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D011655: Pulmonary Embolism

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 (16)


Name (Synonyms) Correlation
drug24 1: Prone positioning Wiki 0.26
drug2341 Optical Coherence Tomography (OCT) Wiki 0.26
drug33 2: No instruction regarding positioning Wiki 0.26
Name (Synonyms) Correlation
drug244 Angiography scanner Wiki 0.26
drug742 Cellectra 2000 Electroporation Wiki 0.26
drug3105 Serology test for COVID-19 Wiki 0.26
drug3360 TNKase Wiki 0.26
drug1199 Enoxaparin 40Mg/0.4Ml Inj Syringe 0.4Ml Wiki 0.26
drug1042 Diagnostic examination for venous thromboembolism Wiki 0.26
drug1108 Duplex ultrasound and Computed Tomography Angiography Wiki 0.26
drug20 18F-GP1 PET CT Wiki 0.26
drug1368 GLS-5300 Wiki 0.18
drug2468 Peripheral blood draw Wiki 0.18
drug1196 Enoxaparin Wiki 0.14
drug2931 Ruxolitinib Wiki 0.09
drug2215 No intervention Wiki 0.06

Correlated MeSH Terms (19)


Name (Synonyms) Correlation
D004617 Embolism NIH 0.90
D054556 Venous Thromboembolism NIH 0.39
D020246 Venous Thrombosis NIH 0.39
Name (Synonyms) Correlation
D013927 Thrombosis NIH 0.38
D013923 Thromboembolism NIH 0.35
D016769 Embolism and Thrombosis NIH 0.26
D009203 Myocardial Ischemia NIH 0.19
D002546 Ischemic Attack, Transient NIH 0.18
D007238 Infarction NIH 0.16
D054058 Acute Coronary Syndrome NIH 0.12
D009205 Myocarditis NIH 0.09
D020141 Hemostatic Disorders NIH 0.07
D001778 Blood Coagulation Disorders NIH 0.07
D008171 Lung Diseases, NIH 0.06
D016638 Critical Illness NIH 0.03
D011024 Pneumonia, Viral NIH 0.03
D011014 Pneumonia NIH 0.03
D045169 Severe Acute Respiratory Syndrome NIH 0.01
D018352 Coronavirus Infections NIH 0.01

Correlated HPO Terms (9)


Name (Synonyms) Correlation
HP:0002204 Pulmonary embolism HPO 0.93
HP:0002625 Deep venous thrombosis HPO 0.41
HP:0001907 Thromboembolism HPO 0.31
Name (Synonyms) Correlation
HP:0002326 Transient ischemic attack HPO 0.18
HP:0001658 Myocardial infarction HPO 0.14
HP:0012819 Myocarditis HPO 0.09
HP:0001928 Abnormality of coagulation HPO 0.07
HP:0002088 Abnormal lung morphology HPO 0.06
HP:0002090 Pneumonia HPO 0.03

Clinical Trials

Navigate: Correlations   HPO

There are 15 clinical trials


1 In-vivo Thrombus Imaging With 18F-GP1, a Novel Platelet PET Radiotracer

To date, the investigators have successfully employed a radiotracer (18F-sodium fluoride) as a marker of necrotic inflammation in human atherosclerosis. The investigators aim to further the mechanistic understanding of atherothrombosis by studying the activation of glycoprotein IIb/IIIa receptors in cardiovascular thrombus using the novel platelet radiotracer (18F-GP1). Binding of 18F-GP1 to activated platelets in venous and arterial thrombi has already been demonstrated in pre-clinical studies and a phase 1 trial in man. If successful, this study would define the role of the glycoprotein IIb/IIIa receptor within in vivo thrombosis across a range of cardiovascular diseases.

NCT03943966
Conditions
  1. Thrombosis
  2. Atherothrombosis
  3. Myocardial Infarction
  4. STEMI
  5. NSTEMI - Non-ST Segment Elevation MI
  6. DVT
  7. Pulmonary Embolism
  8. Stroke
  9. Transient Ischemic Attack
  10. Prosthetic Valve Thrombosis
  11. PET
Interventions
  1. Diagnostic Test: 18F-GP1 PET CT
MeSH:Pulmonary Embolism Ischemic Attack, Transient Myocardial Infarction Thrombosis Embolism Infarction
HPO:Myocardial infarction Pulmonary embolism Transient ischemic attack

Primary Outcomes

Description: Expression of the glycoprotein IIb/IIIa receptor (assessed by SUV) within thrombus in the arterial and venous circulation.

