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COVIDAR - Arrhythmias in COVID-19

Conditions
Atrioventricular Block
Torsades de Pointe Caused by Drug
Atrial Fibrillation
COVID
Bradyarrhythmia
Arrhythmia
Qt Interval, Variation in
Ventricular Arrythmia
Registration Number
NCT04437901
Lead Sponsor
Hospital Clinic of Barcelona
Brief Summary

BACKGROUND AND RATIONALE: There is very limited literature available on the arrhythmia occurrence in the context of an infection by the SARS-CoV2 virus. On the other hand, treatment strategies against the SARS-CoV2 virus may carry a risk of QTc prolongation and pro-arrhythmia/sudden death which may be amplified by concomitant use of other QTc-prolonging drugs and/or ion disbalances. COVIDAR is an international initiative to monitor the occurrence of arrhythmic events in the context of the SARS-CoV2 infection, to identify potential modifiable predisposing factors to reduce their incidence and to inform the best arrhythmia management options in this patient population.

MAIN OBJECTIVE: To describe the incidence and type of arrhythmic events in the context of the SARS-CoV2 infection.

STUDY DESIGN: patient registry (observational). Patients will not undergo any additional investigations. Only data that is generated during routine clinical care will be collected.

STUDY POPULATION: Patients admitted to the hospital highly suspected of or with confirmed COVID-19.

Detailed Description

The COVIDAR Registry is an international longitudinal multicentre observational study worldwide which aims to assess the incidence, type and risk factors of arrhythmias in the context of SARS-CoV2 infection, also providing relevant information on events/management and major cardiovascular outcomes. During the course of the registry patients will be followed up according to the usual practice of the centres. Drug prescriptions and indications to perform diagnostic/therapeutic procedures will be completely left to the treating physicians.

The registry population will consist of patients presenting with a suspicion of SARS-CoV2 infection, who are hospitalised in a medical or surgical department of the participating hospitals. Patients will officially be enrolled in the COVIDAR Registry if the COVID-19 disease has formally been noted or confirmed in the patient's medical record.

The registry will include all patients and collect data at the following timepoints:

* Admission: evaluation before SARS-CoV2 infection treatment initiation

* On-treatment: evaluation 24-28h after treatment initiation

* At any adverse event: evaluation if any adverse event occurs

* At discharge: evaluation of clinical status at the end of the admission period.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
10000
Inclusion Criteria
  • Patients admitted with highly suspected/confirmed infection with SARS-CoV-2.
Exclusion Criteria
  • Formal opposition by the patient to data collection.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
ArrhythmiaFrom date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Any arrhythmic event occurring in COVID-19 patients during hospital admission:

* Monomorphic ventricular tachycardia

* Polymorphic ventricular tachycardia/Torsades de pointes (non-sustained)

* Ventricular fibrillation

* AV-block

* Severe bradycardia, symptomatic and/or requiring treatment

* New-onset atrial fibrillation

* Other

Secondary Outcome Measures
NameTimeMethod
Electrocardiographic changes - Underlying rhythmFrom date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Categorical variable collecting the patient's underlying rhythm at baseline, on treatment and in case of arrhythmic adverse events): sinus rhythm, atrial fibrillation/flutter, other

Electrocardiographic changes - Atrioventricular conductionFrom date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Collected as a categorical (normal, 1st-, 2nd- or 3rd degree AV block) and a continuous (PR duration in ms) at baseline, on treatment and in case of arrhythmic adverse events)

Electrocardiographic changes - QRS durationFrom date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Collected as a continuous variable (ms) at baseline, on treatment and in case of arrhythmic adverse events)

Electrocardiographic changes - presence of Brugada QRS patternFrom date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Collected as a categorical variable (not present, type 1 or type 2) at baseline, on treatment and in case of arrhythmic adverse events)

Electrocardiographic changes - QTc durationFrom date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Collected as a continuous variable (ms) at baseline, on treatment and in case of arrhythmic adverse events)

Laboratory abnormalities - electrolyte misbalanceFrom date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Kalium, magnesium and calcium collected as continuous variables at baseline, on treatment and in case of arrhythmic adverse events). Will be reported as a categorical variable (presence/absence) of electrolyte misbalance

Laboratory abnormalities - liver functionFrom date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Liver enzymes collected at at baseline, on treatment and in case of arrhythmic adverse events)

Laboratory abnormalities - cardiac biomarkersFrom date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Cardiac CK, troponin T and/or troponin I (where available) collected as a continuous variable at baseline, on treatment and in case of arrhythmic adverse events)

Laboratory abnormalities - renal functionFrom date of admission until the date of first documented arrhythmic adverse event or date of death from any cause, whichever came first, assessed up to 12 months

Creatinine clearance at baseline, on treatment and in case of arrhythmic adverse events)

Trial Locations

Locations (5)

Antwerp University Hospital

🇧🇪

Antwerpen, Belgium

Amsterdam UMC

🇳🇱

Amsterdam, AZ, Netherlands

Hospital Clinic of Barcelona

🇪🇸

Barcelona, Spain

St. Georges University Hospitals

🇬🇧

London, United Kingdom

Istituto Auxologico Italiano, IRCCS

🇮🇹

Milan, Italy

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