist Scale (PCL-S)Between 10 days and 1 month and 3 months and 6 months after ICU's discharge

20-item questionnaire, corresponding to the Manual of Mental Disorders (DSM-5) symptom criteria for PTSD.

* Patients group

assess psychological Impairmentchange between 10 days and 1 month and 3 months and 6 months after ICU's discharge

Introduction of neuroleptic Type

* Patients group

Change on psychological Impairment : Conduit addictiveBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Yes/no - Patients group

Change on psychological Impairment : Hospital Anxiety and Depression Scale (HADS)Between 10 days and 1 month and 3 months and 6 months after ICU's discharge

A 14-item self-report screening scale that was originally developed to indicate the possible presence of anxiety and depressive states It contains two 7-item scales: one for anxiety and one for depression both with a score range of 0-21.

* Patients group

Secondary Outcome Measures
NameTimeMethod
Descriptive data of the rehabilitation care pathway after stay in intensive care until return homeBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Number of days to discharge from hospital Service of rehabilitation care hospital at home (HAH) return at home

* Patients group

assess related symptoms nature of COVID-19Between 10 days and 1 month after ICU's discharge

duration of COVID-19-related symptoms nature Laboratory-confirmed SARS-CoV-2 infection as determined by PCR, or other commercial or public health assay and/or CT-scan showing typical radiological findings

* Patients group

assess medical complications in intensive careBetween 10 days and 1 month after ICU's discharge

Pneumopathy pulmonary embolism others

* Patients group

Social statusBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

professional activity unemployment retirement others

* Patients group

Gait analysis 6-minute walk test (6MWT)3 months and 6 months after ICU's discharge

Sub-maximal exercise test used to assess aerobic capacity and endurance. The distance covered over a time of 6 minutes is used as the outcome by which to compare changes in performance capacity.

* Patients group

asses demographics informationBetween 10 days and 1 month after ICU's discharge

Age, sex, formal education, marital status, occupation, place of living, socio-professional category

* Patients group

assess past and current medicationsBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

Precise

* Patients group

Number of new medical qualifying events since last contactBetween 10 days and 1 month and 3 months and 6 months after ICU's discharge

complications

* Patients group

Quality of life Medical outcome study short form 12 items (MOS-SF-12 ) questionnaire3 months and 6 months after ICU's discharge

Self-reported outcome measure assessing the impact of health on an individual's everyday life Patients fill out a 12-question survey which is then scored by a clinician or researcher.

Questionnaire consisting of 12 questions that measure 8 health domains to assess physical and mental health. Physical health-related domains include General Health (GH), Physical Functioning (PF), Role Physical (RP), and Body Pain (BP). Mental health-related scales include Vitality (VT), Social Functioning (SF), Role Emotional (RE), and Mental Health (MH).

* Patients group

Balance and Gait analysis3 months and 6 months after ICU's discharge

Inertial Sensors to Assess Gait Quality

* Patients group

assess comorbiditiesBetween 10 days and 1 month after ICU's discharge

number of comorbidities

* Patients group

Activities of Daily Living (ADL) scale3 months and 6 months after ICU's discharge

Related to personal care (self-performance) looks at four of these tasks: transfer, bed mobility, toileting and eating. The resident's self- performance and the amount of staff support provided are evaluated for all of these tasks ranges from 0 (independent) to 4 (total dependence)

* Patients group

assess characteristics of ongoing hospitalizationBetween 10 days and 1 month after ICU's discharge

number of characteristics of ongoing hospitalization (invasive ventilation, curare, others treatments )

* Patients group

Spatio-temporal parameters of walkingInclusion

Comparison of spatio-temporal measures of walking in patients with severe Covid 19 infection to those of an age- and sex-matched sample of asymptomatic participants.

Both groups

Trial Locations

Locations (2)

Department of Physical Medicine and Rehabilitation

🇫🇷

Issy-les-Moulineaux, France

Department of Rehabilitation, Institute of Rheumatology Cochin

🇫🇷

Paris, France

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