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D004630: Emergencies

Developed by Shray Alag, The Harker School
Sections: Correlations, Clinical Trials, and HPO

Correlations computed by analyzing all clinical trials.

Navigate: Clinical Trials and HPO


Correlated Drug Terms (44)


Name (Synonyms) Correlation
drug2767 RECOP unit patient Wiki 0.25
drug391 BCG vaccine (Freeze-dried) Wiki 0.18
drug2059 Mindfulness program Wiki 0.18
Name (Synonyms) Correlation
drug3532 Treatment as usual Wiki 0.18
drug3791 attendance by ambulance crew Wiki 0.18
drug3324 Symptomatic drugs Wiki 0.18
drug3327 Symptoms entered into the CovidX application Wiki 0.18
drug622 COVID 19 impact Wiki 0.18
drug3222 Standard of Care (Intravenous access) Wiki 0.18
drug1720 Intraosseous access Wiki 0.18
drug3469 Throat swab and/or nasopharyngeal swab Wiki 0.18
drug1180 Emergency surgery Wiki 0.18
drug1179 Emergency Ventilator Splitter Wiki 0.18
drug682 CPAP treatment Wiki 0.18
drug3197 Standard Dissemination Practice Wiki 0.18
drug656 COVID-19 diagnostic PCR Wiki 0.18
drug638 COVID-19 PCR Wiki 0.18
drug642 COVID-19 Pandemic Wiki 0.18
drug3695 WHOQOL-BREF survey Wiki 0.18
drug551 Bridge therapy Wiki 0.18
drug3868 e-ink screen Wiki 0.18
drug1642 Implementation Facilitation (IF) Wiki 0.18
drug571 Buprenorphine Sublingual Product Wiki 0.18
drug4128 stress and anxiety questionnaire Wiki 0.18
drug1724 Intravenous access Wiki 0.18
drug2888 Retrospective data collection Wiki 0.18
drug1295 Farmalarm Wiki 0.18
drug1178 Emergency Laparotomy Wiki 0.18
drug2130 NIO® (Intraosseous access) Wiki 0.18
drug1082 Doctor Spot Wiki 0.18
drug2671 Prophylactic/Intermediate Dose Enoxaparin Wiki 0.18
drug581 CAM2038 Wiki 0.18
drug2002 Medium dosage Inactivated SARS-CoV-2 Vaccine on a 0- and 28-day schedule Wiki 0.13
drug3989 nasopharyngeal swab Wiki 0.13
drug2554 Placebo on a 0- and 28-day schedule Wiki 0.13
drug1886 Low dosage Inactivated SARS-CoV-2 Vaccine on a 0- and 28-day schedule Wiki 0.13
drug1480 High dosage Inactivated SARS-CoV-2 Vaccine on a 0- and 28-day schedule Wiki 0.13
drug997 Data collection Wiki 0.10
drug4130 survey Wiki 0.07
drug3812 blood sample Wiki 0.06
drug2931 Ruxolitinib Wiki 0.06
drug1196 Enoxaparin Wiki 0.05
drug2215 No intervention Wiki 0.04
drug2741 Questionnaire Wiki 0.03

Correlated MeSH Terms (20)


Name (Synonyms) Correlation
D051271 Headache Disorders, Secondary NIH 0.18
D005157 Facial Pain NIH 0.18
D000435 Alcoholic Intoxication NIH 0.18
Name (Synonyms) Correlation
D006261 Headache NIH 0.13
D021821 Communicable Diseases, Emerging NIH 0.13
D008881 Migraine Disorders NIH 0.09
D006323 Heart Arrest NIH 0.09
D011183 Postoperative Complications NIH 0.09
D000428 Alcohol Drinking NIH 0.08
D007511 Ischemia NIH 0.07
D004417 Dyspnea NIH 0.06
D019966 Substance-Related Disorders NIH 0.05
D007251 Influenza, Human NIH 0.04
D014947 Wounds and Injuries NIH 0.03
D004194 Disease NIH 0.03
D003141 Communicable Diseases NIH 0.03
D014777 Virus Diseases NIH 0.02
D007239 Infection NIH 0.02
D045169 Severe Acute Respiratory Syndrome NIH 0.01
D018352 Coronavirus Infections NIH 0.01

Correlated HPO Terms (4)


Name (Synonyms) Correlation
HP:0002315 Headache HPO 0.13
HP:0002076 Migraine HPO 0.10
HP:0001695 Cardiac arrest HPO 0.09
Name (Synonyms) Correlation
HP:0002098 Respiratory distress HPO 0.06

Clinical Trials

Navigate: Correlations   HPO

There are 31 clinical trials


1 Burden of Influenza-related Hospitalizations and Emergency Room Visits in Children in Spain

This study aims to quantify the inpatient and ER visits burden of laboratory-confirmed influenza, and compare the clinical features, severity, complications, risk factors and socioeconomic impact of influenza in children presenting with acute respiratory illness (ARI) and/or isolated fever, with or without laboratory-confirmed influenza.

NCT01592799
Conditions
  1. Influenza
Interventions
  1. Procedure: Throat swab and/or nasopharyngeal swab
  2. Other: Data collection
MeSH:Influenza, Human Emergencies

Primary Outcomes

Description: ARI was defined as one or more of the following symptoms: sore throat (in children greater than or equal to (≥) 3 years old), coryza (runny nose), cough, breathing difficulties. Isolated fever was defined as: oral temperature ≥37.5°C / axillary temperature ≥37.5°C / Rectal temperature ≥38°C / tympanic temperature on oral setting ≥37.5°C / tympanic temperature on rectal setting ≥38°C without an obvious cause.

Measure: Number of Subjects With Laboratory-confirmed Influenza Presenting With an Acute Respiratory Illness (ARI) and/or Isolated Fever

Time: Day 0 till Day 28-37

Description: Ward specific room charge and Intensive Care Unit (ICU) were computed as daily charge multiplied by the number of days.

Measure: Direct Medical Cost Per Hospitalization or ER Visit With Laboratory-confirmed Influenza

Time: Day 0 till Day 28-37

Secondary Outcomes

Description: Among the other laboratory-confirmed respiratory viruses there were:adenovirus, respiratory syncytial virus, parainfluenza virus 1, 2 and 3, metapneumovirus, bocavirus, rhinovirus or coronavirus. The outcome was assessed in subjects with an acute respiratory illness (ARI) and/or isolated fever episode.

Measure: Number of Subjects With Other Laboratory-confirmed Respiratory Viruses

Time: Day 0 till Day 28-37

Description: Deaths from ARI and/or fever episodes by laboratory-confirmed influenza status were assessed.

Measure: Number of Subjects With Fatal Outcomes

Time: Day 0 till Day 28-37

Description: The outcome assessed the various complications by laboratory-confirmed influenza status.

Measure: Number of Subjects With Secondary Bacterial Infections

Time: Day 0 till Day 28-37

Description: Risk factors were classified as pre-existing conditions, breast-feeding status and day-care status.

Measure: Number of Subjects With Potential Risk Factors at Study Start by Laboratory-confirmed Influenza Status

Time: Day 0 till Day 28-37

Description: The outcomes was assessed in subjects with laboratory-confirmed influenza status

Measure: Number of Days of Hospitalization

Time: Day 0 till Day 28-37 (between October 2010 until May 2011)

Description: ARI and/or fever related medication included: antivirals, antibiotics, cough suppressants, pain medication, antipyretics and mucolytics.

Measure: Number of Subjects Using Any ARI and/or Fever Related Medication Taken Prior to Hospitalization or ER Visit by Laboratory-confirmed Influenza Status

Time: Day 0 till Day 28-37

Description: ARI and/or fever related medication included: antivirals, antibiotics, cough suppressants, pain medication, antipyretics and mucolytics.

Measure: Number of Subjects Using Any ARI and/or Fever Related Medication Prescribed During Hospitalization or ER Visit by Laboratory-confirmed Influenza Status

Time: Day 0 till Day 28-37

Description: ARI and/or fever related medication included: antivirals, antibiotics, cough suppressants, pain medication, antipyretics and mucolytics.

Measure: Number of Subjects Using Any ARI and/or Fever Related Medication Prescribed Since Hospitalization or ER Visit by Laboratory-confirmed Influenza Status

Time: Day 0 till Day 28-37

Description: ARI and/or fever related medication included: antivirals, antibiotics, cough suppressants, pain medication, antipyretics and mucolytics.

Measure: Number of Subjects Using Any Non-prescribed ARI and/or Fever Related Medication Taken Since Hospitalization or ER Visit

Time: Day 0 till Day 28-37

Description: School absenteeism was assessed among patients during the follow-up period by laboratory-confirmed influenza status.

Measure: Number of Days of School Absenteeism

Time: Day 0 till Day 28-37

Description: This outcome assessed absenteeism among caregivers to provide patient care during the follow-up period by laboratory-confirmed influenza status.

Measure: Number of Days of Parent or Caregiver Time Off Work

Time: Day 0 till Day 28-37

Description: This outcome assessed the number of cases with household contacts presenting influenza like illness symptoms during the follow-up period by laboratory-confirmed influenza status.

Measure: Number of Subjects With Household Members With Influenza-like Illness

Time: Day 0 till Day 28-37

Description: This outcome assessed the proportion of influenza like illness (ILI) among household members of children < 15 years with and without laboratory-confirmed influenza.

Measure: Proportion of Household Members Presenting Influenza Like Illness Symptoms (ARI and/or Isolated Fever)

Time: Day 0 till Day 28-37
2 Opioid Use Disorder in the Emergency Department: Clinical Trials Network-0069

The purpose of this study is to evaluate the impact of (1) Implementation Facilitation (IF) on rates of provision of Emergency Department (ED)-initiated buprenorphine/naloxone (BUP) treatment with referral for ongoing medication-assisted treatment (MAT) and the (2) effectiveness of IF on patient engagement in formal addiction treatment at 30 days.

NCT03023930
Conditions
  1. Opioid Use Disorder
Interventions
  1. Other: Standard Dissemination Practice
  2. Other: Implementation Facilitation (IF)
MeSH:Disease Emergencies Substance-Related Disorders

Primary Outcomes

Description: The primary implementation outcome will be evaluated assessing the rate of ED-initiated BUP therapy with referral for ongoing MAT over the 12 month period.

Measure: Implementation (Considered the Primary Outcome)

Time: 12 months

Description: The primary effectiveness outcome is defined as the rates of patient engagement in formal addiction treatment on the 30th day post enrollment.

Measure: Effectiveness

Time: 30 Days Post Enrollment

Secondary Outcomes

Description: Fidelity will be measured using a critical action checklist relating to the provision of ED-initiated BUP with referral for ongoing MAT in eligible patients.

Measure: Implementation: Fidelity

Time: Baseline Period (Baseline)

Description: Fidelity will be measured using a critical action checklist relating to the provision of ED-initiated BUP with referral for ongoing MAT in eligible patients.