Measure: Ratio of 18F-GP1 standardised uptake values (SUV's) in thrombus compared with the SUVs recorded in the blood pool.

Time: 6 months from end of recruitment

Secondary Outcomes

Description: Expression of the glycoprotein IIb/IIIa receptor (assessed by SUV) within thrombus in the arterial and venous circulation in all 5 disease states

Measure: Ratio of 18F-GP1 standardised uptake values (SUV's) in thrombus formed in each of the 5 disease states.

Time: 6 months from end of recruitment
2 Screening of Cardiovascular Complications in Patients With COVID-19

Patients with COVID-19 in the Intensive Care Unit (ICU) or hospitalized with severe form have a poor prognosis (almost 30% rate of death). They present often a high cardiovascular risk profile (almost 30% of hypertension and 19% of diabetes). Troponin has been described to be elevated in a high proportion of patients (one fifth of all patients and 50% of non-survivors) suggesting the possibility of cardiomyopathies. High levels of DDimers (81% of non survivors) and fibrin degradation products are also associated with increased risk of mortality suggesting also the possibility of venous thromboembolism. Therefore, screening for cardiomyopathies and venous thromboembolism could represent an important challenge for patients with COVID-19 management.

NCT04335162
Conditions
  1. COVID
  2. Acute Coronary Syndrome
  3. Myocardial Infarction
  4. Myocarditis
  5. Venous Thromboembolism
  6. Deep Vein Thrombosis
  7. Pulmonary Embolism
MeSH:Pulmonary Embolism Myocardial Infarction Thrombosis Acute Coronary Syndrome Thromboembolism Embolism Venous Thromboembolism Venous Thrombosis Myocarditis
HPO:Deep venous thrombosis Myocardial infarction Myocarditis Pulmonary embolism Thromboembolism Venous thrombosis

Primary Outcomes

Description: Incidence of cardiomyopathies and/or venous thromboembolism at day 28

Measure: Determine the incidence of cardiomyopathies and venous thromboembolism

Time: 28 days

Secondary Outcomes

Description: Incidence of mortality at day 28

Measure: Mortality

Time: 28 days

Description: Number of day of using mechanical ventilation for each patients

Measure: Duration of mechanical ventilation

Time: 28 days

Description: Incidence of shock at day 28

Measure: shock at day 28

Time: 28 days

Description: Number of day in intensive care unit

Measure: length of stay in the intensive care unit

Time: 28 days
3 Incidence of Acute Pulmonary Embolism in Covid-19 Patients on CT Angiography and Relationship to D-dimer Levels

Reports of acute pulmonary embolism (APE) associated with COVID-19 have emerged in the literature. For example, Chen et al. described 25 pulmonary CT angiograms examinations from 1008 COVID-19 patients; 10 were positive for pulmonary embolism mostly as segmental or sub-segmental APE. Case reports of APE in Covid-19 patients have been published. Cui et al. found an incidence of deep venous thrombosis in intensive care unit (ICU) patients with severe Covid-19 pneumonia near to 25% (20/81), however without any correlation with potential APE. Despite these initial reports, it is not clear whether APE is more frequent in Covid-19 patients or if the association is just random. In favor of the former, D-dimer levels have been reported as elevated in patients with Covid-19 by two studies, and it has been suggested an independent association between the severity of the disease and the level of D-dimer. Finally, Tang et al. showed that anticoagulant therapy is associated with a decreased mortality at Day-28 in severe Covid-19 patients, in favor of a possible associated coagulopathy. The purpose of this study is to describe the rate of pulmonary embolus in patients classified as COVID-19 infection and who underwent chest CT angiography. The purpose of this study is to describe the rate of pulmonary embolus in patients classified as COVID-19 infection and who underwent chest CT angiography.

NCT04373486
Conditions
  1. Covid-19 With Positive RT-PCR
MeSH:Pulmonary Embolism Embolism
HPO:Pulmonary embolism

Primary Outcomes

Measure: Rate of positivity for Acute Pulmonary Embolism

Time: March 1, 2020 - March 31, 2020
4 Effectiveness of Weight-adjusted Prophylactic Low Molecular Weight Heparin Doses Compared With Lower Fixed Prophylactic Doses to Prevent Venous Thromboembolism in COVID-2019. The Multicenter Randomized Controlled Open-label Trial COVI-DOSE

