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D003693: Delirium

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

Correlations computed by analyzing all clinical trials.

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Correlated Drug Terms (11)


Name (Synonyms) Correlation
drug1006 Dexmedetomidine Injectable Product Wiki 0.45
drug603 COVID-19 Swab Wiki 0.45
drug751 Choices and judgements Wiki 0.45
Name (Synonyms) Correlation
drug2704 Quetiapine Wiki 0.45
drug3530 Valproate Wiki 0.45
drug581 COVID visitation restrictions Wiki 0.45
drug604 COVID-19 Therapeutic Biologics - Spike-GM-CSF Protein Lactated Ringer's Injection Wiki 0.32
drug152 Ad26.COV2.S Wiki 0.22
drug3218 Survey Wiki 0.12
drug3138 Standard of Care Wiki 0.07
drug2448 Placebo Wiki 0.02

Correlated MeSH Terms (17)


Name (Synonyms) Correlation
D020196 Trauma, Nervous System NIH 0.45
D013896 Thoracic Diseases NIH 0.45
D009421 Nervous System Malformations NIH 0.45
Name (Synonyms) Correlation
D000071257 Emergence Delirium NIH 0.45
D001927 Brain Diseases NIH 0.40
D000013 Congenital Abnormalities NIH 0.32
D006331 Heart Diseases NIH 0.17
D006333 Heart Failure NIH 0.16
D016638 Critical Illness NIH 0.11
D007249 Inflammation NIH 0.08
D002318 Cardiovascular Diseases NIH 0.08
D011024 Pneumonia, Viral NIH 0.05
D013577 Syndrome NIH 0.04
D012127 Respiratory Distress Syndrome, Newborn NIH 0.04
D055371 Acute Lung Injury NIH 0.04
D012128 Respiratory Distress Syndrome, Adult NIH 0.03
D011014 Pneumonia NIH 0.02

Correlated HPO Terms (5)


Name (Synonyms) Correlation
HP:0000707 Abnormality of the nervous system HPO 0.45
HP:0001298 Encephalopathy HPO 0.40
HP:0001635 Congestive heart failure HPO 0.16
Name (Synonyms) Correlation
HP:0001626 Abnormality of the cardiovascular system HPO 0.07
HP:0002090 Pneumonia HPO 0.02

Clinical Trials

Navigate: Correlations   HPO

There are 5 clinical trials


1 Impact of Dexmedetomidine Infusion on the Time Course and Outcomes of Acute Respiratory Distress Syndrome (ARDS) in Patients Affected by the SARS-CoV-2 (COVID-19) Admitted to Critical Care Unit

A continuous infusion of Dexmedetomidine (DEX) will be administered to 80 patients admitted to Critical Care because of signs of Respiratory Insufficiency requiring non-invasive ventilation. Measurements of respiratory performance and quantification of cellular and molecular inflammatory mediators. The primary outcome will be the avoidance of mechanical ventilation with secondary outcomes duration of mechanical ventilation, avoidance of delirium after sedation and association of mediators of inflammation to outcomes. Outcomes will be compared to a matched historical control (no DEX) series

NCT04358627
Conditions
  1. Acute Respiratory Distress Syndrome
  2. Inflammation
  3. Dexmedetomidine
  4. Cytokine Storm
  5. Delirium, Emergence
Interventions
  1. Drug: Dexmedetomidine Injectable Product
MeSH:Respiratory Distress Syndrome, Newborn Respiratory Distress Syndrome, Adult Acute Lung Injury Delirium Emergence Delirium Syndrome Inflammation

Primary Outcomes

Description: (Presence/Absence) requirement of mechanical ventilation

Measure: Mechanical ventilation

Time: expected within first three days (non conclusive due to lack of evidence yet)

Secondary Outcomes

Description: Duration of mechanical ventilation if it is required (hours from the start)

Measure: Duration of mechanical ventilation

Time: expected within first seven days (non conclusive due to lack of evidence yet)

Description: Delirium criteria as defined in DSM-4

Measure: Delirium on recovery from sedation

Time: First 24 hours after retiring dexmedetomidine sedation
2 Biomarker-guided Assessment of Neurocognitive Impairment in Patients With COVID-19 - a Multicenter Case-control Study

Delirium and acute neurocognitive impairment are increasingly observed in adult and pediatric patients with COVID-19. Prospective clinical studies combining clinical and laboratory examinations including specific biomarkers of neuroaxonal injury were not performed for COVID-19. The value of biomarkers of neuroaxonal injury was proven in preliminary studies. These biomarkers could thus contribute to the systematic detection of neurocognitive impairment in patients with COVID-19. Due to worldwide increasing numbers of hospitalized patients with COVID-19, biomarkers of neuroaxonal injury are highly valuable to detect and monitor cognitive impairment, especially with regard to limited resources available to perform time-consuming brain imaging. Biomarkers of neuroaxonal injury are therefore not only of great interest to detect neurocognitive impairment but also to quantify the severity of brain injury in patients with COVID-19.

