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A Study of Post COVID-19 Mechanisms for Chronic Lung Sequelae

Recruiting
Conditions
COVID-19
Interventions
Procedure: Bronchoscopies and Bronchoalveolar Lavages (BALs)
Diagnostic Test: Chest Tomography (CT)
Diagnostic Test: Electrocardiogram (ECG)
Diagnostic Test: Pulmonary function tests (PFTs)
Diagnostic Test: 6 minute walk test (6MWT)
Registration Number
NCT06006884
Lead Sponsor
Mayo Clinic
Brief Summary

The purpose of this study is to understand why some people experience long term effects, such as shortness of breath and fatigue, after a severe COVID-19 infection

Detailed Description

Each participant will be in the study for approximately 12 months and will be required to come to Mayo Clinic for 3 visits. These visits will take place approximately 2-3 months after confirmed COVID-19 diagnosis (visit 1), 6 months after diagnosis (visit 2), and 12 months after diagnosis (visit 3).

Comprehensive clinical evaluation and symptom characterization, quantitative lung CT image analysis and pulmonary function testing, and quality of life questionnaires will be obtained at each visit. Bronchoscopy with BAL (collected at visits 1 and 3 only) and blood samples (collected at all visits) will dissect the dynamic immunological and molecular signatures in the respiratory tract and in the circulation longitudinally. We will also perform highly sensitive viral reservoir or remnant assays to address the potential contribution of viral factors in regulating chronic lung conditions post-acute COVID-19.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
75
Inclusion Criteria

For the Sequelae Group

  • Age ≥18 years at screening, PCR confirmed COVID19 illness (+PCR defines day 0 of illness), hospitalization for COVID-19, absence of pre-existing history of interstitial lung disease, or significant other lung disease.
  • Severity of illness will be categorized as moderate disease (supplemental oxygen need 1-8L at any time during hospitalization), severe disease (need for high flow oxygen delivery ≥8L at any time during hospitalization) and critical illness (need for ICU admission or mechanical ventilation).

Control Recovery Group

  • Age ≥18 years at screening
  • PCR confirmed COVID-19 cases who had nonsymptomatic or mild acute infection that do not require hospitalization 7,48,49
  • Absence of pre-existing history of interstitial lung disease, or significant other lung disease, absence of any ongoing respiratory and systemic symptoms.
Exclusion Criteria
  • Inability to provide informed consent, evidence of pre-existing interstitial lung disease or chronic lung disease;
  • Active cigarette smoking, vaping or other inhalation use.
  • Immunocompromised host status due to ongoing therapy with methotrexate, CellCept, azathioprine, rituximab, cyclophosphamide or other biologic agents;
  • > 20 pack year smoking history.
  • History of chemotherapy or radiation therapy in the last two years; and pregnancy.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Sequelae groupPulmonary function tests (PFTs)COVID-19 convalescents that recover from prior severe acute diseases requiring hospitalization and who will be at high risk of chronic lung sequelae (with an estimate of \>50% having moderate to severe sequelae based on current literature)
Recovery group6 minute walk test (6MWT)Age and gender matched individuals who had mild SARS-CoV-2 infection and experienced complete resolution of symptoms
Sequelae groupBronchoscopies and Bronchoalveolar Lavages (BALs)COVID-19 convalescents that recover from prior severe acute diseases requiring hospitalization and who will be at high risk of chronic lung sequelae (with an estimate of \>50% having moderate to severe sequelae based on current literature)
Sequelae groupChest Tomography (CT)COVID-19 convalescents that recover from prior severe acute diseases requiring hospitalization and who will be at high risk of chronic lung sequelae (with an estimate of \>50% having moderate to severe sequelae based on current literature)
Recovery groupChest Tomography (CT)Age and gender matched individuals who had mild SARS-CoV-2 infection and experienced complete resolution of symptoms
Recovery groupBronchoscopies and Bronchoalveolar Lavages (BALs)Age and gender matched individuals who had mild SARS-CoV-2 infection and experienced complete resolution of symptoms
Recovery groupPulmonary function tests (PFTs)Age and gender matched individuals who had mild SARS-CoV-2 infection and experienced complete resolution of symptoms
Sequelae group6 minute walk test (6MWT)COVID-19 convalescents that recover from prior severe acute diseases requiring hospitalization and who will be at high risk of chronic lung sequelae (with an estimate of \>50% having moderate to severe sequelae based on current literature)
Sequelae groupElectrocardiogram (ECG)COVID-19 convalescents that recover from prior severe acute diseases requiring hospitalization and who will be at high risk of chronic lung sequelae (with an estimate of \>50% having moderate to severe sequelae based on current literature)
Recovery groupElectrocardiogram (ECG)Age and gender matched individuals who had mild SARS-CoV-2 infection and experienced complete resolution of symptoms
Primary Outcome Measures
NameTimeMethod
Decipher clinical, imaging, immune, molecular and/or viral traits underlying post-acute COVID-19 lung sequelae4 years

This study will expand on prior observations from a previous study and discover potential drivers and targets for therapy of post-acute COVID-19 lung disease by recruiting a larger group of COVID-19 convalescents, following up longitudinally up to 12 months after acute infection. This longitudinal approach will allow for assess immune dysregulation and establish the etiology of lung sequelae of COVID-19

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Mayo Clinic Minnesota

🇺🇸

Rochester, Minnesota, United States

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