Measure: Implementation: Fidelity

Time: IF Evaluation Period (18 months)

Description: ED provider readiness and preparedness ruler score to initiate BUP and provide referral for ongoing MAT

Measure: Implementation: ED provider Readiness and Preparedness Ruler Score

Time: Pre IF (Baseline)

Description: ED provider readiness and preparedness ruler score to initiate BUP and provide referral for ongoing MAT

Measure: Implementation: ED provider Readiness and Preparedness Ruler Score

Time: Post IF (6 months)

Description: ED provider readiness and preparedness ruler score to initiate BUP and provide referral for ongoing MAT

Measure: Implementation: ED provider Readiness and Preparedness Ruler Score

Time: post IF Evaluation Period (12 months)

Description: ED ORCA score relating to ED-initiated BUP with referral for ongoing MAT

Measure: Implementation: ED Organizational Readiness to Change Assessment (ORCA) Score

Time: Pre IF (Baseline)

Description: ED ORCA score relating to ED-initiated BUP with referral for ongoing MAT

Measure: Implementation: ED Organizational Readiness to Change Assessment (ORCA) Score

Time: Post IF (6 months)

Description: ED ORCA score relating to ED-initiated BUP with referral for ongoing MAT

Measure: Implementation: ED Organizational Readiness to Change Assessment (ORCA) Score

Time: Post IF Evaluation Period (12 months)

Description: Community opioid treatment provider/program readiness and preparedness ruler score to continue MAT for patients with OUD who have received ED-initiated BUP

Measure: Implementation: Community Readiness and Preparedness Ruler Score

Time: Pre IF (Baseline)

Description: Community opioid treatment provider/program readiness and preparedness ruler score to continue MAT for patients with OUD who have received ED-initiated BUP

Measure: Implementation: Community Readiness and Preparedness Ruler Score

Time: Post IF (6 months)

Description: Community opioid treatment provider/program readiness and preparedness ruler score to continue MAT for patients with OUD who have received ED-initiated BUP

Measure: Implementation: Community Readiness and Preparedness Ruler Score

Time: post IF Evaluation Period (12 months)

Description: Community opioid treatment provider/program ORCA score relating to receiving patients with OUD who have received ED-initiated BUP

Measure: Implementation: Community ORCA Score

Time: Pre IF (Baseline)

Description: Community opioid treatment provider/program ORCA score relating to receiving patients with OUD who have received ED-initiated BUP

Measure: Implementation: Community ORCA Score

Time: Post IF (6 months)

Description: Community opioid treatment provider/program ORCA score relating to receiving patients with OUD who have received ED-initiated BUP

Measure: Implementation: Community ORCA Score

Time: post IF Evaluation Period (12 months)

Description: Self-reported days of illicit opioid use (past 7 days) as measured by Time-Line Follow-Back methods at 30 days

Measure: Effectiveness: Opioid Use

Time: 30 days post enrollment

Description: Overdose event (past 30 days) captured by participant self-report, state medical examiner records, National Death Index and review of medical records

Measure: Effectiveness: Overdose Event

Time: 30 days post enrollment

Description: HIV risk taking behaviors (past 30 days) as measured by HIV Risk Taking Behavior Scale

Measure: Effectiveness: HIV Risk

Time: 30 days post enrollment

Description: All Healthcare Service Utilization Inpatient and Outpatient

Measure: Effectiveness: Healthcare Service Utilization

Time: 30 days post enrollment

Description: Rates of illicit opioid negative urines

Measure: Effectiveness: Illicit Opioid Urine Toxicology

Time: 30 days post enrollment
3 Emergency Department-Initiated Buprenorphine Validation Network Trial

This study will (1) recruit, train and provide resources to approximately 30 Emergency Department (ED) sites throughout the U.S. using implementation facilitation strategies to provide ED-initiated buprenorphine (BUP) for patients presenting with opioid use disorder (OUD) who are not receiving medications for opioid use disorder (MOUD). Once implementation is adequately achieved, the sites will (2) conduct a randomized controlled trial (RCT) to compare the effectiveness of sublingual buprenorphine (SL-BUP) versus extended-release buprenorphine (XR-BUP) on ED patients' engagement in formal addiction treatment 7-days after their ED visit. In addition, in an ancillary component of the study, the investigators will (3) assess the use of XR-BUP in ED patients with Clinical Opioid Withdrawal Scale (COWS) scores < 8 in a case series to potentially expand the eligibility of patients in the larger RCT to those presenting with little to no opioid withdrawal symptoms. Finally, the investigators will (4) develop and validate ED electronic health record (EHR) opioid-related phenotypes, both of which will inform the main RCT.

NCT04225598
Conditions
  1. Opioid-use Disorder
Interventions
  1. Drug: CAM2038
  2. Drug: Buprenorphine Sublingual Product
MeSH:Emergencies

Primary Outcomes

Description: Engagement in formal addiction treatment will be defined as enrollment and receiving formal addiction treatment on the 7th day post randomization, confirmed by contact with the facility and/or treating clinician. Formal addiction treatment will be operationally defined as those treatments consistent with the American Society of Addiction Medicine's levels of care (1-4) and can include a range of clinical settings including office-based providers of BUP or naltrexone, opioid treatment programs (OTPs), intensive outpatient, inpatient, or residential treatments. Patients do not need to be receiving MOUD at 7 days to be considered engaged in formal addiction treatment. Participation in a mutual-help program such as Alcoholics Anonymous (AA) or (Narcotics Anonymous) NA alone will not be considered as engagement in formal addiction treatment. Additional analyses evaluating the effects of patient and site characteristics will also be conducted.

Measure: RCT Component: Patient engagement (yes/no) in formal addiction treatment at 7 days post randomization

Time: 7 days post randomization

Description: Engagement in formal addiction treatment will be defined as enrollment in formal addiction treatment on the 30th day post randomization, confirmed by direct contact with the facility and/or treating clinician. Formal addiction treatment will be operationally defined as those treatments consistent with the American Society of Addiction Medicine's levels of care (1-4) and can include a range of clinical settings including office-based providers of BUP or naltrexone, OTPs, intensive outpatient, inpatient, or residential treatments. Patients do not need to be receiving MOUD on the 30th day post randomization to be considered engaged in formal addiction treatment. Participation in a mutual-help program such as Alcoholics or Narcotics Anonymous alone will not be considered as engagement in formal addiction treatment. Additional analyses evaluating the effects of patient and site characteristics will also be conducted.

Measure: RCT Component: Patient engagement (yes/no) in formal addiction treatment at 30 days post randomization

Time: 30 days post randomization

Description: The primary economic outcome will be the incremental cost-effectiveness ratio (ICER). The ICER will be calculated as the incremental mean cost of XR-BUP relative to SL-BUP, divided by the incremental mean effectiveness of XR-BUP relative to SL-BUP. Measures of effectiveness include: engagement in formal addiction treatment at 7 days and on the 30th day; quality-adjusted life-years (QALYs) gained; and Abstinent Years, a measure of time abstinent from opioids.

Measure: RCT Component: Cost effectiveness of XR-BUP compared to SL-BUP at 7 days post randomization

Time: 7 days post randomization

Description: The primary economic outcome will be the incremental cost-effectiveness ratio (ICER). The ICER will be calculated as the incremental mean cost of XR-BUP relative to SL-BUP, divided by the incremental mean effectiveness of XR-BUP relative to SL-BUP. Measures of effectiveness include: engagement in formal addiction treatment at 7 days and on the 30th day; quality-adjusted life-years (QALYs) gained; and Abstinent Years, a measure of time abstinent from opioids.

Measure: RCT Component: Cost effectiveness of XR-BUP compared to SL-BUP at 30 days post randomization

Time: 30 days post randomization

Secondary Outcomes

Description: self-report verified with treatment provider(s)

Measure: RCT Component: Engagement in MOUD (yes/no) at 7 days post randomization

Time: 7 days post randomization

Description: The Timeline Follow-back procedure will be used to elicit the patient participant's self-reported days of use of opioids.

Measure: RCT Component: Self-reported days of illicit opioid use (past 7 days) at 7 days post randomization

Time: 7 days post randomization

Description: The Timeline Follow-back procedure will be used to elicit the patient participant's self-reported quantity of use of opioids.

Measure: RCT Component: Self-reported days (quantity) of illicit opioid use (past 7 days) at 7 days post randomization

Time: 7 days post randomization

Description: The Timeline Follow-back procedure will be used to elicit the patient participant's self-reported route of administration of use of opioids.

Measure: RCT Component: Self-reported days (route of administration) of illicit opioid use (past 7 days) at 7 days post randomization

Time: 7 days post randomization

Description: The investigators will use visual analogue scales (VAS) to assess craving, desire to use opioids and need to use opioids with a scale of 0-100.

Measure: RCT Component: Craving scores at 7 days post randomization

Time: 7 days post randomization

Description: The investigators will modify the patient satisfaction scale where overall experience is rated from 1 to 5 (1 is completely ineffective and 5 is completely effective) and treatment characteristics are rated 1 to 7 (1 is not important and 7 is extremely important) based on previous published data.

Measure: RCT Component: Patient satisfaction with BUP at 7 days post randomization

Time: 7 days post randomization

Description: self report verified with treatment provider(s)

Measure: RCT Component: Patient Engagement in MOUD (yes/no) at 30 days post randomization

Time: 30 days post randomization

Description: The Timeline Follow-back procedure will be used to elicit the patient participant's self-reported days of use of opioids.

Measure: RCT Component: Self-reported days of illicit opioid use (past 7 days) at 30 days post randomization

Time: 30 days post randomization

Description: The Timeline Follow-back procedure will be used to elicit the patient participant's self-reported quantity of use of opioids.

Measure: RCT Component: Self-reported days (quantity) of illicit opioid use (past 7 days) at 30 days post randomization

Time: 30 days post randomization

Description: The Timeline Follow-back procedure will be used to elicit the patient participant's self-reported route of administration of use of opioids.

Measure: RCT Component: Self-reported days (route of administration) of illicit opioid use (past 7 days) at 30 days post randomization

Time: 30 days post randomization

Description: A brief, structured interview regarding health care utilization (inpatient and outpatient) will be used, which collects information on the type and amount of services received. This includes ED visits, hospitalizations, primary medical care visits (excluding those for BUP treatment and self-help sources of support (e.g., NA).

Measure: RCT Component: Healthcare services utilization (past 30 days) regarding ED visits and hospitalizations at 30 days post randomization

Time: 30 days post randomization

Description: Assessment of past 30-day overdose events will be completed at 30 days post study enrollment. In addition, Site PIs will search local electronic medical records for fatal and non-fatal overdose events.