NCT04359914
Conditions
  1. Critical Illness
  2. COVID-19
  3. Central Nervous System Injury
  4. Delirium
  5. Encephalopathy
MeSH:Delirium Brain Diseases Trauma, Nervous System Critical Illness
HPO:Encephalopathy

Primary Outcomes

Description: Assessment of neurocognitive impairment using validated tools

Measure: Incidence of delirium/neurocognitive impairment in adult and pediatric patients with COVID-19 compared to patients without COVID-19

Time: Day 90

Description: Measurement of biomarker levels (e.g. NSE, S100B, neurofilament proteins) derived from blood samples

Measure: Change in neuroaxonal injury biomarker levels in patients with COVID-19 compared to patients without COVID-19

Time: Change from baseline biomarker levels at day 28

Description: Assessment of the neurocognitive performance of patients using validated tests (e.g. Short Blessed Test)

Measure: Neurocognitive 3-months outcome in patients with COVID-19 compared to patients without COVID-19

Time: Day 90

Description: Assessment of the change in the neurocognitive performance of patients using validated tests (e.g. IQCODE)

Measure: Neurocognitive 3-months outcome in patients with COVID-19 compared to patients without COVID-19

Time: Change from baseline IQCODE results at day 90

Secondary Outcomes

Description: Assessment of the overall quality of life using validated tests [e.g. Modified Rankin Scale with a range from 0 (no symptoms) to 6 (dead)]

Measure: Quality of life in patients with COVID-19 compared to patients without COVID-19 after hospital discharge

Time: Day 90

Description: Cumulative days in hospital

Measure: Length of hospital stay in patients with COVID-19 compared to patients without COVID-19

Time: 1 year

Description: Survival after 90 days

Measure: 90-day survival in patients with COVID-19 compared to patients without COVID-19

Time: Day 90
3 A Practical, Pilot, Randomized, Controlled Trial of Valproate Alone or in Combination With Quetiapine for Severe COVID-19 Pneumonia With Agitated Delirium

The primary purpose of this research is to determine whether Valproate alone, and in combination with Quetiapine, lowers confusion and agitation in persons with severe Corona Virus Disease (COVID)19 pneumonia during weaning from the breathing machine (ventilator). Though Valproate and Quetiapine are often given to persons with severe confusion with agitation, the purpose of this small research study is specifically for: a) persons infected with COVID 2019 on a ventilator whose agitation is not responding to the usual medications (like dexmedetomidine), and b) to reduce the time persons are treated with dexmedetomidine, which requires continuous close monitoring in an ICU.

NCT04513314
Conditions
  1. Covid19
  2. Hyperactive Delirium
  3. Pneumonia, Viral
Interventions
  1. Drug: Valproate
  2. Drug: Quetiapine
  3. Other: Standard of Care
MeSH:Pneumonia, Viral Pneumonia Delirium
HPO:Pneumonia

Primary Outcomes

Description: Richmond Agitation Sedation Scale (RASS) score ranges from +4 (combative) to 0 (alert & calm) to -5 (unarousable).

Measure: Change from baseline RASS score of +3 or greater

Time: Baseline, Day 7

Secondary Outcomes

Description: Total dose of dexmedetomidine administered will be reported from baseline RASS score of +3 or greater.

Measure: Total dose of dexmedetomidine administered

Time: Day 7

Description: Incidence of Treatment Emergent Adverse Events will include: QTc duration > 470 msecs. Increase in Liver Function Tests to a Grade 3 or higher using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v5.0. Suicidality reported as having a score of moderate or high risk using the Columbia-Suicide Severity Rating Scale Screening (C-SSRS). C-SSRS is a calculated risk assessment tool that scores suicidality from no risk to high risk.

