Developed by Shray Alag, The Harker School
Sections: Correlations,
Clinical Trials, and HPO
Navigate: Clinical Trials and HPO
| Name (Synonyms) | Correlation |
|---|
Navigate: Correlations HPO
There is one clinical trial.
In the last 10 years, severe acute respiratory infection (SARI) was responsible of multiple outbreaks putting a strain on the public health worldwide. Indeed, SARI had a relevant role in the development of pandemic and epidemic with terrible consequences such as the 2009 H1N1 pandemic which led to more than 200.000 respiratory deaths globally. In late December 2019, in Wuhan, Hubei, China, a new respiratory syndrome emerged with clinical signs of viral pneumonia and person-to-person transmission. Tests showed the appearance of a novel coronavirus, namely the 2019 novel coronavirus (COVID-19). Two other strains, the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) have caused severe respiratory illnesses, sometimes fatal. In particular, the mortality rate associated with SARS-CoV and MERS-CoV, was of 10% and 37% respectively. Even though COVID-19 appeared from the first time in China, quickly it spread worldwide and cases have been described in other countries such as Thailand, Japan, South Korea, Germany, Italy, France, Iran, USA and many other countries. An early paper reported 41 patients with laboratory-confirmed COVID-19 infection in Wuhan. The median age of the patients was 49 years and mostly men (73%). Among those, 32% were admitted to the ICU because of the severe hypoxemia. The most associated comorbidities were diabetes (20%), hypertension (15%), and cardiovascular diseases (15%). On admission, 98% of the patients had bilateral multiple lobular and sub-segmental areas of consolidation. Importantly, acute respiratory distress syndrome (ARDS) developed in 29% of the patients, while acute cardiac injury in 12%, and secondary infection in 10%. Invasive mechanical ventilation was required in 10% of those patients, and two of these patients (5%) had refractory hypoxemia and received extracorporeal membrane oxygenation (ECMO). In a later retrospective report by Wang and collaborators, clinical characteristics of 138 patients with COVID-19 infection were described. ICU admission was required in 26.1% of the patients for acute respiratory distress syndrome (61.1%), arrhythmia (44.4%), and shock (30.6%). ECMO support was needed in 11% of the patients admitted to the ICU. During the period of follow-up, overall mortality was 4.3%. The use of ECMO in COVID-19 infection is increasing due to the high transmission rate of the infection and the respiratory-related mortality. Therefore, the investigators believe that ECMO in case of severe interstitial pneumonia caused by COVID could represent a valid solution in order to avoid lung injuries related to prolonged treatment with non-invasive and invasive mechanical ventilation. In addition, ECMO could have a role for the systemic complications such as septic and cardiogenic shock as well myocarditis scenarios. Potential clinical effects and outcomes of the ECMO support in the novel coronavirus pandemic will be recorded and analyzed in our project. The researchers hypothesize that a significant percentage of patients with COVID-19 infection will require the utilize of ECMO for refactory hypoxemia, cardiogenic shock or septic shock. This study seeks to prove this hypothesis by conducting an observational retrospective/prospective study of patients in the ICU who underwent ECMO support and describe clinical features, severity of pulmonary dysfunction and risk factors of COVID-patients who need ECMO support, the incidence of ECMO use, ECMO technical characteristics, duration of ECMO, complications and outcomes of COVID-patients requiring ECMO support.