Worldwide observational studies indicate a significant prothrombogenic effect associated with SARS-CoV-2 infection with a high incidence of venous thromboembolism (VTE), notably life-threatening pulmonary embolism. According to recommendations for acute medical illnesses, all COVID-19 hospitalized patients should be given VTE prophylaxis such as a low molecular weight heparin (LMWH). A standard prophylactic dose (eg. Enoxaparin 4000IU once daily) could be insufficient in obese patients and VTE has been reported in patients treated with a standard prophylactic dose. In COVID-19 patients, guidelines from several international societies confirm the existence of an hypercoagulability and the importance of thromboprophylaxis but the "optimal dose is unknown" and comparative studies are needed. In view of these elements, carrying out a trial comparing various therapeutic strategies for the prevention of VTE in hospitalized patients with COVID-19 constitutes a health emergency. Thus, we hypothesize that an increased prophylactic dose of weight-adjusted LMWH would be greater than a lower prophylactic dose of LMWH to reduce the risk of life-threatening VTE in hospitalized patients. The benefit-risk balance of this increase dose will be carefully evaluated because of bleeding complications favored by possible renal / hepatic dysfunctions, drug interactions or invasive procedures in COVID-19 patients. This multicenter randomized (1:1) open-label controlled trial will randomize hospitalized adults with COVID-19 infection to weight-adjusted prophylactic dose vs. lower prophylactic dose of LMWH.

NCT04373707
Conditions
  1. COVID
  2. Thrombosis
  3. Pulmonary Embolism
  4. Deep Vein Thrombosis
Interventions
  1. Drug: Enoxaparin
  2. Drug: Enoxaparin
MeSH:Pulmonary Embolism Thrombosis Thromboembolism Embolism Venous Thromboembolism Venous Thrombosis
HPO:Deep venous thrombosis Pulmonary embolism Thromboembolism Venous thrombosis

Primary Outcomes

Description: Risk of deep vein thrombosis or pulmonary embolism or venous thromboembolism-related death

Measure: Venous thromboembolism

Time: 28 days

Secondary Outcomes

Description: Risk of major bleeding defined by the ISTH

Measure: Major bleeding

Time: 28 days

Description: Risk of Major Bleeding and Clinically Relevant Non-Major Bleeding Defined by the ISTH

Measure: Major Bleeding and Clinically Relevant Non-Major Bleeding

Time: 28 days

Description: Risk of Venous Thromboembolism and Major Bleeding

Measure: Net Clinical Benefit

Time: 28 days and 2 months

Description: Risk of venous thrombosis at other sites: e.g. superficial vein, catheters, hemodialysis access, ECMO, splanchnic, encephalic, upper limb

Measure: Venous Thromboembolism at other sites

Time: 28 days

Description: Risk of arterial thrombosis at any sites

Measure: Arterial Thrombosis

Time: 28 days

Description: Risk of all-cause mortality

Measure: All-Cause Mortality

Time: 28 days and 2 months

Description: Identification of associations between the risk of venous thromboembolism and clinical (eg. past medical history of thrombosis, cardiovascular risk factors, treatments, severity of COVID-19) and laboratory variables (e.g. D-dimers, fibrinogen, CRP) collected in the eCRF

Measure: Factors associated with the risk of venous thromboembolism

Time: 28 days
5 Risk of Venous Thromboembolism in Critically Ill Patients With Severe COVID-19

Severe COVID-19 patients at a high risk of venous thromboembolism. We studied patients in 2 intensive care units of university hospitals in Barcelona and Badalona, Spain. We performed a cut-off screening of deep venous thrombosis (DVT) with bilateral duplex ultrasound to 230 patients.

NCT04374617
Conditions
  1. COVID-19
  2. Critical Illness
  3. Venous Thromboembolism
  4. Venous Thromboses
  5. Venous Thromboses, Deep
  6. Venous Thrombosis Pulmonary
  7. Pulmonary Embolism
  8. Pulmonary Embolism and Thrombosis
  9. Sars-CoV2
  10. SARS-CoV Infection
Interventions
  1. Diagnostic Test: Duplex ultrasound and Computed Tomography Angiography
MeSH:Coronavirus Infections Severe Acute Respiratory Syndrome Pulmonary Embolism Thrombosis Thromboembolism Embolism Venous Thromboembolism Venous Thrombosis Embolism and Thrombosis Critical Illness
HPO:Deep venous thrombosis Pulmonary embolism Thromboembolism Venous thrombosis

Primary Outcomes

Description: Patients with symptomatic pulmonary embolism confirmed on the CT-angiography and those with a swollen limb and confirmed deep venous thrombosis on compression ultrasound were considered to have "symptomatic venous thromboembolisms". The remaining patients with positive limb ultrasound or CT-angiography were considered to have "asymptomatic venous thrombembolism"

Measure: Venous thromboembolisms

Time: 7 days

Secondary Outcomes

Description: Deaths from all causes during the follow-up

Measure: Deaths

Time: 7 days
6 Enoxaparin for Primary Thromboprophylaxis in Ambulatory Patients With Coronavirus: The Multicenter Randomized Controlled Ovid Trial

The OVID study will show whether prophylactic-dose enoxaparin improves survival and reduces unplanned hospitalizations in ambulatory patients aged 50 or older diagnosed with COVID-19, a novel viral disease characterized by severe systemic, pulmonary, and vessel inflammation and coagulation activation.

