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Non-invasive Ventilatory Support of Patients Affected by COVID-19

Completed
Conditions
Covid-19
Interventions
Device: Non-invasive ventilatory support
Registration Number
NCT04382235
Lead Sponsor
University of Milano Bicocca
Brief Summary

Prospective, observational, multicenter study aiming to evaluate the number of COVID-19 pneumonia related patients treated with non-invasive ventilatory support outside the intensive care unit.

In addition, the study aims to obtain information related to the clinical characteristics and hospital results of these patients.

Detailed Description

In February 2020, the first case of transmission of the syndrome, indicated as COVID-19, was reported in Italy. Unfortunately, during March 2020, the syndrome spread rapidly throughout the country, affecting tens of thousands of patients, including several thousands have requested hospitalization and some hospitalization in intensive care, putting a strain on the entire regional health system.

Patients that present intermediate severity of the infection are often treated with non-invasive ventilatory support which includes high-flow nasal cannulas (HFNC), non-invasive ventilation (NIV), continuous positive airway pressure (CPAP) through face mask or helmet (helmet).

The exponential growth in the number of patients has made the massive use of these devices necessary even outside the intensive or semi-intensive wards where they are traditionally used.

Epidemiological knowledge regarding the type of patients treated with this strategy and the outcome of these patients are limited, but very important in a context of emergency.

Thus, the objective of this prospective multicenter study is to evaluate the number of patients with COVID-19 related pneumonia, treated with non-invasive ventilatory support outside the intensive care unit and to evaluate the clinical characteristics and hospital outcomes of these patients.

SAMPLE SIZE (n. Patients):

The study will collect all patients with the inclusion criteria, so the study size being by definition equal to the maximum size.

STUDY DESIGN:

Patients will be enrolled on a single day (March 26, 2020 or March 31, 2020 chosen by the participating centres).

Total duration of the Study: 5 months (enrollment, collection and analysis of data).

Enrollment Start: March 26, 2020. Enrollment Closure: March 31, 2020. End of the Study (indicative date, last visit, last patient): May 2020.

The patient will be enrolled in the study when informed consent is obtained.

In this phase, the following data are collected:

* Patient registration;

* Demographic and anthropometric data;

* Comorbidity

* Hospitalization data;

* Ventilation / Hemodynamics data;

* Blood chemistry tests.

Upon discharge other data will be collected such as the necessary intubation or intubation date.

STATISTICAL ANALYSIS:

The enrolled cases will be counted and the percentages of the three types of non-invasive ventilatory supports will be specifically described by centre. The heterogeneity of these percentages will be assessed through a model with mixed effects.

The anamnestic and clinical data of the enrolled patients will be analysed through descriptive statistics on continuous quantitative variables.

The impact of the type of ventilation and of the blood chemistry parameters and aspects of comorbidity will be assessed with reference to the probability of developing a transition to the death and to hospitalization in intensive care through a multinomial model.

These factors will also be included in a logistic model with outcome defined by patient survival.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
909
Inclusion Criteria
  • Age> = 18 years
  • Diagnosis of COVID-related pneumonia requiring non-invasive ventilatory support (high-flow nasal cannula, and / or non-invasive ventilation and / or CPAP)
Exclusion Criteria
  • Explicit refusal to participate in the study

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Covid-19 related Pneumonia patientsNon-invasive ventilatory supportThe cohort is defined by subjects with a diagnosis of COVID 19-related pneumonia requiring non-invasive ventilatory support.
Primary Outcome Measures
NameTimeMethod
The number of patients treated with non-invasive ventilation devices.Until patient discharge from the hospital (approximately 5 months)

The first purpose of the study is to evaluate the number of COVID-19 related pneumonia patients treated with devices for non-invasive ventilation outside intensive care units.

Secondary Outcome Measures
NameTimeMethod
Incidence of organ failureUntil patient discharge from the hospital (approximately 5 months)

Assess the clinical characteristics of patients treated with devices for non-invasive ventilation using the following endpoint: incidence of organ failure.