Measure: RCT Component: Overdose Events at 30 days post randomization

Time: 30 days post randomization

Measure: BUP Implementation Component (ED): Change in the number of ED visits during which BUP is administered in the ED (prior 30 days)

Time: Baseline to site initiation (up to 8 months post baseline)

Measure: BUP Implementation Component (ED): Change in the number of ED visits during which BUP is administered in the ED (prior 30 days )

Time: Site initiation to 6 months post site initiation

Measure: BUP Implementation Component (ED): Change in the umber of ED visits during which BUP is administered in the ED (prior 30 days)

Time: 6 months post site initiation to 12 months post site initiation

Measure: BUP Implementation Component (ED): Change in the number of ED visits during which patients receive a prescription for BUP in the ED (prior 30 days )

Time: Baseline to site initiation (up to 8 months post baseline)

Measure: BUP Implementation Component (ED): Change in the number of ED visits during which patients receive a prescription for BUP in the ED (prior 30 days)

Time: Site initiation to 6 months post site initiation

Measure: BUP Implementation Component (ED): Change in the number of ED visits during which patients receive a prescription for BUP in the ED (prior 30 days)

Time: 6 months post site initiation to 12 months post site initiation

Measure: BUP Implementation Component (ED): Change in the number of unique ED prescribers who are DATA 2000 X-waivered (prior 30 days)

Time: Baseline to site initiation (up to 8 months post baseline)

Measure: BUP Implementation Component (ED): Change in the number of unique ED prescribers who are DATA 2000 X-waivered (prior 30 days)

Time: Site initiation to 6 months post site initiation

Measure: BUP Implementation Component (ED): Change in the number of unique ED prescribers who are DATA 2000 X-waivered (prior 30 days)

Time: 6 months post site initiation to 12 months post site initiation

Measure: BUP Implementation Component (ED): Change in the number of unique ED prescribers who administered BUP in the ED (prior 30 days)

Time: Baseline to site initiation (up to 8 months post baseline)

Measure: BUP Implementation Component (ED): Change in the number of unique ED prescribers who administered BUP in the ED (prior 30 days)

Time: Site initiation to 6 months post site initiation

Measure: BUP Implementation Component (ED): Change in the number of unique ED prescribers who administered BUP in the ED (prior 30 days)

Time: 6 months post site initiation to 12 months post site initiation

Measure: BUP Implementation Component (ED): Change in the number of unique ED prescribers who are prescribing BUP from the ED (prior 30 days)

Time: Baseline to site initiation (up to 8 months post baseline)

Measure: BUP Implementation Component (ED): Change in the number of unique ED prescribers who are prescribing BUP from the ED (prior 30 days)

Time: Site initiation to 6 months post site initiation

Measure: BUP Implementation Component (ED): Change in the number of unique ED prescribers who are prescribing BUP from the ED (prior 30 days)

Time: 6 months post site initiation to 12 months post site initiation

Measure: BUP Implementation Component (ED): Change in the percent adherence to the critical action checklist for ED-initiated SL-BUP and XR-BUP (prior 30 days)

Time: Baseline to site initiation (up to 8 months post baseline)

Measure: BUP Implementation Component (ED): Change in the percent adherence to the critical action checklist for ED-initiated SL-BUP and XR-BUP (prior 30 days)

Time: Site initiation to 6 months post site initiation

Measure: BUP Implementation Component (ED): Change in the percent adherence to the critical action checklist for ED-initiated SL-BUP and XR-BUP (prior 30 days)

Time: 6 months post site initiation to 12 months post site initiation

Measure: BUP Implementation Component (ED): Change in the number of ED prescribers who fully adhere to the critical action checklist (prior 30 days)

Time: Baseline to site initiation (up to 8 months post baseline)

Measure: BUP Implementation Component (ED): Change in the number of ED prescribers who fully adhere to the critical action checklist (prior 30 days)

Time: Site initiation to 6 months post site initiation

Measure: BUP Implementation Component (ED): Change in the number of ED prescribers who fully adhere to the critical action checklist (prior 30 days)

Time: 6 months post site initiation to 12 months post site initiation

Measure: BUP (XR and SL) Implementation Component (Community): Change in number of programs accepting patients into formal addiction treatment at 7 days following the ED visits

Time: Baseline to site initiation (up to 8 months post baseline)

Measure: BUP (XR and SL) Implementation Component (Community): Change in number of programs accepting patients into formal addiction treatment at 7 days following the ED visits

Time: Site Initiation to 6 months post site initiation

Measure: BUP (XR and SL) Implementation Component (Community): Change in number of programs accepting patients into formal addiction treatment at 7 days following the ED visits

Time: 6 months post site initiation to 12 months post site initiation

Measure: BUP (XR and SL) Implementation Component (Community): Change in number of formal systems (e.g., formal, informal, feedback) pathways in place for arranging referrals for ongoing MOUD.

Time: Baseline to site initiation (up to 8 months post baseline)

Measure: BUP (XR and SL) Implementation Component (Community): Change in number of formal systems (e.g., formal, informal, feedback) pathways in place for arranging referrals for ongoing MOUD.

Time: Site initiation to 6 months post site initiation

Measure: BUP (XR and SL) Implementation Component (Community): Change in number of formal systems (e.g., formal, informal, feedback) pathways in place for arranging referrals for ongoing MOUD.

Time: 6 months post site initiation to 12 months post site initiation

Measure: BUP (XR and SL) Implementation Component (Community): Change in proportion of patients engaged in formal addiction treatment at 7 days following the ED visit

Time: Baseline to site initiation (up to 8 months post baseline)

Measure: BUP (XR and SL) Implementation Component (Community): Change in proportion of patients engaged in formal addiction treatment at 7 days following the ED visit

Time: Site initiation to 6 months post site initiation

Measure: BUP (XR and SL) Implementation Component (Community): Change in proportion of patients engaged in formal addiction treatment at 7 days following the ED visit

Time: 6 months post site initiation to 12 months post site initiation

Measure: BUP (XR and SL) Implementation Component (Community): Change in proportion of patients engaged in MOUD at 7 days following the ED visit

Time: Baseline to site initiation (up to 8 months post baseline)

Measure: BUP (XR and SL) Implementation Component (Community): Change in proportion of patients engaged in MOUD at 7 days following the ED visit

Time: Site initiation to 6 months post site initiation

Measure: BUP (XR and SL) Implementation Component (Community): Change in proportion of patients engaged in MOUD at 7 days following the ED visit

Time: 6 months post site initiation to 12 months post site initiation

Description: The investigators will use a visual analogue scale (VAS) "Desire to Use" to assess craving. Participants will be asked "At this moment I desire opioids" and indicate on the line the point that corresponds to the extent to which they desire opioids. Anchors will include 0 mm - "definitely not" to 100 mm - "definitely so". At follow up daily calls they will report a number between 0 and 100.

Measure: Ancillary Component: Desire to Use post XR-BUP injection at ED Index Visit (Day 0)

Time: Pre-injection and 240 minutes post injection

Description: The investigators will use a VAS to assess bad drug effects. Participants will be asked to respond to the statement: "At this moment, I feel bad drug effects" and place a mark across the line at the point that corresponds to the extent to which they are feeling any bad drug effects. Anchors will include 0 mm - 'not at all' to 100 mm - 'extremely'.

Measure: Ancillary Component: Bad drug effects post XR-BUP injection at ED Index Visit (Day 0)

Time: Pre-injection and 240 minutes post injection

Description: Adjective Rating Scale for Withdrawal (ARSW) - The ARSW is a 16-item self-report scale that measures subjective severity of opioid withdrawal and symptoms using a scale of 1 to 9 (1 is none and 9 is severe).

Measure: Ancillary Component: Changes in withdrawal severity at post XR-BUP injection at ED Index Visit (Day 0)

Time: Pre-injection and 240 minutes post-injection

Description: Participants will report the degree of pain at the injection site after the injection is administered using a numerical rating scale ranging from 0 - no pain to 10 - worst possible pain.

Measure: Ancillary Component: Pain at injection site post XR-BUP injection at ED Index Visit (Day 0)

Time: Immediately following XR-BUP injection, 30 minutes and 240 minutes post injection

Description: Vital signs (temperature) collected while sitting, following a rest period of at least 3 minutes are used to medically monitor any changes during the 240 minute time frame.

Measure: Ancillary Component: Vital Signs (temperature) post XR-BUP injection at ED Index Visit (Day 0)

Time: Every 30 minutes for a total of 240 minutes post XR-BUP injection

Description: Vital signs (systolic blood pressure, mmHg) collected while sitting, following a rest period of at least 3 minutes are used to medically monitor any changes during the 240 minute time frame.

Measure: Ancillary Component: Vital Signs (blood pressure- systolic) post XR-BUP injection at ED Index Visit- (Day 0)

Time: Every 30 minutes for a total of 240 minutes post XR-BUP injection

Description: Vital signs (diastolic blood pressure, mmHg) collected while sitting, following a rest period of at least 3 minutes are used to medically monitor any changes during the 240 minute time frame.

Measure: Ancillary Component: Vital Signs (diastolic blood pressure) post XR-BUP injection at ED Index Visit- (Day 0)

Time: Every 30 minutes for a total of 240 minutes post XR-BUP injection

Description: Vital signs (pulse rate- beats per minute) collected while sitting, following a rest period of at least 3 minutes are used to medically monitor any changes during the 240 minute time frame.

Measure: Ancillary Component: Vital Signs (pulse rate) post XR-BUP injection at ED Index Visit- (Day 0)

Time: Every 30 minutes for a total of 240 minutes post XR-BUP injection

Description: Vital signs (respiratory rate- breaths/min) collected while sitting, following a rest period of at least 3 minutes are used to medically monitor any changes during the 240 minute time frame.

Measure: Ancillary Component: Vital Signs (respiratory rate) post XR-BUP injection at ED Index Visit- (Day 0)

Time: Every 30 minutes for a total of 240 minutes post XR-BUP injection

Description: Vital signs (oxygen saturation- collected while sitting, following a rest period of at least 3 minutes) collected while sitting, following a rest period of at least 3 minutes are used to medically monitor any changes during the 240 minute time frame.

Measure: Ancillary Component: Vital Signs (oxygen saturation) post XR-BUP injection at ED Index Visit- (Day 0)

Time: Every 30 minutes for a total of 240 minutes post XR-BUP injection

Description: Clinical Opiate Withdrawal Scale (COWS) - the COWS is a validated measure of the severity of opioid withdrawal that consists of 11 subjective and objective items. Scores on the individual items are combined to a single overall score that has been used to determine the SL-BUP induction strategy. COWS scoring, and interpretation is as follows: Score: 5-12 = mild opioid withdrawal; 13-24 = moderate opioid withdrawal; 25-36 = moderately severe opioid withdrawal; more than 36 = severe opioid withdrawal.

Measure: Ancillary Component: Changes in withdrawal severity (COWS) at post XR-BUP injection at ED Index Visit (Day 0)

Time: Every 30 minutes for a total of 240 minutes post XR-BUP injection

Description: The Objective Opioid Withdrawal Scale (OOWS) - The OOWS is a validated measure of the severity of opioid withdrawal that consists of 13 objective items.

Measure: Ancillary Component: Changes in withdrawal severity (OOWS) at post XR-BUP injection at ED Index Visit (Day 0)

Time: Every 30 minutes for a total of 240 minutes post XR-BUP injection

Description: Adjective Rating Scale for Withdrawal (ARSW) - The ARSW is a 16-item self-report scale that measures subjective severity of opioid withdrawal and symptoms using a scale of 1 to 9 (1 is none and 9 is severe).

Measure: Ancillary Component: Changes in withdrawal severity (ARSW) at post XR-BUP injection at ED Index Visit (Day 0)

Time: Every 30 minutes for a total of 240 minutes post XR-BUP injection

Description: This will be assessed via pupillometry. Two measurements should be taken and if they are discrepant by >0.5mm discrepant, the Research Associate will need to repeat assessment until they achieve two consecutive readings with agreement of <0.5mm. The average of the two measurements is entered.