NCT04400799
Conditions
  1. COVID-19
  2. Pulmonary Embolism, Deep Vein Thrombosis
Interventions
  1. Drug: Enoxaparin 40Mg/0.4Ml Inj Syringe 0.4Ml
MeSH:Pulmonary Embolism Thrombosis Embolism Venous Thrombosis
HPO:Deep venous thrombosis Pulmonary embolism Venous thrombosis

Primary Outcomes

Measure: hospitalizations

Time: 30 days

Measure: all-cause death

Time: 30 days

Secondary Outcomes

Description: including deep vein thrombosis (including catheter-associated), pulmonary embolism, myocardial infarction/myocarditis, arterial ischemia including mesenteric and extremities, acute splanchnic vein thrombosis, or ischemic stroke

Measure: Number of cardiovascular events

Time: within 14 days, 30 days, and 90 days of randomization

Measure: any hospitalizations

Time: within 14 days, 30 days, and 90 days of randomization

Measure: all-cause death

Time: within 14 days, 30 days, and 90 days of randomization

Description: measured by number of cardiovascular events, and major bleeding

Measure: Net clinical benefit

Time: within 14 days, 30 days, and 90 days of enrolment.

Description: ISTH criteria, in-hospital diagnosis

Measure: Disseminated intravascular coagulation

Time: within 14 days, 30 days, and 90 days of enrolment
7 Prevalence and Severity of Venous Thromboembolism in a General Population During the COVID-19 Pandemic

The purpose of this study is to investigate the prevalence of venous thromboembolism in a regional health care system (Region Östergötland, Sweden) before and during the SARS-COV-2 pandemic. In a retrospective observational study, we will review patient data, diagnostic data and treatment data over a three-month period since the onset of the SARS-COV-2 pandemic. This data will be compared with data from the corresponding time frame during the years 2015 to 2019.

NCT04400877
Conditions
  1. COVID-19
  2. Venous Thromboembolism
  3. Pulmonary Embolism
  4. Deep Vein Thrombosis
  5. SARS-CoV 2
Interventions
  1. Diagnostic Test: Diagnostic examination for venous thromboembolism
MeSH:Pulmonary Embolism Thrombosis Thromboembolism Embolism Venous Thromboembolism Venous Thrombosis
HPO:Deep venous thrombosis Pulmonary embolism Thromboembolism Venous thrombosis

Primary Outcomes

Measure: Is there an increased prevalence of venous thromboembolism in a regional healthcare system in Sweden during the SARS-CoV-2 pandemic?

Time: March to May in 2020

Measure: Is a SARS-CoV-2-infection an isolated risk factor for thromboembolism?

Time: March to May in 2020

Secondary Outcomes

Measure: Are there geographic differences in the prevalence of venous thromboembolism within the healthcare system?

Time: March to May in 2020

Measure: Is venous thromboembolism associated with increased mortality adjusted for relevant comorbidities?

Time: March to May in 2020

Measure: How long is the time between symptom onset of the SARS-CoV-2-infection and any subsequent venous thromboembolism?

Time: March to May in 2020

Measure: Is treatment with prophylactic antithrombotic or anticoagulant treatment associated with increased survival?

Time: March to May in 2020
8 Incidence of Thromboembolic Events and Prognosis of COVID-19 Patients Hospitalized in Intensive Care Units in France

The main objective of this study is to describe the incidence of thromboembolic events in a population of patients hospitalized in intensive care units in France for severe COVID-19. The secondary objective of this study is to describe the evolution of hemostasis parameters during the first two weeks of intensive care hospitalization and to evaluate the influence of different anticoagulation regimens on these parameters and on the incidence of thromboembolic events

NCT04405869
Conditions
  1. Pulmonary Thromboembolism
MeSH:Pulmonary Embolism Thromboembolism
HPO:Pulmonary embolism Thromboembolism

Primary Outcomes

Measure: Analysis of incidence of thromboembolic events in patients with Sars-CoV-2

Time: 1 month
9 Optical Coherence Tomography for Microvascular Lung Vessels Obstructive Thromboinflammatory Syndrome Assessment in Patients With COVID-19: an Exploratory Study

To evaluate by intravascular OCT study the presence of microvascular pulmonary thrombosis in patients with COVID-19, high D-dimer levels and contrast CT scan negative for pulmonary thrombosis. We'll also evaluate the extension of microvascular pulmonary thrombosis in patients with contrast CT scan positive for pulmonary embolism in areas where contrast CT scan was negative.

