Predictors of Disease Severity in COVID-19 Patients
- Conditions
- COVID-19
- Interventions
- Other: Standard of health care
- Registration Number
- NCT04887142
- Lead Sponsor
- Zeljko Mijailovic
- Brief Summary
The primary goal of the VIRIONUM project is to analyze the association of clinical, socio-demographic characteristics of patients and their genetic polymorphism, inflammatory and other biochemical markers with disease progression and death in subjects with COVID-19 disease. The research is an observational, cohort study with nested-case control design, including adult, male and female COVID-19 inpatients. Primary dependent variable will be outcome of disease, defined as discharge from the hospital or death. The outcomes and putative risk factors will be analyzed using binary logistic regressions. The proposed multi- and inter-disciplinary study should provide additional scientific evidence about risk factors for the development of severe forms of the disease and the COVID-19-related death.
- Detailed Description
Background: Severe acute respiratory syndrome 2 (SARS-CoV-2) is etiological agent of heterogeneous corona-virus disease 19 (COVID-19), which clinical condition range from asymptomatic or mild to critically severe with high odds for fatal outcome. Since the pathophysiological pathways of COVID-19 disease development are not fully elucidated, resulting in repeated changes in treatment plans, there is an unmet need for more research into genetic, biochemical, immunological, and clinical predictive indicators of better outcomes in COVID-19 patients.
Aim: The VIRIONUM project's main aim is to investigate the relation between genetic polymorphisms, inflammatory and other biochemical markers, and disease severity and mortality in COVID-19-infected hospitalized patients.
Method and patients: The observational nested case-control clinical study will be conducted in at least 1019 COVID-19 patients. The genetic polymorphisms (ACE2, IFNL3/4 and TMPRSS2), serum concentration of soluble ACE2 and the pro- and anti-inflammatory cytokines, blood concentration of common inflammatory and other biomarkers, peripheral blood mononuclear leukocyte (PBMC) phenotype, demographic and clinical risk factors will be monitored as independent variables, while the dependent variables will be the outcome of the disease and the severity of the clinical condition. Genotyping will be performed by Real-Time PCR method, and serum concentrations of ACE2 and pro- and anti-inflammatory cytokines by ELISA method, and PBMC phenotype by flow cytometry. The disease severity will be assessed according to WHO criteria.
Expected results: The findings of this clinical study will contribute to understanding of significant genetic, biochemical, and clinical determinants of severity and lethal outcomes in COVID-19 patients, as well as, creation of set of recommendations for individuals at higher risk - future, evidence-based, targeted and individualized approach.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 1019
- Adult age, 18 years old or more
- Male or female
- Hospitalization for COVID-19 after confirmation by SARS-CoV-2 rapid antigen test or RT-PCR
- Voluntary written consent of the subject to participate
- Pregnant and breastfeeding women
- Fatal outcome during the first 24 hours of hospitalization
- Inability to collect the necessary study data
- Declining of the subject to voluntary participate in the study
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description The discharged subjects Standard of health care The COVID-19 inpatients treated with standard care who survived the disease and discharged from hospital. The deceased subjects Standard of health care The COVID-19 inpatients treated with standard care who died from the disease.
- Primary Outcome Measures
Name Time Method Number of Participants with Fatal Outcome Up to 6 weeks from recruitment to hospital discharge or death Case fatality ratio will be calculated as the proportion of patients who died from all causes (all-cause mortality) compared to the total number of patients
- Secondary Outcome Measures
Name Time Method Ordinal Scale for Clinical Improvement Up to 6 weeks from recruitment to hospital discharge or death Patients' COVID-19 severity and clinical improvement will be assessed according to the recommendations of World Health Organization using Ordinal Scale for Clinical Improvement and the patient state will be classified as mild (score 4 or less) or severe (score 5 or more).
Trial Locations
- Locations (5)
Spitali Amerikan
🇦🇱Tirana, Albania
KBC Rijeka, University of Rijeka
ðŸ‡ðŸ‡·Rijeka, Croatia
University of Montenegro, Faculty of Medicine
🇲🇪Podgorica, Montenegro
General Hospital "Prim. dr. Abdulah Nakaš"
🇧🇦Sarajevo, Bosnia and Herzegovina
Faculty of Medical Sciences, University Clinical Center Kragujevac
🇷🇸Kragujevac, Srbija, Serbia