Incidence of patients requiring mechanical ventilationUntil patient discharge from the hospital (approximately 5 months)

Assess the clinical characteristics of patients treated with devices for non-invasive ventilation using the following endpoint: incidence of patients requiring mechanical ventilation.

Duration of hospitalizationUntil patient discharge from the hospital (approximately 5 months)

Measure the hospital outcomes of patients treated with devices for non-invasive ventilation using the following endpoint: duration of hospitalization.

Clinical outcome at hospital dischargeUntil patient discharge from the hospital (approximately 5 months)

Measure the hospital outcomes of patients treated with devices for non-invasive ventilation using the following endpoint: clinical outcome at hospital discharge.

Trial Locations

Locations (34)

ASST Lariana - Ospedale Sant'Anna

🇮🇹

Como, Italy

ASST Lecco - Ospedale "A. Manzoni"

🇮🇹

Lecco, Italy

ASST Lodi - Ospedale Maggiore di Lodi

🇮🇹

Lodi, Italy

ASST OVEST Milanese - Ospedale di Magenta

🇮🇹

Magenta, Italy

ASST Garda - Ospedale di Manerbio

🇮🇹

Manerbio, Italy

ASST Mantova - Ospedale Carlo Poma

🇮🇹

Mantova, Italy

ASST Melegnano e della Martesana - Presidio di Melzo-Gorgonzola

🇮🇹

Melzo, Italy

ASST Fatebenefratelli - Presidi Fatebenefratelli & M. Melloni

🇮🇹

Milano, Italy

ASST Fatebenefratelli - Sacco

🇮🇹

Milano, Italy

ASST Grande Ospedale Metropolitano Niguarda

🇮🇹

Milano, Italy

Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico

🇮🇹

Milano, Italy

Ospedale San Giuseppe

🇮🇹

Milano, Italy

ASST Spedali Civili -Presidio Ospedaliero di Montichiari

🇮🇹

Montichiari, Italy

ASST Monza - Ospedale San Gerardo

🇮🇹

Monza, Italy

Fondazione IRCCS Policlinico San Matteo - Pavia

🇮🇹

Pavia, Italy

Policlinico San Pietro

🇮🇹

Ponte San Pietro, Italy

ASST Valle Olona - Ospedale di Saronno

🇮🇹

Saronno, Italy

Istituto Clinico Humanitas Rozzano

🇮🇹

Rozzano, Italy

ASST Bergamo OVEST - Ospedale "Treviglio-Caravaggio" di Treviglio

🇮🇹

Treviglio, Italy

Ospedale di Circolo e Fondazione Macchi - Varese

🇮🇹

Varese, Italy

ASST Vimercate - Ospedale di Vimercate

🇮🇹

Vimercate, Italy

ASST Melegnano e della Martesana - Ospedale di Vizzolo Predabissi

🇮🇹

Vizzolo Predabissi, Italy

ASST Papa Giovanni XXIII - Bergamo

🇮🇹

Bergamo, Italy

Azienda Ospedaliera - Universitaria di Bologna, Policlinico S. Orsola Malpighi

🇮🇹

Bologna, Italy

ASST Spedali Civili - Brescia

🇮🇹

Brescia, Italy

ASST Valle Olona - Ospedale di Busto Arsizio

🇮🇹

Busto Arsizio, Italy

ASST Crema - Ospedale Maggiore di Crema

🇮🇹

Crema, Italy

Istituto Clinico Humanitas Gavazzeni

🇮🇹

Cremona, Italy

ASST Cremona - Ospedale di Cremona

🇮🇹

Cremona, Italy

ASST Garda - Presidio di Desenzano del Garda

🇮🇹

Desenzano Del Garda, Italy

ASST Monza - Desio

🇮🇹

Desio, Italy

ASST Spedali Civili -Ospedale di Gardone Val Trompia

🇮🇹

Gardone Val Trompia, Italy

ASST Ovest milanese - Ospedale di Legnano

🇮🇹

Legnano, Italy

Policlinico San Marco - Ospedale Zingonia

🇮🇹

Bergamo, BG, Italy

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