NCT04410549
Conditions
  1. Covid19
  2. Pulmonary Embolism
Interventions
  1. Diagnostic Test: Optical Coherence Tomography (OCT)
MeSH:Pulmonary Embolism Embolism
HPO:Pulmonary embolism

Primary Outcomes

Description: Study primary endpoints will be evaluation of OCT procedure overall safety in COVID-19 pneumonia patients and assessment of the presence of microvascular pulmonary thrombosis in COVID-19 patients, both in "ground glass" and "healthy" ventilated areas.

Measure: optical coherence tomography pulmonary microthrombosis assessment in COVID-19 pneumonia patients

Time: through study completion, an average of 1 month

Secondary Outcomes

Description: Pulmonary artery vessel anatomy characterization in COVID-19 pneumonia patients through OCT diagnostic technique Correlations with single trans-thoracic echocardiography (TTE) pulmonary hypertension (PH, estimated systolic pulmonary artery pressure > 35 mmHg) and right ventricular disfunction (RVD: tricuspid annular plane systolic excursion < 17 mm or Doppler tissue imaging S wave < 9.5 cm/sec). Dynamic correlations with standard inflammatory, coagulation and tissue damage biomarkers: CRP, ferritin, D-dimer, NT-proBNPO, troponins, LDH)

Measure: Pulmonary artery vessel anatomy characterization

Time: through study completion, an average of 1 month

Description: Correlations with single trans-thoracic echocardiography (TTE) pulmonary hypertension (PH, estimated systolic pulmonary artery pressure > 35 mmHg) and right ventricular disfunction (RVD: tricuspid annular plane systolic excursion < 17 mm or Doppler tissue imaging S wave < 9.5 cm/sec)

Measure: Correlation between TTE pulmonary hypertension and right ventricular disfunction

Time: through study completion, an average of 1 month

Description: Pneumonia COVID-19 dynamic correlation with inflammation and coagulation markers

Measure: Correlations with standard inflammatory, coagulation and tissue damage

Time: through study completion, an average of 1 month
10 Incidence and Characteristics of Pulmonary Embolism in COVID-19 Patients Hospitalized for Acute Respiratory Syndrome

Multicentric case-control study that is aims at: - evaluating the prevalence of pulmonary embolism among a large population of consecutive patients admitted for COVID-19 pneumonia into two large university hospitals in Paris, France: Groupe Hospitalier Paris Saint-Joseph (GHPSJ) and Hôpital Européen Georges Pompidou (HEGP) - and identifying the characteristics associated with pulmonary embolism by using a nested case control study design within the patients who underwent either unenhanced computed tomograpghy (CT) or CT pulmonary angiogram (CTPA) evaluation.

NCT04420312
Conditions
  1. Pulmonary Embolism
  2. Covid-19
MeSH:Pulmonary Embolism Embolism
HPO:Pulmonary embolism

Primary Outcomes

Description: Evaluate the prevalence of Pulmonary embolism among a large population of consecutive COVID-19 patients presenting respiratory symptoms

Measure: Impact of PE on COVID-19 patients

Time: March 1st, 2020

Secondary Outcomes

Description: Identify the clinical, radiological or biological characteristics associated with pulmonary embolism.

Measure: Clinical and radiological characteristics

Time: April 20th,2020
11 Registry of the Evolution of Diagnosed and/or Hospitalized Patients for Pulmonary Embolism During the Covid-19 Pandemic: Retrospective and Prospective Multicentric Study.

The purpose of the study COVID-EP is to classify all the complications occurring after the diagnosis of pulmonary embolism in patients tested initially COVID-19 positive and negative by RT-PCR (on nasopharyngeal sample) during the peak of the pandemic in France (April 2020). The patients will be followed for 1 year in order to provide clinical and paraclinical data not yet published in the literature. In order to secondarily confirm the COVID-19 status of initially negative COVID-19 patients (by RT-PCR), a serology test will be performed. The collected complications will then be compared between each of the 3 following groups: [PCR-COVID 19-Neg & Sero-COVID 19-Neg] versus [PCR-COVID 19-Neg & Sero-COVID 19-Pos] versus [PCR-COVID 19-Pos].