Description: age in years
Measure: Age Time: at baselineDescription: male/female
Measure: Gender Time: at baselineDescription: in kilograms
Measure: Weight Time: at baselineDescription: in meters
Measure: Height Time: at baselineDescription: weight and height combined to calculate BMI in kg/m^2
Measure: BMI Time: at baselineDescription: Asthma y/n, cystic fibrosis y/n, chronic obstructive pulmonary disease y/n, pulmonary hypertension y/n, pulmonary fibrosis y/n, chronic restrictive lung disease y/n
Measure: Pre-existing pulmonary disease y/n Time: at baselineDescription: diabetes mellitus y/n, chronic renal failure y/n, ischemic heart disease y/n, heart failure y/n, chronic liver failure y/n, neurological impairment y/n
Measure: Main co-morbidities y/n Time: at baselineDescription: in dd-mm-yyyy or mm-dd-yyyy
Measure: Date of signs of COVID-19 infection Time: at baseline or date of occurenceDescription: in dd-mm-yyyy or mm-dd-yyyy
Measure: Date of positive swab Time: at baseline or date of occurenceDescription: in days
Measure: Pre-ECMO length of hospital stay Time: at or during ECMO-implantDescription: in days
Measure: Pre-ECMO length of ICU stay Time: at or during ECMO-implantDescription: in days
Measure: Pre-ECMO length of mechanical ventilation days Time: at or during ECMO-implantDescription: y/n, what kind
Measure: Use of antibiotics Time: up to 6 monthsDescription: y/n, what kind
Measure: Use of anti-viral treatment Time: up to 6 monthsDescription: y/n, what kind (eg prone-position, recruitment manoeuvers, neuromuscular blockade etc)
Measure: Use of second line treatment Time: up to 6 monthsDescription: respiratory or cardiac
Measure: Indications for ECMO-implant Time: at ECMO-implantDescription: veno-venous, veno-arterial or veno-venoarterial
Measure: Type of ECMO-implant Time: at ECMO-implantDescription: peripheral or central
Measure: Type of access Time: at ECMO-implantDescription: in dd-mm-yyyy or mm-dd-yyyy
Measure: Date of ECMO implant Time: at ECMO-implantDescription: l/min
Measure: ECMO blood flow rate Time: from day of ECMO-implant for every 24 hours until date of weaning or death, up to 6 monthsDescription: l/min
Measure: ECMO gas flow rate Time: from day of ECMO-implant for every 24 hours until date of weaning or death, up to 6 monthsDescription: y/n
Measure: ECMO configuration change Time: up to 6 monthsDescription: in dd-mm-yyyy or mm-dd-yyyy
Measure: Date of ECMO configuration change Time: up to 6 monthsDescription: veno-venous, veno-arterial, veno-venoarterial, other
Measure: New ECMO configuration Time: up to 6 monthsDescription: right ventricular failure, left ventricular failure, refractory hypoxemia
Measure: Indications for ECMO configuration change Time: up to 6 monthsDescription: settings of ventilator
Measure: Ventilator setting on ECMO Time: from day of ECMO-implant for every 24 hours until date of weaning or death, up to 6 monthsDescription: heparin, bivalirudin, nothing
Measure: Anticoagulation during ECMO Time: from day of ECMO-implant for every 24 hours until date of weaning or death, up to 6 monthsDescription: amount of ECMO circuit changes (1, 2, 3 etc.)
Measure: Frequency of ECMO circuit change Time: up to 6 monthsDescription: Hemorrhagic, infection, other complications
Measure: ECMO complications Time: up to 6 monthsDescription: y/n
Measure: ECMO Weaning Time: from day of ECMO-implant for every 24 hours until date of weaning or death, up to 6 monthsDescription: y/n, date
Measure: ICU discharge Time: from day of ICU-admission for every 24 hours until date of discharge or death, up to 6 monthsDescription: Ward, another ICU, rehabilitation center, home
Measure: Type of discharge Time: up to 6 monthsAlphabetical listing of all HPO terms. Navigate: Correlations Clinical Trials
Data processed on September 26, 2020.
An HTML report was created for each of the unique drugs, MeSH, and HPO terms associated with COVID-19 clinical trials. Each report contains a list of either the drug, the MeSH terms, or the HPO terms. All of the terms in a category are displayed on the left-hand side of the report to enable easy navigation, and the reports contain a list of correlated drugs, MeSH, and HPO terms. Further, all reports contain the details of the clinical trials in which the term is referenced. Every clinical trial report shows the mapped HPO and MeSH terms, which are also hyperlinked. Related HPO terms, with their associated genes, protein mutations, and SNPs are also referenced in the report.
Drug Reports MeSH Reports HPO Reports