Measure: Ancillary Component: Pupillary diameter post XR-BUP injection at ED Index Visit (Day 0)

Time: Every 30 minutes for a total of 240 minutes post XR-BUP injection

Description: SL-BUP and ancillary medications will be provided according to a uniform protocol. Research Associates (RAs) and nurses will document the timing and provision of all medications received before and during the 4-hour observation period in the ED. In addition, the Research Associate will review the electronic medical record to determine any additional medications or intravenous fluids were administered to the patient during their ED visit and the timing of those medications.

Measure: Ancillary Component: Provision of post Injection Medications post XR-BUP injection at ED Index Visit (Day 0)

Time: Every 30 minutes for a total of 240 minutes post XR-BUP injection

Description: Precipitated Withdrawal will be documented on the Precipitated Withdrawal Form along with time of occurrence.

Measure: Ancillary Component: Precipitated Withdrawal (yes/no) post XR-BUP injection at ED Index Visit (Day 0)

Time: Every 30 minutes for a total of 240 minutes post XR-BUP injection

Description: The Research Associate will assess the degree of erythema and swelling at the injection site using a 4-point rating scale ranging from 0 - none to 3-severe.

Measure: Ancillary Component: Local Tolerability post XR-BUP injection at ED Index Visit (Day 0)

Time: At 30 and 240 minutes post XR-BUP injection

Measure: Ancillary Component: Proportion of participants that experience clinician determined precipitated withdrawal within 1 hour of XR-BUP administration

Time: Within 1 hour post XR-BUP injection

Description: Clinical Opiate Withdrawal Scale (COWS) - the COWS is a validated measure of the severity of opioid withdrawal that consists of 11 subjective and objective items. Scores on the individual items are combined to a single overall score that has been used to determine the SL-BUP induction strategy. COWS scoring, and interpretation is as follows: Score: 5-12 = mild opioid withdrawal; 13-24 = moderate opioid withdrawal; 25-36 = moderately severe opioid withdrawal; more than 36 = severe opioid withdrawal.

Measure: Ancillary Component: Proportion of participants that experience a 5 or greater increase in COWS score within 4 hours of of XR-BUP administration

Time: Within 4 hours of XR-BUP administration

Description: Clinical Opiate Withdrawal Scale (COWS) - the COWS is a validated measure of the severity of opioid withdrawal that consists of 11 subjective and objective items. Scores on the individual items are combined to a single overall score that has been used to determine the SL-BUP induction strategy. COWS scoring, and interpretation is as follows: Score: 5-12 = mild opioid withdrawal; 13-24 = moderate opioid withdrawal; 25-36 = moderately severe opioid withdrawal; more than 36 = severe opioid withdrawal.

Measure: Ancillary Component: Proportion of participants that transition to moderate withdrawal (COWS 13-24) within 4 hours of XR-BUP administration

Time: Within 4 hours of XR-BUP administration

Description: The Daily Substance Use assessment solicits participant use of substances of interest daily via a text-messaging application.

Measure: Ancillary Component: Daily Substance Use (Days 1-6 post injection)

Time: Days 1-6 post injection

Description: The investigators will use a visual analogue scale (VAS) "Desire to Use" to assess craving. Participants will be asked "At this moment I desire opioids" and indicate on the line the point that corresponds to the extent to which they desire opioids. Anchors will include 0 mm - "definitely not" to 100 mm - "definitely so". At follow up daily calls they will report a number between 0 and 100 (daily via a text-messaging application).

Measure: Ancillary Component: Desire to Use (Days 1-6 post injection)

Time: Days 1-6 post injection

Description: Urine testing will be performed for the presence of the following drugs: opioids, oxycodone, benzodiazepines, cocaine, methamphetamine, amphetamine, ecstasy (MDMA), marijuana (THC), barbiturate, methadone, buprenorphine, and fentanyl.

Measure: Ancillary Component: Presence of opioids, oxycodone, benzodiazepines, cocaine, methamphetamine, amphetamine, ecstasy (MDMA), marijuana (THC), barbiturate, methadone, buprenorphine and fentanyl (7 days post injection)

Time: 7 days post injection

Description: Clinical Opiate Withdrawal Scale (COWS) - the COWS is a validated measure of the severity of opioid withdrawal that consists of 11 subjective and objective items. Scores on the individual items are combined to a single overall score that has been used to determine the SL-BUP induction strategy. COWS scoring, and interpretation is as follows: Score: 5-12 = mild opioid withdrawal; 13-24 = moderate opioid withdrawal; 25-36 = moderately severe opioid withdrawal; more than 36 = severe opioid withdrawal.

Measure: Ancillary Component: Opioid Withdrawal (7 days post injection)

Time: 7 days post injection

Description: The Daily Substance Use assessment solicits participant use of substances of interest.

Measure: Ancillary Component: Daily Substance Use (7 days post injection)

Time: 7 days post injection

Description: The investigators will use a visual analogue scale (VAS) "Desire to Use" to assess craving. Participants will be asked "At this moment I desire opioids" and indicate on the line the point that corresponds to the extent to which they desire opioids. Anchors will include 0 mm - "definitely not" to 100 mm - "definitely so". At follow up daily calls they will report a number between 0 and 100

Measure: Ancillary Component: Desire to Use (7 days post injection)

Time: 7 days post injection

Description: At 7-day follow up the participant will be queried about pain, itching, discharge and tenderness at the site. Study staff will examine the patient for erythema at the injection.

Measure: Ancillary Component: Injection Site Reactions (7 days post injection)

Time: 7 days post injection

Description: Participant satisfaction and preference will be assessed using quantitative and qualitative mixed methods at 7-day follow-up. Satisfaction will be rated on a Likert 1-5 scale by the participant, and preference order ranking to receive ongoing treatment with SL-BUP, preference to receive ongoing treatment with XR-BUP, and preference to not receive any formulation of BUP will be ranked. The investigators will use open-ended questions to explore patient satisfaction, preference and study experience.

Measure: Ancillary Component: Patient satisfaction with BUP (7 days post injection)

Time: 7 days post injection

Description: A brief, structured interview (not scored) regarding health care utilization (inpatient and outpatient) will be used, which collects information on the type and amount of services received. This includes ED visits, hospitalizations, primary medical care visits (excluding those for BUP treatment and self-help sources of support (e.g., NA).

Measure: Ancillary Component: Health Services Utilization (7 days post injection)

Time: 7 days post injection

Description: At 7 days post enrollment, participants will be asked to report OUD treatment received. Data will be reported on the Engagement in Treatment - Patient Survey (not scored).

Measure: Ancillary Component: Engagement in Treatment (7 days post injection)

Time: 7 days post injection

Description: Assessment of past 30-day overdose events will be completed at day 7 In addition, Site PIs will search local electronic medical records for fatal and non-fatal overdose events.

Measure: Ancillary Component: Overdose Events (7 days post injection)

Time: 7 days post injection
4 COVID-19 Seroconversion Among Medical and Paramedical Staff in Emergency, ICU and Infectious Disease Services During the 2020 Epidemic

The epidemic due to the Sars-CoV2 virus is spreading in France, without knowning precisely since when the virus has actually circulated on the territory. Data from China but also systematic samples taken from the passengers of the Diamond Princess boat also report almost 50% of asymptomatic forms of Covid-19. The medical and paramedical staff of the front-line services for the care of patients infected with Covid-19 are in fact potentially exposed to the risk of occupational contamination due to the large number of patients treated, including in the pre-epidemic phase. Therefore, and despite the application of standard protective measures, it is possible that a certain number of these personnel already have or will contract Covid-19 disease, including in its asymptomatic form.

NCT04304690
Conditions
  1. Sars-CoV2
Interventions
  1. Other: blood sample
MeSH:Communicable Diseases Infection Emergencies

Primary Outcomes

Description: Sars-CoV2 seroconversion is defined by a T0 sample with no specific antibody (negative) and M3 sample with the presence of specific IgG.

Measure: Quantify the proportion of patients with documented Sars-CoV2 infection among medical and paramedical staff

Time: 3 months

Secondary Outcomes

Description: "Age, gender, type of staff, medical staff: resident, Clinic Chief or University Hospital Assistant (CCA / AHU), Associate Practitioner (PA), Contractual Hospital Practitioner (PHC), Hospital Practitioner (PH), Lecturer-Hospital Practitioner (MCU-PH) , University Professor-Hospital Practitioner (PUPH) non-medical staff: nursing assistants (AS), nurses (IDE), physiotherapist, managers, others, Seniority in the profession (number of years) Service tenure (years), Night, day, day or mixed work, Type of service: emergency department, infectious disease service, ICU), Type of hospital (firstline reference hospital or not), Documented contact with a confirmed patient."

Measure: Identification of risk factors for seroconversion

Time: 3 months

Description: "Seroconversion without clinical manifestation (fever, body aches, headache, sweating, chills + respiratory symptoms (cough dyspnea, sputum) or digestive (nausea / vomiting diarrhea abdominal pain) reported via the weekly self-monitoring booklet. The asymptomatic characteristics will be determined by an adjudication committee, in the light of the weekly self-monitoring notebooks, without knowing the results of the serologies."

Measure: Quantify the proportion of asymptomatic infections among staff who have seroconverted

Time: 3 months

Description: "Description of symptomatic infections Clinical manifestations associated with seroconversion. On the intermediate sample if necessary, performed within 10 days of the start of a clinical picture compatible with an acute Sars-CoV2 infection (fever, body aches, headache, sweating, chills + respiratory picture (cough dyspnea, sputum, ) or digestive (nausea / vomiting diarrhea abdominal pain) "

Measure: " Describe symptomatic infections for personnel developing acute clinical (respiratory or digestive) viral syndrome "

Time: 3 months
5 EC-COVID-RCT. Early CPAP in COVID Patients With Respiratory Failure. A Randomized Clinical Trial

The study aims at clarifying whether early treatment with continuous positive airway pressure (CPAP) ventilation is able to reduce the need for intubation or death in patients visiting an emergency department (ED) with known or suspected COVID-19 infection and insufficiency respiratory.

NCT04326075
Conditions
  1. CPAP Ventilation
  2. COVID-19
  3. Emergency Departments
Interventions
  1. Device: CPAP treatment
MeSH:Respiratory Insufficiency Emergencies

Primary Outcomes

Description: The study outcomes will be death or need of intubation within 7 days since ED arrival.

Measure: Death or need of intubation

Time: 7 days since ED arrival

Secondary Outcomes

Description: 30-day mortality

Measure: 30-day mortality

Time: 30 days since ED arrival
6 Prevalence of Covid-19 in Children Admitted to Paediatric Emergency Departments During the Pandemic Period in France

Arriving in December 2019, Coronavirus COVID-19 infection is causing a global pandemic with high morbidity and mortality among adults and especially seniors. The child appears little or no affected by this infection. It is estimated that the child could be asymptomatic or pauci-symptomatic carrier and thus be vector of the disease. For this reason, measures have been taken to close schools and contain populations in a large number of countries, including France. However, there are no data on the prevalence of COVID-19 in children.