NCT04465656
Conditions
  1. Pulmonary Embolism
Interventions
  1. Diagnostic Test: Serology test for COVID-19
MeSH:Pulmonary Embolism Embolism
HPO:Pulmonary embolism

Primary Outcomes

Description: PE complications : Chronic interstitial pathology, or Recurrence of PE, or Pulmonary hypertension, or Death.

Measure: % of patients for each group presenting the occurrence of PE complications defined by the occurrence of at least ONE of the following events up to 6 months after PE diagnosis.

Time: 6 months after PE diagnosis

Secondary Outcomes

Description: PE complications : Chronic interstitial pathology, or Recurrence of PE, or Pulmonary hypertension, or Death.

Measure: % of patients for each group and subgroup presenting the occurrence of PE complications defined by the occurrence of at least ONE of the following events up to 12 months after PE diagnosis.

Time: 12 months after PE diagnosis

Description: PE complications : Chronic interstitial pathology, or Recurrence of PE, or Pulmonary hypertension, or Death.

Measure: % of patients in each group presenting the occurrence of each of the following events at each follow-up (3 months, 6 months and 12 months after PE diagnosis).

Time: 3, 6 and 12 months after PE diagnosis

Measure: % of patients diagnosed COVID - at M0 by RT-PCR on nasopharyngeal swab and diagnosed COVID + by serology 3 months after PE diagnosis

Time: 3 months after PE diagnosis

Description: Category of treatments: Heparin + AVK Heparin + DOAC PE complication : Chronic interstitial pathology, or Recurrence of PE, or Pulmonary hypertension, or Death.

Measure: Effectiveness of the different category of treatments used in all patients and in the groups: % of occurrence of PE complications for each categories of treatments

Time: 12 months after PE diagnosis

Description: Category of treatments: Heparin + AVK Heparin + DOAC Bleeding complications: classification 1-2-3-5 according to BARC

Measure: Effectiveness of the different category of treatments used in all patients and in the groups: % of patients with occurrence of bleeding complications for each categories of treatments

Time: 12 months after PE diagnosis

Description: Category of treatments: Heparin + AVK Heparin + DOAC

Measure: Effectiveness of the different category of treatments used in all patients and in the groups: % of patients with no occurrence of complications for each categories of treatments

Time: 12 months after PE diagnosis

Description: Category of treatments: Heparin + AVK Heparin + DOAC

Measure: Effectiveness of the different category of treatments used in all patients and in the groups: duration of Heparin treatment (number of day)

Time: 12 months after PE diagnosis
12 Assessment of the Risk of Pulmonary Embolism and Coagulation Profile in Patients With SARS Coronavirus (COV-2) Lung Disease

The current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is complicated by pneumonia (15 to 20% of cases) requiring hospitalization with oxygen therapy. Almost 20 to 25% of hospitalized patients require intensive care and resuscitation; half die. The main cause of death is acute respiratory distress syndrome (ARDS). However, some deaths have been linked to pulmonary embolism (PE). Recognition of PE is important because there is specific treatment to limit its own mortality. The identification of biological parameters of hemostasis predictive of thromboembolic disease is crucial in these patients. To evaluate the frequency of PE in the patients having to be hospitalized is to practice of a systematic thoracic angiography scanner in the patients having no contra-indication for its realization, as well as during hospitalization in patients deteriorating without any other obvious cause. The thromboembolic events and disturbances of the coagulation system described in patients with SARS-CoV-2 pneumonitis suggest that this viral infection is associated with an increase in the activation of coagulation contributing to the occurrence of thrombosis and especially from PE.

NCT04479540
Conditions
  1. Pneumonia, Viral
Interventions
  1. Radiation: Angiography scanner
MeSH:Pneumonia, Viral Pneumonia Lung Diseases Pulmonary Embolism Embolism
HPO:Abnormal lung morphology Pneumonia Pulmonary embolism

Primary Outcomes

Description: Rate of patients with pulmonary embolism diagnosed by thoracic angiography scanner

Measure: Rate of patients with pulmonary embolism

Time: up to Day 12

Secondary Outcomes

Description: Measure of prothrombin level to assess hemostasis parameters of patients with SARS-COV-2pneumonitis during hospitalization

Measure: Prothrombin level measurement

Time: up to Day 12

Description: Measure of activated partial thromboplastin time to assess hemostasis parameters of patients with SARS-COV-2pneumonitis during hospitalization

Measure: activated partial thromboplastin time measurement

Time: up to Day 12

Description: Measure of fibrinogen to assess hemostasis parameters of patients with SARS-COV-2pneumonitis during hospitalization

Measure: Fibrinogen measurement

Time: up to Day 12

Description: Measure of D-dimers to assess hemostasis parameters of patients with SARS-COV-2pneumonitis during hospitalization

Measure: D-dimers measurement

Time: up to Day 12

Description: Measure of Protein C to assess hemostasis parameters of patients with SARS-COV-2pneumonitis during hospitalization

Measure: Protein C measurement

Time: up to Day 12

Description: Measure of Willebrand antigen to assess hemostasis parameters of patients with SARS-COV-2pneumonitis during hospitalization

Measure: Willebrand antigen measurement

Time: up to Day 12

Description: Measure of Soluble tissue factor to assess hemostasis parameters of patients with SARS-COV-2pneumonitis during hospitalization

Measure: Soluble tissue factor measurement

Time: up to Day 12

Description: Measure of soluble thrombomodulin to assess hemostasis parameters of patients with SARS-COV-2pneumonitis during hospitalization

Measure: Soluble thrombomodulin measurement

Time: up to Day 12

Description: Measure of E-selectin to assess hemostasis parameters of patients with SARS-COV-2pneumonitis during hospitalization

Measure: E-selectin measurement

Time: up to Day 12

Description: Measure of thrombin-antithrombin complex to assess hemostasis parameters of patients with SARS-COV-2pneumonitis during hospitalization

Measure: Thrombin-antithrombin complex measurement

Time: up to Day 12

Description: Assessment of clot formation curve by Thrombodynamics® to identify ones predictive of the onset of Pulmonary Embolism or a poor prognosis

Measure: Assessment of clot formation curve

Time: Day 1

Description: Assessment of thrombin generation by Thrombodynamics® to identify ones predictive of the onset of Pulmonary Embolism or a poor prognosis

Measure: Assessment of thrombin generation

Time: Day 1

Description: Assessment of fibrinolysis by Thrombodynamics® to identify ones predictive of the onset of Pulmonary Embolism or a poor prognosis

Measure: Assessment of fibrinolysis

Time: Day 1

Description: Determine patient mortality

Measure: Mortality

Time: Day 30
13 Effect of the Use of Anticoagulant Therapy During Hospitalization and Discharge in Patients With COVID-19 Infection

Viral infections provoke the systemic inflammatory response and cause an imbalance between the procoagulant and anticoagulant homeostatic mechanisms. Multiple pathogenic mechanisms are involved, including endothelial dysfunction, increased von Willebrand factor, Toll receptor activation, and tissue factor pathway activation. D-dimer levels greater than 1000 ng / mL are associated with an 18-fold increased risk of mortality. In this context, many patients may require prophylaxis or antithrombotic treatment with low molecular weight heparins. Currently, there is no validated scheme on the dose and timing of the use of antithrombotic drugs. The study aims to identify the effect of two anticoagulant strategies (prophylactic and therapeutic) on the progression to ventilatory support or death in patients with COVID-19 infection who require hospital care.

NCT04508439
Conditions
  1. Covid19
  2. Pneumonia
  3. Coagulation Disorder
  4. Pulmonary Embolism
Interventions
  1. Drug: Enoxaparin
MeSH:Pneumonia Pulmonary Embolism Embolism Hemostatic Disorders Blood Coagulation Disorders
HPO:Abnormality of coagulation Abnormality of the coagulation cascade Pneumonia Pulmonary embolism

Primary Outcomes

Description: Identify the benefit of different doses of low molecular weight heparin (enoxaparin) on ventilatory support time in patients requiring hospital care for COVID-19 infection.

Measure: low molecular weight heparin (enoxaparin) and ventilatory support time

Time: 30 days

Description: To compare oral anticoagulation therapy by administering Rivaroxaban 10mg PO every 24 hours on early thrombotic complications

Measure: thrombotic complications and Rivaroxaban

Time: 30 days

Description: Identify the benefit of different doses of low molecular weight heparin (enoxaparin) on the length of hospital stay in patients requiring hospital care for COVID-19 infection.

Measure: low molecular weight heparin (enoxaparin) and length of hospital stay

Time: 30 days

Description: Identify the benefit of different doses of low molecular weight heparin (enoxaparin) over mortality rate in patients requiring hospital care for COVID-19 infection.