NCT04336761
Conditions
  1. Coronavirus
  2. COVID
  3. Infection Viral
Interventions
  1. Diagnostic Test: nasopharyngeal swab
MeSH:Virus Diseases Emergencies

Primary Outcomes

Measure: Prevalence of positivity of COVID-19 virus measured by rt-PCR

Time: At 28 days

Secondary Outcomes

Description: children admitted to pediatric emergencies for respiratory signs Children hospitalized as a result of travelling to pediatric emergency departments for respiratory signs Respiratory asymptomatic children admitted to pediatric emergencies

Measure: Prevalence of positivity of COVID-19 virus measured by rt-PCR in the following subpopulations of emergency patients

Time: at the end an average 28 days

Measure: Respiratory signs of children tested within 28 day

Time: through study completion, an average 28 days

Measure: Percentage of children hospitalized tested within 28 day

Time: through study completion, an average 28 days

Description: the degree of relationship with these contacts and the time spent in contact with them within 24 hours before emergency

Measure: Contact frequency

Time: At inclusion

Measure: Prevalence of positivity of other respiratory viruses measured by rt-PCR

Time: at 28 days
7 The Impact of the Coronavirus Disease 2019 (Covid-19) Outbreak on Emergency Room Attendances of Surgical Patients at a Tertiary Medical Center

Since December 2019, when the novel coronavirus disease (Covid-19) spread throughout the world, data have been needed on the effects of the pandemic on various aspects of healthcare systems. Recommendations for social distancing and quarantine decrees made by local governments, alongside the general public fear from the spread of the virus, are presumed to have markedly affected the trends in hospitals visits. Understanding the exact nature of the effect is critical for better anticipating and preparing health systems in the event of future outbreaks and in the post outbreak period. Therefore we intend to To identify retrospectively all patients who presented to the emergency department at our medical institute between January 1 - March 31 in the following years: 2017, 2018, 2019, 2020. We will examine the impact of COVID-19 on the rates of surgical emergency visits, ratio of surgical visits to non-surgical visits, the ratio of severe presentations to non-severe presentations, and the impact of age on ED attendance.

NCT04338672
Conditions
  1. Emergency Service, Hospital
  2. General Surgery
Interventions
  1. Other: COVID-19 Pandemic
MeSH:Emergencies

Primary Outcomes

Measure: Rates of emergency visits needing surgical consult

Time: January 1 - March 31 in the following years: 2017, 2018, 2019, 2020

Measure: The ratio of severe presentations to non-severe presentations

Time: January 1 - March 31 in the following years: 2017, 2018, 2019, 2020

Secondary Outcomes

Measure: The impact of age on ED attendance rates

Time: January 1 - March 31 in the following years: 2017, 2018, 2019, 2020

Measure: Differences in ED surgical visits (in terms of capacity and severity) of surgical patients depending on the presentation and the co morbidity

Time: January 1 - March 31 in the following years: 2017, 2018, 2019, 2020
8 Registry for Clinical Presentation and Management of Patients With COVID-19 in the Emergency Room

Patients with COVID-19 usually present in the ED and receive their initial medical check-up here. We will try to gather information of comorbidities and other conditions at the time of presentation of COVID-19 patients to the ED. The course of the disease prior to admission as well as the momentary health status at presentation to the ED are of interest because they influence risk stratification and decision-making of treating physicians. The ratio of patients with mild or moderate to severe symptoms will help to calculate the need for hospital beds including beds on Intensive Care Units (ICU) and Intermediate Care Units (IMC), as well as the need for other hospital resources.

NCT04351854
Conditions
  1. Corona Virus Infection
  2. SARS-CoV 2
Interventions
  1. Other: Retrospective data collection
MeSH:Coronavirus Infections Severe Acute Respiratory Syndrome Emergencies

Primary Outcomes

Description: Identification of risk factors present at the earliest stage of hospital care (i.e. in the ED) that warrant hospital admission.

Measure: Identification of risk factors present at the earliest stage of hospital care (i.e. in the ED) that warrant hospital admission.

Time: 6 months

Secondary Outcomes

Description: Determination of the course of the disease (days since onset of symptoms, nature of symptoms, e.g. fever, chills, headache) and the state at which patients present to the ED

Measure: Determination of the course of the disease (days since onset of symptoms, nature of symptoms, e.g. fever, chills, headache) and the state at which patients present to the ED

Time: 6 months

Description: Identification of the ratio of patients with mild or moderate to severe disease

Measure: Identification of the ratio of patients with mild or moderate to severe disease

Time: 6 months
9 Evaluation of the Management of Dental Emergencies During COVID 19 Crisis

"For 12 years, the odontology service of the Pitié-Salpêtrière hospital group (GHPS) has been responsible for day and night dental emergency care. Several surveys have been conducted in order to analyze the sociological characteristics of the patients and the typology of the acts performed. These studies indicate that pain is the main reason for consultations, cited by 60 to 80% of patients. So far, very few studies have been done in the context of emergencies. Very recently, a study was undertaken on the satisfaction of patients consulting the odontological emergencies of the GHPS, during a thesis work. This study, carried out in collaboration with the URC Pitié Salpêtrière, under analysis, relates to the satisfaction of patients consulting the odontological emergencies of the GHPS during the day and week, Monday to Friday, excluding night and week emergencies -end (WE). An additional study (URGDENT-NW) aiming at completing this study by focusing on patients consulting the emergency room at night and during the weekend is also in progress. The COVID19 Crisis changed the organization and the venue of patients at the emergency dental service. Therefore this project, based on the same protocol as URGENT and URGDENT-WE, aims at evaluating the Odontology Emergency Reception Service (SAUO) during the COVID 19 epidemy. It will be carried out in the form of a survey whose objective is to assess: on the one hand, the effectiveness of the care provided in this emergency functional unit, and on the other hand the satisfaction of the patients after their passage to the emergency room ."

NCT04354272
Conditions
  1. Orofacial Pain
  2. Orofacial Edema
  3. Dental Trauma
  4. Oral Infection
Interventions
  1. Other: Questionnaire
MeSH:Emergencies Facial Pain

Primary Outcomes

Description: "Self report measure of pain on the numeric scale 24h after the visit "

Measure: Pain score evolution measured by a 0-10 numeric scale (NS) where 0 is no pain and 10 the worst pain imaginable

Time: Day 1

Secondary Outcomes

Description: the pain is measured with the numeric scale

Measure: Pain scores evolution 3 days and 7 days after first visit measured by a numeric scale where 0 is no pain and 10 the worst pain imaginable

Time: Day 3 and Day 7

Description: Perception of welcoming, waiting time will be measured with a 0-10 numeric scale

Measure: welcoming quality from hospital staff

Time: Day 1

Description: The patient anxiety will be measured by numeric scale at Day 0, Day 1, Day 3, Day 7

Measure: anxiety score

Time: Day 0, Day 1, Day 3, Day 7

Description: The perception is measured just after care with a 0-10 numeric scale

Measure: perception of the technical quality of the emergency treatment

Time: Day 1
10 An Open-Label Expanded Access Program of Ruxolitinib for the Emergency Treatment of Cytokine Storm From COVID-19 Infection

To provide ruxolitinib through an expanded access program for the treatment of cytokine storm due to COVID-19 in the United States to patients who are eligible but not able to be hospitalized or who are hospitalized with a clinical diagnosis and/or positive test for SARD-CoV-2 infection.

NCT04355793
Conditions
  1. COVID-19
Interventions
  1. Drug: Ruxolitinib
MeSH:Emergencies

11 Intraosseous Versus Intravenous Access During COVID-19 Patients Performed by Paramedics Wearing Level C Personal Protective Equipment. A Multi-center Prospective Randomized Crossover Single-blinded Simulation Trial

The current COVID-19 pandemic, this is especially since the transmission of SARS-CoV-2 is thought to occur mainly through respiratory droplets generated by coughing and sneezing, by direct contact with contaminated surfaces and because in a large number of patients COVID-19 disease may be asymptomatic. As recommended by the CDC medical personnel should be equipped with full personal protective equipment (PPE) for AGP in contact with suspected/confirmed COVID-19 patient. Therefore, it is reasonable to search for the most effective methods of intravascular access in those conditions.

NCT04366297
Conditions
  1. Cardiac Arrest
  2. Emergencies
Interventions
  1. Device: Intravenous access
  2. Device: Intraosseous access
MeSH:Emergencies

Primary Outcomes

Description: successful placement of intravascular device

Measure: successful rate of first intravascular access attempt

Time: 1 day

Secondary Outcomes

Measure: time to successful access

Time: 1 day

Description: number of attempts to successful access

Measure: number of attempts to successful access

Time: 1 day

Description: time to therapy including but not limited to time to fluids, antibiotics, and antiarrythmics

Measure: time to infusion

Time: 1 day

Description: complication rates

Measure: complication rates

Time: 1 day

Description: self-reported percentage the vocal cord visualization. A 100% score is a extremely difficult procedure. A Ease of use score of 1% means that procedure is extremely easy

Measure: ease of use

Time: 1 day

Description: participants were asked which method of intravascular access they would prefer in a real-life resuscitation.

Measure: Preferred intravascular access method

Time: 1 day
12 Comparison of Intraosseous Versus Intravenous Access in Suspected/Confirmed COVID-19 Patient in Prehospital Setting

The current COVID-19 pandemic, this is especially since the transmission of SARS-CoV-2 is thought to occur mainly through respiratory droplets generated by coughing and sneezing, by direct contact with contaminated surfaces and because in a large number of patients COVID-19 disease may be asymptomatic. As recommended by the CDC medical personnel should be equipped with full personal protective equipment (PPE) for AGP in contact with suspected/confirmed COVID-19 patient. Therefore, it is reasonable to search for the most effective methods of intravascular access in those conditions.

NCT04366947
Conditions
  1. Emergency Medicine
  2. Cardiopulmonary Arrest
  3. Shock
Interventions
  1. Device: NIO® (Intraosseous access)
  2. Device: Standard of Care (Intravenous access)
MeSH:Heart Arrest Emergencies
HPO:Cardiac arrest Cardiorespiratory arrest

Primary Outcomes

Description: successful placement of intravascular device

Measure: Success rate of first intravascular access attempt

Time: 1 day

Secondary Outcomes

Description: time to successful access

Measure: time to successful access

Time: 1 day

Description: number of attempts to successful access

Measure: number of attempts to successful access

Time: 1 day

Description: time to therapy including but not limited to time to fluids, antibiotics, and antiarrythmics

Measure: time to infusion

Time: 1 day

Description: complication rates

Measure: complication rates

Time: 1 day

Description: the rate of survival to hospital admission

Measure: ROSC

Time: 1 day
13 Emergency Management in a Dedicated Respiratory Unit of Patients With a Possible COVID-19 Infection (Unit "COVID Possible")

This research aims to improve knowledge of the epidemiology of patients consulting in the COvid Possible REspiratory Units (RECOP unit). Indeed, the epidemic linked to COVID19 affects France and impacts its health system. The reception of all intermediate patients will be on the Emergency Structures (SU). Indeed, the French healthcare system centralizes unscheduled urgent care on the ER. The aspecific respiratory symptomatology in "intermediate" patients indicates them all the more at an admission to SU or the diagnostic approach to respiratory difficulty may be carried out. It will be necessary to identify the diagnosis of the dyspneic patient and to define his virological status COVID before referring him to the appropriate units. The investigatory propose an original strategy of dedicating entire care sectors to the care of patients admitted for dyspnea in our ER. These units will be named RECOP units. This study would improve epidemiological knowledge of COVID-19 and ability to receive these patients within the SU.

NCT04371328
Conditions
  1. Emergencies
Interventions
  1. Other: RECOP unit patient
MeSH:Emergencies

Primary Outcomes

Description: The virological condition will be taken with PCR tests on naso-pharyngeal samples or on sputum for patients taking

Measure: Describe the characteristics of patients admitted to reCOP units according to their virological status vis-à-vis COVID-19

Time: 30 days

Secondary Outcomes

Description: demographic variables, usual history and treatments, episode characteristics (symptomatology, evolution, treatment taken) and data from the initial clinical examination will be collected by doctor

Measure: Develop a predictive model of the risk of being COVID for patients admitted to the emergency room for dyspnea

Time: 0 days

Other Outcomes

Description: Virological status will be collected by a phone call at the patient

Measure: Virological status

Time: 30 days

Description: Mortality status will be collected by a phone call at the patient

Measure: Mortality status

Time: 30 days
14 Emergency Ventilator Splitting Between Two or More Patients Using a Single Ventilator to Address Critical Ventilator Shortages During a Pandemic

The purpose of this study is to develop a safe, easily scalable, and simple method to split a single ventilator for use amongst two or more patients, thus serving as a capacity bridge to save patient lives until manufacturers can produce enough ventilators.

NCT04381013
Conditions
  1. COVID-19
Interventions
  1. Device: Emergency Ventilator Splitter
MeSH:Emergencies

Primary Outcomes

Description: This outcome will measure whether the device will function for respiratory support for 1 minute (yes or no; phase 1 only)

Measure: Completion of 1-minute test

Time: Up to 1 minute

Description: This outcome will measure whether the device will function for respiratory support for 24 hours (yes or no; phase 2 only)

Measure: Completion of 24-hour test

Time: Up to 1 minute

Description: This outcome will measure whether the device will function for respiratory support for 1 hour (yes or no; phase 3 only)

Measure: Completion of 24-hour test

Time: Up to 1 hour
15 Evaluation of Emergency Department (ED) Staff Stress Level During COVID-19 Pandemic

In the context of the COVID-19 pandemic, Emergency Department (ED) are in front line for the reception of patients presenting COVID-19 symptoms and have to face a new situation given the expected number of patients. Staff participate in suspect patients triage, in the diagnosis and the management of Covid-19 patients, having to follow the instructions and recommendations that evolve in real time, depending on the stage, resources and means available. This situation requires that the staff immediately adaptation within this reorganization and redeployment of the activity. Then; they are subject to many stress and anxiety factors such as: - Increased activity: massive influx of patients, overload of work, lack of material and human resources - Modification of practices: training in procedures, measures isolation and prevention of contamination of other patients, replacement by professionals reassigned from other departments - Ethical dilemma: decisions to be made in an emergency, patient prioritization - Numerous, evolving information, from various sources and sometimes contradictory (national, governance, service, media) - Individual: fear of personal contamination and of those close to you, personal organization in a situation of confinement of the population, loss of usual social support - Anxiety and stress management of patients and relatives, their entourage and colleagues In this study, it is proposed to study the psychic impact of the COVID-19 pandemic on emergency department staff.

NCT04383886
Conditions
  1. Emergency Department Staff During the COVID-19 Pandemic
  2. Emergency Department Staff's Level of Stress
Interventions
  1. Other: stress and anxiety questionnaire
MeSH:Emergencies

Primary Outcomes

Description: The level of stress will be measured using the Chamoux et Simard visual analogic scale. This scale is composed of 3 subscales evaluating the stress level at work, at home and in the life in general. Each scale are rating from 0 to 10, 0 being the absence of stress and 10 the highest level of stress ever experienced a cotation at each scale greater than 6 will defined the presence of a stress.

Measure: Change of emergency department staff's level of stress during the covid19 pandemic, measured using the Chamoux et Simard visual analogic scale

Time: Every 15 days from baseline to 3 months
16 Accuracy of Routine Biomarkers and Blood Leucocytes Count to Assist Diagnosis of COVID-19-related Pneumonia in Adult Patients Visiting the Emergency Department

December 2019 was the onset of an outbreak of an infection related to SARS-CoV-2, a new coronavirus detected in January 2020 and responsible for a disorder termed COVID-19. Since then, COVID-19 has spread worldwide and is responsible for an unprecedented pandemic with major threat on global health and social and economic stability. Covid-19 has a large spectrum of symptoms. Most patients experience mild or moderate flu-like disorder with cough, fever, and shortness of breath. More severe presentations may occur; patients sometimes develop an acute pneumonia that can lead to adult respiratory distress syndrome. A considerable number of publications have been released for the last 10 weeks to help physicians making diagnosis and treat patients. Chinese authors have extensively proposed description of the disease. As signs and symptoms are poorly specific, diagnosis mostly relies on detection of the virus by RT-PCR in the upper respiratory tract. Some uncommon images and localization are highly specific and sensitive on chest CT-scan, which is cornerstone for initial diagnosis. However, resources may lack during healthcare crisis and results of these investigations may be delayed or unavailable developper. Special attention should also be paid to usual laboratory analysis. Indeed, decreased lymphocytes and eosinophilic counts are frequently described as well as increase in D-dimers levels. Variation of C-reactive protein (CRP) and procalcitonin (PCT) have been reported. Coronavirus may have cardiac tropism and changes in cardiac biomarkers concentration may occur. Therefore, some data suggest that values of routine biomarkers and blood cell count may assist physicians at bedside to support diagnosis of COVID-19. To face the outbreak, organization of emergency departments (ED) was mandatory to separate patients flows and avoid mixing patients with COVID-19 and others. Most patients visiting EDs dedicated to initial COVID-19 management suffered of pneumonia-like symptoms. Despite initial triage, patients had either COVID-19-related pneumonia either alternative diagnoses. We took advantage of this to evaluate the ability of routine biomarkers and leucocytes count helping identification of COVID-19 from alternative diagnoses.

NCT04401241
Conditions
  1. Covid19
MeSH:Emergencies

Primary Outcomes

Description: assess sensitivity of routine biomarkers and blood cell count for diagnosis of COVID-19-related pneumonia in low and high probability groups for level of certainty using the adjudication committee classification

Measure: routine biomarkers and blood cell count are discriminant to diagnose COVID-19

Time: 2 months

Secondary Outcomes

Description: An adjudication committee with full access to medical charts will classify patients in 4 categories for diagnosis of COVID-19 associated pneumonia : certain, probable, unlikely, and excluded. Patients will be distributed in 2 probability groups : high probability (certain + probable) and compared with low probability patients (unlikely + excluded). Se, Sp, PPV, NPV, Likelihood ratios will be assessed comparing the 2 groups regarding CRP.

Measure: Probability of COVID-19 and CRP

Time: 2 months

Description: An adjudication committee with full access to medical charts will classify patients in 4 categories for diagnosis of COVID-19 associated pneumonia : certain, probable, unlikely, and excluded. Patients will be distributed in 2 probability groups : high probability (certain + probable) and compared with low probability patients (unlikely + excluded). Se, Sp, PPV, NPV, Likelihood ratios will be assessed comparing the 2 groups regarding PCT.

Measure: Probability of COVID-19 and PCT

Time: 2 months

Description: An adjudication committee with full access to medical charts will classify patients in 4 categories for diagnosis of COVID-19 associated pneumonia : certain, probable, unlikely, and excluded. Patients will be distributed in 2 probability groups : high probability (certain + probable) and compared with low probability patients (unlikely + excluded). Se, Sp, PPV, NPV, Likelihood ratios will be assessed comparing the 2 groups regarding Ddimers.

Measure: Probability of COVID-19 and Ddimers

Time: 2 months

Description: An adjudication committee with full access to medical charts will classify patients in 4 categories for diagnosis of COVID-19 associated pneumonia : certain, probable, unlikely, and excluded. Patients will be distributed in 2 probability groups : high probability (certain + probable) and compared with low probability patients (unlikely + excluded). Se, Sp, PPV, NPV, Likelihood ratios will be assessed comparing the 2 groups regarding NTproBNP.

Measure: Probability of COVID-19 and NTproBNP

Time: 2 months

Description: An adjudication committee with full access to medical charts will classify patients in 4 categories for diagnosis of COVID-19 associated pneumonia : certain, probable, unlikely, and excluded. Patients will be distributed in 2 probability groups : high probability (certain + probable) and compared with low probability patients (unlikely + excluded). Se, Sp, PPV, NPV, Likelihood ratios will be assessed comparing the 2 groups regarding cTnT-HS.

Measure: Probability of COVID-19 and cTnT-HS

Time: 2 months

Description: An adjudication committee with full access to medical charts will classify patients in 4 categories for diagnosis of COVID-19 associated pneumonia : certain, probable, unlikely, and excluded. Patients will be distributed in 2 probability groups : high probability (certain + probable) and compared with low probability patients (unlikely + excluded). Se, Sp, PPV, NPV, Likelihood ratios will be assessed comparing the 2 groups regarding blood cell counts.

Measure: Probability of COVID-19 and blood cell counts

Time: 2 months

Description: Assess performance of combined routine biomarkers and blood cell count for diagnosis of COVID-19-related pneumonia independent parameters that will significantly differ in a univariate analysis will be combined. Their characteristics will be reported (Se, Sp, PPV, NPV, Likelihood ratios). The above mentioned assessment will be held at the exclusion of others

Measure: performance of combined routine biomarkers

Time: 2 months

Description: ii) to assess performance of combined routine biomarkers and blood cell count for diagnosis of COVID-19-associated pneumonia; assessment of characteritics for high probability and low probability patients : P value and AUC [95% CI] will be assessed comparing the 2 groups. iii) to assess whether usual biomarkers and blood cell count were associated with diagnosis of COVID-19-associated pneumonia using sensitivity analyses in predefinite subgroups chosen a priori; 1) when comparing definite versus excluded patients; 2) when comparing high vs. low probability patients, excluding bacterial infection (respiratory and extra-respiratory) in the low probability COVID-19-associated pneumonia group; 3) when comparing definite versus excluded probability patients, excluding bacterial infections (respiratory and extra-respiratory) in excluded patients. For each, P value and AUC [95% CI] will be assessed comparing the 2 groups

Measure: Assess usual biomarkers and blood cell count

Time: 2 months
17 Effects of the COVID-19 Health Emergency on the Biopsychosocial Health of Rural Residents of New Mexico Using Mixed Methods Research

There is a critical need to determine the impact of the COVID-19 emergency on the comprehensive well-being of people as they are living through the emergency and sequelae of the emergency period. The research team is requesting National Institutes of Health funding with the goal to investigate rural vs. urban living people's response to the crisis and its impact using mixed methods research.