Measure: low molecular weight heparin (enoxaparin) and mortality rate

Time: 30 days
14 COVID-19 Registry to Assess Frequency, Risk Factors, Management, and Outcomes of Arterial and Venous Thromboembolic Complications (CORONA-VTE NETWORK)

Novel coronavirus 2019 (COVID-19) has emerged as a major international public health concern. While much of the morbidity and mortality associated with COVID-19 has been attributed to acute respiratory distress syndrome (ARDS) or end-organ failure, emerging data suggest that disorders of coagulation, in particular hypercoagulability and venous thromboembolism (VTE), may represent an additional major, and possibly preventable, complication (Wu C, et al. JAMA Intern Med. 2020 Mar 13. [Epub ahead of print] and Tang N, et al. Thromb. Haemost. 2020 Feb 19. [EPub Ahead of Print]). Abnormal coagulation testing results, especially markedly elevated D-dimer and FDP, have been associated with a poor prognosis in COVID-19 infection. We propose the following Electronic Health Record (EHR)-guided 10000-patient, retrospective observational cohort study to assess VTE incidence, risk factors, prevention and management patterns, and thrombotic outcomes in patients with COVID-19 infection. In order to gain the valuable perspective of other regional and national centers providing care for large populations of COVID-19, we have started a collaborative network with 5 additional sites which will provide us with de-identified data from 1000 patients each. These 5000 patients in addition to the 5000-patient cohort we are enrolling within the Mass General Brigham Network will comprise this study population.

NCT04535128
Conditions
  1. Covid19
  2. Thrombosis Embolism
  3. DVT
  4. Pulmonary Embolism
  5. Myocardial Infarction
  6. Stroke
Interventions
  1. Other: No intervention
MeSH:Pulmonary Embolism Myocardial Infarction Thrombosis Embolism Embolism and Thrombosis Infarction
HPO:Myocardial infarction Pulmonary embolism Thromboembolism

Primary Outcomes

Description: Frequency (%) of arterial or venous thromboembolism

Measure: Frequency of arterial or venous thromboembolism over 30 days

Time: 30 days

Description: Frequency (%) of arterial or venous thromboembolism

Measure: Frequency of arterial or venous thromboembolism over 90 days

Time: 90 days

Secondary Outcomes

Description: Frequency (%) of all-cause death, bleeding, and thromboembolic outcomes

Measure: Frequency of all-cause death, bleeding, and thromboembolic outcomes at 30 days

Time: 30 days

Description: Frequency (%) of all-cause death, bleeding, and thromboembolic outcomes

Measure: Frequency of all-cause death, bleeding, and thromboembolic outcomes at 90 days

Time: 90 days
15 Low-Dose Tenecteplase in Covid-19 Patients With Acture Pulmonary Embolism: A Randomized, Double-Blind, Placebo-Controlled Trial

- There is a knowledge gap associated with the management of patients with COVID-19 lung injury and a laboratory picture compatible with disseminated intravascular coagulation (DIC). Clinical data to date support that COVID-19 is associated with a prothrombotic state that is not simply explained by an influx of more critically ill individuals. - These patients suffer from severe respiratory failure; hypoxemia and ventilator dependence are the primary concerns; ARDS with respiratory failure is frequently the cause of death. Macroscopic and probable microvascular thromboembolic events are a major concern in this population. - When DIC is associated with COVID-19, it predicts a very poor prognosis. - We plan to evaluate the clinical efficacy and safety of low-dose IV bolus tenecteplase (TNK) together with anticoagulation compared with control patients on therapeutic anticoagulation alone in hospitalized adults diagnosed with COVID-19 and acute intermediate-risk PE. We believe that acute PE in the setting of active COVID-19 infections likely portend a poor prognosis. - Prospective, multicenter, randomized two-arm trial enrolling consecutive patients who meet enrollment criteria. - We hope to generate evidence that low-dose TNK together with anticoagulation is beneficial in these patients.

NCT04558125
Conditions
  1. Pulmonary Embolism
  2. COVID
Interventions
  1. Drug: TNKase
MeSH:Pulmonary Embolism Embolism
HPO:Pulmonary embolism

Primary Outcomes

Description: For example, a patient may start with a heart rate of 100/min and systolic BP of 100 mm Hg (shock index = 1) and after therapy, HR might be 90, with systolic BP of 110 mm Hg (shock index of 0.81), an improvement of 19%.

Measure: Percent improvement in shock index (HR/SBP) 6 hours after the TNK/placebo bolus.

Time: 6 hours post TNK/placebo infusion

Secondary Outcomes

Description: Assessment of patient status using an ordinal scale will be recorded at baseline and once daily in the morning while hospitalized.

Measure: 1. Clinical status at 24 hours after administration of TNK / placebo based upon 7-point scale.

Time: 24 +/- 6 hours post TNK/placebo infusion.

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.

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