NCT04409535
Conditions
  1. Activities
  2. Mental Health Issue
  3. Life Style
Interventions
  1. Other: WHOQOL-BREF survey
MeSH:Emergencies

Primary Outcomes

Description: participant responses about quality of life during COVID-19 emergency

Measure: World Health Organization Quality of Life-Brief Scale

Time: From enrollment until post-event (Feb. 2021)

Secondary Outcomes

Description: Participants responses to open-ended interview questions regarding alteration in daily life routines

Measure: Open-ended Interview

Time: From enrollment until post-event (Feb. 2021)
18 Home-withdrawal Program Combined With Behavioural Approach in Patients With Medication Overuse Headache During Covid-19 Emergency: Incidence of Relapses in Overuse and Changes in Impact at One Year Follow up

Medication Overuse Headache (MOH) is a disabling condition that affects the 2% of migraine population. Medication overuse (MO) makes this condition very difficult to treat. The literature of the last decades confirm the efficacy of withdrawal for patients with medication overuse, but it is also confirmed that patients have to be carefully followed after withdrawal to avoid relapses and to improve the clinical benefit of the therapeutic approach. Clinical results can be improved when traditional therapies are combined with behavioral approaches in particular mindfulness, that help patient to become more conscious about their symptoms and able to manage pain without medication. As the emergency situation due to the Corona-virus pandemic phenomenon in Italy, the regular clinical practice adopted for patients with CM-MO has changed in the last weeks: patients cannot come to the hospital for the withdrawal iv therapy and for regular follow up as the reduced mobility due to the emergency in particular in the Lombardia region, but all over Italy. So the investigators propose a pilot study to enforce the application of a Home-program for the withdrawal procedure for patients and the use of technology like smartphone and video calls so that patients can continue to be followed in their therapeutic process by using behavioral support and mindfulness practice. Patients will perform the withdrawal program at home, by oral administration of therapies, with specific instructions and education. Also the information for behavioral approach and mindfulness practice will be given, to use every day at home. Daily standardized mindfulness sessions of 12 minutes on their smartphone will be combined with weekly video-call to evaluate the clinical condition and to encourage the use strategies for pain management. Face-to-face visits at the follow up every three months will be scheduled. This modality will allow the patients to continue their therapeutic process and to be regularly followed during the one year after withdrawal.

NCT04410536
Conditions
  1. Migraine, Hemicrania
Interventions
  1. Drug: Symptomatic drugs
  2. Drug: Bridge therapy
  3. Behavioral: Mindfulness program
MeSH:Headache Disorders, Secondary Migraine Disorders Emergencies Headache
HPO:Headache Migraine

Primary Outcomes

Description: Drop-out rates after withdrawal treatment

Measure: Drop out rates

Time: at 12 months

Secondary Outcomes

Description: Percentages of patients with absence of Medication Overuse Headache

Measure: Absence of Medication Overuse Headache (MOH)

Time: at 12 months from withdrawal program (assessed by Daily Diary Card)
19 Emergency Laparotomies and Outcomes During the COVID-19 Pandemic - a Retrospective Cohort Study

NLR has previously been observed to correlate with complications in upper GI (1) and colorectal (2) surgery. The investigators sought to assess if a similar correlation can be identified in emergency general surgical patients and if the presence of suspected or confirmed COVID-19 may impact on this. Given the heterogeneity of emergency general surgery the investigators therefore plan to perform a retrospective review of patients having emergency laparotomies only at a single NHS site during COVID-19 pandemic. Assessment of outcomes and Neutrophil:lymphocyte ratio as a predictor of outcomes will be completed. Outcomes will be completed in line with the recent COVIDSurg study criteria (3). The primary outcome is 30-day mortality. Secondary outcomes are 7-day mortality, re-operation, length of stay, post-operative respiratory failure, post-operative ARDS (Acute Respiratory Distress Syndrome), post-operative sepsis and ITU (Intensive Therapy Unit)/HDU (High Dependency Unit) admission.

NCT04419571
Conditions
  1. COVID-19
  2. Emergency General Surgery
Interventions
  1. Procedure: Emergency Laparotomy
MeSH:Emergencies

Primary Outcomes

Description: Mortality

Measure: 30-day mortality

Time: 30 days

Secondary Outcomes

Description: Mortality

Measure: 7-day mortality

Time: 7 days

Description: Re-operation

Measure: Number of participants returning to theatre

Time: 30 days

Description: Inpatient stay during index admission

Measure: Length of stay

Time: 30 days

Description: Presence of respiratory failure in the post-operative period as defined in the clinical notes or discharge summaries

Measure: Post-operative respiratory failure

Time: 30 days

Description: ARDS diagnosed radiologically

Measure: Post-operative ARDS

Time: 30 days

Description: Presence of sepsis in the post-operative period as defined in the clinical notes or discharge summaries

Measure: Post-operative sepsis

Time: 30 days

Description: ITU/HDU admission post-operatively

Measure: ITU/HDU admission

Time: 30 days

Other Outcomes

Description: Other documented post-operative complications

Measure: Other complications

Time: 30 days

Description: Neutrophil:Lymphocyte Ratio will be recorded daily in the peri-operative period

Measure: Peri-operative NLR

Time: First 3 post-operative days

Description: Absolute platelet counts recorded daily in the peri-operative period

Measure: Post-operative platelet counts

Time: First 3 post-operative days

Description: Defined as the presence of increased PT (prothrombin time) OR APTT (activated partial thromboplastin time) OR TT (thrombin time) OR fibrinogen above 1.5X the upper limit of normal. Coagulation will either be defined as normal or abnormal for each patient if one or more of these derangement are identified.

Measure: Post-operative coagulopathy

Time: First 3 post-operative days
20 Evaluation of the COVID-19 Infection Response in Patients Admitted to the Emergency Department for Dyspnea

This research aims to improve our knowledge of the epidemiology of patients consulting in the COvid-19 Possible REspiratory Units (RECOP unit). Indeed, the epidemic linked to COVID-19 affects France and impacts its health system. The reception of all intermediate patients will be on the Emergency Structures (SU). Indeed, the French healthcare system centralizes unscheduled urgent care on the ER. The aspecific respiratory symptomatology in "intermediate" patients indicates them all the more at an admission to SU or the diagnostic approach to respiratory difficulty may be carried out. A central issue of this diagnostic strategy will be to be rapid, since the diagnosis will have to be made in the context of significant flows, with a need to quickly refer patients to the most suitable downstream service, while limiting the risk contamination of caregivers and vulnerable patients if a COVID-19 + patient is admitted to an unsuitable service. However, virological tests do not currently allow rapid results for COVID-19. Research project of investigatory aims to develop a predictive model of the risk of being COVID-19 positive for patients admitted to the emergency room for acute dyspnea.

NCT04422587
Conditions
  1. Emergencies
Interventions
  1. Other: RECOP unit patient
MeSH:Dyspnea Emergencies
HPO:Dyspnea Respiratory distress

Primary Outcomes

Description: demographic variables, usual history and treatments, episode characteristics (symptomatology, evolution, treatment taken) and data from the initial clinical examination will be collected by doctor

Measure: Develop a predictive model of the risk of being COVID-19 for patients admitted to the emergency room for dyspnea

Time: inclusion day

Secondary Outcomes

Description: The COVID-19 virological condition will be taken with PCR tests on naso-pharyngeal samples or on sputum for patients taking

Measure: Describe the characteristics of patients admitted to reCOP units according to their virological status

Time: 30 days

Description: Virological status will be collected by a phone call at the patient

Measure: Virological status

Time: 30 days

Description: Mortality status will be collected by a phone call at the patient

Measure: Mortality status

Time: 30 days
21 COVID Follow-App: Telematic Monitoring Through a Mobile Application of Patients With COVID-19: A Randomized Clinical Trial

Open-label randomized clinical trial, one center, to compare the need for face-to-face re-consultation after discharge for COVID-19 between a telematic monitoring through a mobile app and the regular primary care setting.

NCT04423289
Conditions
  1. Face-to-face Reconsultation to Emergency Room
Interventions
  1. Other: Farmalarm
MeSH:Emergencies

Primary Outcomes

Description: Number of patients needing face-to-face re-consultations

Measure: Re-consultation

Time: 2 weeks

Secondary Outcomes

Description: Number of patients making telephone calls to emergency services

Measure: Telephone calls

Time: 2 weeks
22 Delivery of Protocolised Emergency Surgical Care During COVID-19 Pandemic Based on Case Series

Emergency general surgical care during the COVID-19 pandemic presents a unique set of considerations and challenges. Patients presenting with acute surgical conditions and concomitant COVID-19 infection have higher risk of mortality and morbidity. The investigators present their experience with COVID-19 positive patients presenting with acute surgical conditions and reviewed the implementation of a protocolized pathway to mitigate the impact of COVID-19 infection.

NCT04450277
Conditions
  1. COVID-19
  2. Emergency Surgery
Interventions
  1. Procedure: Emergency surgery
MeSH:Emergencies

Primary Outcomes

Measure: Surgical morbidity in patients with COVID-19 infection and general surgical conditions

Time: Follow up 1 month
23 The Impact of COVID-19 Pandemic on Critical Limb Threatening Ischemia and Emergency Vascular Practice

This is a retrospective analytical study conducted at Vascular and Endovascular surgery Department, Mansoura University Hospital, including all patients admitted at the two periods first six months of 2019 and 2020.To demonstrate the effect of COVID-19 pandemic on the practice of emergency vascular surgery and critical limb threatening ischemia interventions by comparison two periods first six months of 2019 and 2020.

NCT04452682
Conditions
  1. COVID
  2. Critical Limb Ischemia
Interventions
  1. Other: COVID 19 impact
MeSH:Emergencies Ischemia

Primary Outcomes

Description: The ICU admission caused by Pneumonia proved radio-logically at both periods

Measure: The ICU admission with associated Pneumonia

Time: 6 months

Description: percentage of different diagnoses at both periods

Measure: Impact of COVID-19 on the different presentation of vascular surgery at the emergency

Time: 6 months

Secondary Outcomes

Description: Mortality percentages at both periods

Measure: Mortality rates

Time: 6 months
24 Acceptability of Telehealth Triage Using Robotic Systems in COVID-19

The overall objective of this investigation is to understand the patient response to a robotic platform used to facilitate telehealth triage in the emergency department during the COVID-19 pandemic. The COVID-19 pandemic has altered the manner in which emergency department triage is completed. Attempts at cohorting individuals with potential COVID-19 disease in order to prevent disease transmission to healthcare workers and minimize the use of personal protective equipment (PPE) have renewed interest in telemedical solutions as a method to triage and manage individuals with COVID-19. This investigation deploys a legged robotic platform to facilitate agile, highly mobile telemedicine to manage COVID-19 patients in the emergency department. The primary objective is to measure the patient response to interacting with these systems.

NCT04452695
Conditions
  1. COVID-19
  2. Telemedicine
  3. Robotics
  4. Emergencies
  5. Emerging Infectious Disease
Interventions
  1. Device: Doctor Spot
MeSH:Communicable Diseases Infection Communicable Diseases, Emerging Emergencies

Primary Outcomes

Description: Quantitative questionnaire on the acceptance of virtual robotic care graded on a likert scale (higher scores better)

Measure: Acceptance of robotic telehealth system

Time: Immediately after completion of triage

Description: Quantitative questionnaire on the willingness to use this system again based on a likert scale (higher scores better)

Measure: Willingness to interact with robotic telehealth system

Time: Immediately after completion of triage

Description: Quantitative questionnaire on the user satisfaction with their triage experience (How satisfied were you with your experience interacting with the robotic system today?)

Measure: Satisfaction of interacting with a robotic telehealth system

Time: Immediately after completion of triage

Secondary Outcomes

Description: Quantitative questionnaire comparing robotic triage process with in-person triage: Do you think your interaction with the robotic system was better, the same or no different than an in-person evaluation?)

Measure: Use of robotic system versus in-person triage

Time: Immediately after completion of triage
25 Healthcare Renunciation During the Confinement Period in Connection With the COVID-19 Epidemic in Adult Emergency Departments

Healthcare renunciation is defined as: "Individuals give up care when they do not seek services and health care professionals when they experience a disorder, experience a physical or mental disorder, or when they do not access all of the prescribed care." In 2008, 16.5% of the general French population reported having renounced care. The causes mentioned of the renunciation are mainly the financial difficulties, the deadlines of appointments considered too long, the geographical remoteness. In the department of Sarthe, the rate of cessation of care is estimated at 27.6% over the period from 2014 to 2017. In the context of the COVID-19 epidemic, containment was applied in France counted from 17 March 2020. The widespread message was "save lives, stay at home". The Ministry of Solidarity and Health has provided health professionals with a circular to adapt the management of patients with chronic disease, requiring elective surgical care and pregnant women. The decline in activity of general practitioners is estimated at 44% and that of other specialists at 71%. In Paris, visits to the emergency room fell by 45% for adults and 70% for children. The main risk is the deterioration of the health status of some patients with the worsening of chronic diseases, the discovery of pathologies during episodes of decompensation and the absence of management of serious acute pathologies. The study aims to assess the importance of giving up care during this period of COVID-19 and in comparison with a study conducted at the University Hospital of Angers and the hospital of Le Mans in 2017.

NCT04460196
Conditions
  1. Emergency Medicine
Interventions
  1. Other: survey
MeSH:Emergencies

Primary Outcomes

Measure: rate of patients who gave up consulting in the emergency department

Time: 1 day
26 Feasibility of Self-monitoring and Patient Decision Support for Suspected COVID-19 Patients After Emergency Department Discharge

This feasibility study is being conducted to understand how discharged emergency department patients who were tested for the SARS-CoV-2 virus (COVID-19) engage with a symptom-tracking web application. Study participants that are enrolled in the study will be asked to enter daily information about their health into the CovidX web application (app.). In addition, patients will answer questions regarding anxiety levels, use a pulse oximeter to record information (if you own one or are given one). The investigators predict that participants will be able to engage with the CovidX web application over several days to weeks for the purposes of symptom tracking, and may have decreased anxiety over the study period.

NCT04462783
Conditions
  1. COVID
  2. Covid-19
  3. SARS-CoV 2
Interventions
  1. Other: Symptoms entered into the CovidX application
MeSH:Emergencies

Primary Outcomes

Measure: Change in the percent of participants using the CovidX web application (app) on 50% or greater of days

Time: baseline, up to 30 days

Measure: Average compliance rate with daily symptom tracking by day 30

Time: Day 30

Description: The proportion of patients approached for the study who enroll

Measure: Recruitment rate

Time: through study completion an average of 1 year

Secondary Outcomes

Description: The PROMIS Emotional Distress-Anxiety-Short Form 4a is a 4-item scale that assesses fear, anxiety, worry, and uneasiness. It uses a 5-point Likert scale (1 = never to 5 = always). Raw scores range from 4-20 with lower scores representing less endorsement of anxiety.

Measure: Change in Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety short form 4a

Time: completed at baseline (enrollment), up to 30 days

Description: This is a 5- item questionnaire that assess anxiety related to the Coronavirus. Participants select from (0 = not at all to 4 = nearly every day over the last 2 weeks). The higher the total number the more anxiety.

Measure: Change in Coronavirus Anxiety Scale

Time: completed at baseline (enrollment), up to 30 days

Description: The questionnaire is a series of 8 questions answered on a 1-7 Likert scale, with lower numbers indicating better usability. There are also 2 open-ended questions about why participants did or didn't like the application and other feedback is collected.

Measure: CovidX web application usability and utility measured adapted by mHealth App Usability Questionnaire

Time: 30 days

Description: This will be measured by the compliance rates

Measure: Differences in CovidX web application engagement between patients who do and do not receive a pulse oximeter

Time: 30 days
27 Ambulance Calls for Substance Use and Alcohol in a Pandemic (ASAP): Exploring Attendance at Incidents Involving Substance and/or Alcohol Use During COVID-19 Pandemic

The Primary objective is to explore ambulance service attendance at incidents involving alcohol and/or substance use over the period of the pandemic lockdown, and the following months. This will be to determine prevalence and explore factors such as patient gender, age, ethnicity or location. Analysis will examine the calls over the course of the year prior to the lockdown, and then compare this to the period of lockdown and following months.

NCT04474444
Conditions
  1. Alcohol Use, Unspecified
  2. Substance Use
  3. Intoxication Alcohol
  4. Emergencies
  5. COVID-19 Pandemic
  6. Treatment
Interventions
  1. Other: attendance by ambulance crew
MeSH:Emergencies Alcoholic Intoxication Alcohol Drinking

Primary Outcomes

Description: Counts of attendances for alcohol and drug use by the East Midland's Ambulance Service over the time period. This will be a number per day of people attended.

Measure: Attendances for alcohol and drug use

Time: Full data set 23/03/2019 compared to 22/03/2021 to look at interruption (lockdown) in the time series.
28 The Impact of COVID-19 Pandemic to Trauma Patients in Emergency Department: A Multicenter Experience of Istanbul

COVID-19, which emerged in China in December 2019, has become a pandemic with its spread to many countries of the world. The aim of this multi-centered study is to guide for the approach, organization, diagnosis and treatment of the patients admitted due to trauma to emergency department during the pandemic period.

NCT04479124
Conditions
  1. Trauma
  2. Covid19
Interventions
  1. Diagnostic Test: COVID-19 PCR
MeSH:Emergencies Wounds and Injuries

Primary Outcomes

Description: within the study period, trauma patients who admitted to any of the seven study centers will be recorded.

Measure: trauma admissions

Time: 3 months
29 Postoperative Complications and Mortality of Patients Submited to Emergency Digestive Surgery During the COVID-19 Pandemic (COVIDCIR Study): a Multicenter Cohorts' Study Protocol

A multi-centre, observational cohort study will be carried out in consecutive patients operated on for urgent digestive pathology. Two cohorts will be defined: the 'pandemic' cohort, which will include all patients [COVID-19-positive or negative] operated on for emergency digestive pathology during the months of March to June 2020; and the control cohort, which will include all patients operated on for emergency digestive pathology during the months of March to June 2019. Information will be gathered on demographic characteristics, clinical and analytical parameters, scores on the usual risk scales for quality management in a General Surgery service (POSSUM, P-POSSUM and LUCENTUM scores), prognostic factors applicable to all patients, specific factors for patients infected with SARS-CoV-2, complications and postoperative mortality (at 30 and 90 postoperative days). In the pandemic cohort it will be detailed whether or not the patient was infected with SARS-CoV-2. The main objective will be to determine the incidence of postoperative complications and mortality. This variable will be analysed in the "full analysis set" population. Secondary objective will be to develop a specific postoperative risk propensity model for SARS-CoV-2 infected patients.

NCT04479150
Conditions
  1. Covid19
  2. Surgery--Complications
MeSH:Emergencies Postoperative Complications

Primary Outcomes

Description: Mortality for any cause at 30 days after urgent gastrointestinal surgery.

Measure: 30-day mortality

Time: 30 days post-surgery

Secondary Outcomes

Description: Mortality for any cause within 90 days of surgery

Measure: 90-day mortality

Time: 90 days post-surgery

Description: Postoperative complications within 30 days of surgery: classic postoperative complications, typical complications after digestive surgery and/or complications specifically associated with the evolution of COVID-19

Measure: Postoperative complications

Time: 30 days post-surgery

Description: Postoperative complications within 30 days of surgery graded as equal or superior to IIIA grade according to the Clavien-Dindo classification

Measure: Severe complications

Time: 30 days post-surgery

Description: Number of days of hospital stay from the day of admission to the date of hospital discharge or death

Measure: Lenght of stay

Time: 90 days post-surgery
30 Experience of an Emergency Intensive Care Unit During COVID-19 Pandemic: Retrospective Cohort Study

COVID-19, which emerged in China in December 2019, has become a pandemic with its spread to many countries of the world. Emergency departments also carried out an important part of the fight against pandemics in our country/Turkey. The emergency department including an intensive care unit is very few in this country/Turkey and the only hospital, which has an Emergency Intensive Care Unit (EICU) in Istanbul, is the study center. Therefore, this retrospective study aimed to provide useful information about how an effective EICU should be, especially how to use them during pandemic periods.

NCT04480060
Conditions
  1. Covid19
Interventions
  1. Diagnostic Test: COVID-19 diagnostic PCR
MeSH:Emergencies

Primary Outcomes

Description: Mortality of the COVID-19 patients who followed up by emergency department ICU

Measure: Mortality of the COVID-19 patients

Time: 3 months
31 Improving Patient Satisfaction Through Information Display Using Virtual White Boards

Communication with patients on their clinical status is important in delivering care in the emergency department. During times of high volume or complex patients, there may be lapses in communicating with patients about their hospital course or plans of action. These miscommunications may be enhanced during the current COVID-19 pandemic as there is minimized in-person interaction with patients in order to conserve personal protective equipment and decrease the risk of disease transmission. This study utilizes a virtual white board to deliver updates to patients about the status of their emergency department stay.

NCT04497922
Conditions
  1. Satisfaction, Patient
  2. Covid19
  3. Emergencies
  4. Satisfaction
  5. Information Disclosure
Interventions
  1. Device: e-ink screen
  2. Behavioral: Treatment as usual
MeSH:Emergencies

Primary Outcomes

Description: Satisfaction of overall emergency department stay measured by a 1-5 likert scale, hospital developed question on satisfaction (how satisfied were you with your emergency department stay today?)- higher score is better

Measure: emergency department satisfaction: likert scale

Time: 30 minutes after disposition decision for patient

Description: Quality of information conveyed to participant (rated on 5 point likert scale on questions about quality of waiting time for test results, staff concern, perceived teamwork in the hospital)

Measure: Quality of emergency department stay: likert scale

Time: 30 minutes after disposition decision for patient

Secondary Outcomes

Description: Question on preference for virtual white board compared to a standard emergency department room without a white board (1-4 likert scale, with 4 being strongly prefer white board room)

Measure: Preference for virtual white board

Time: 30 minutes after disposition decision for patient

HPO Nodes


HPO

Alphabetical listing of all HPO terms. Navigate: Correlations   Clinical Trials


HPO Nodes


Reports

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  

Interventions

4,180 reports on interventions/drugs

MeSH

691 reports on MeSH terms

HPO

263 reports on HPO terms

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Alphabetical index of all Terms

Google Colab

Python example via Google Colab Notebook