Measure: Incidence of Treatment Emergent Adverse Events

Time: Day 7
4 Absent Visitors: The Wider Implications of COVID-19 on Non-COVID Cardiothoracic ICU Patients, Relatives and Staff

Patients are part of a family network. When any person in a family becomes critically unwell and requires the assistance of an Intensive Care Unit (ICU), this has an impact on all members of that family. COVID-19 changed visiting for all patients in hospitals across Scotland. It is not known what effect these restrictions will have on patients' recovery, nor do we understand the impact it may have on their relatives or staff caring for them. This study will look at the implications of the visiting restrictions as a consequence of the COVID-19 pandemic upon patients without COVID-19 who are in the cardiothoracic ICU. It will also explore the impact of these restrictions on them, their relatives and staff. This study will be carried out within a single specialised intensive care unit in Scotland using mixed methods. The first arm of this study will use retrospective data that is routinely collected in normal clinical practice. The investigators will compare patient outcomes prior to COVID-19 with outcomes following the implementation of COVID-19 visiting restrictions. The aim is to establish if the restrictions on visiting has an impact on the duration of delirium. Delirium is an acute mental confusion and is associated with longer hospital stays and worse outcomes in this patient group. The second arm of this study involves semi-structured interviews with patients, relatives and staff that will allow deeper exploration of the issues around current visiting policy. The interviews will last approximately 1 hour and will address these issues. They will then be transcribed word for word and analysed using grounded theory, meaning the theories will develop from the data as it is analysed.

NCT04538469
Conditions
  1. Cardiovascular Diseases
  2. Delirium
  3. Critical Illness
  4. Intensive Care Unit Delirium
  5. Thoracic Diseases
  6. Respiratory Failure
  7. Cardiac Disease
  8. Cardiac Failure
Interventions
  1. Other: COVID visitation restrictions
MeSH:Respiratory Insufficiency Thoracic Diseases Delirium Cardiovascular Diseases Heart Diseases Heart Failure Critical Illness
HPO:Abnormal left ventricular function Abnormality of the cardiovascular system Congestive heart failure Right ventricular failure

Primary Outcomes

Description: Number of days patient found to have delirium using the Confusion Assessment Method for the ICU (CAM-ICU)

Measure: Duration of delirium

Time: From the date of admission to the Intensive Care Unit (ICU) until discharge from the ICU or death, whichever came first, up to 12 months.

Secondary Outcomes

Description: CAM-ICU

Measure: Incidence of delirium

Time: From the date of admission to the Intensive Care Unit (ICU) until discharge from the ICU or death, whichever came first, up to 12 months.

Description: Days

Measure: Length of critical care stay

Time: From the date of admission to the ICU until discharge from the ICU or death, whichever came first, up to 12 months.

Description: Days

Measure: Length of hospital stay

Time: From the date of admission to the hospital until discharge from the hospital or death, whichever came first, up to 12 months.

Measure: Doses of specified drugs during ICU admission

Time: From the date of admission to the ICU until discharge from the ICU or death, whichever came first, up to 12 months.

Description: Days

Measure: Length of time ventilated

Time: From the date of admission to the ICU until discharge from the ICU or death, whichever came first, up to 12 months.

Measure: Mortality

Time: 6 months

Other Outcomes

Description: Semi structured interviews

Measure: Exploring the experiences of patients, relatives and staff of the visitation restrictions during the COVID-19 pandemic

Time: 18 months
5 Neurological Abnormalities in SARS-CoV-2 ICU Patients. A Prospective Study. NeuroCOVID Study

The SARS-CoV-2 epidemic is leading to a large number of patients in intensive care units due to severe hypoxemic pneumonia. After an acute phase that may require controlled mechanical ventilation and deep sedation, removal of sedation often reveals a pathological awakening in the vast majority of patients. This encephalopathy state remains, to date and to our knowledge, unexplained. Clinical features do not appear to fully correlate with regular delirium. This encephalopathy might be explained by deep and prolonged hypoxemia, a wide use of sedation drugs, systemic inflammation or the hostile ICU environment.

NCT04643548
Conditions
  1. SARS-CoV-2 Infection
  2. Intensive Care Unit Patient
  3. Neurological Abnormality
  4. Delirium
  5. Encephalopathy
MeSH:Delirium Brain Diseases Nervous System Malformations Congenital Abnormalities
HPO:Abnormality of the nervous system Encephalopathy

Primary Outcomes

Description: Plasminogen activator inhibitor-1 (PAI-1), E-selectin and angiopoietin-2

Measure: Dosage of biomarkers typically explored in intensive care unit delirium

Time: Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every 2 days

Description: S100 β, Neuron Specific Enolase (NSE), GFAP, UCHL1, NFL

Measure: Dosage of neuronal injury markers

Time: Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every 2 days

Secondary Outcomes

Description: CAM-ICU (Confusion Assessment Method - Intensive Care Unit) scale

Measure: Delirium assessment

Time: Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days

Description: ICDSC (Intensive Care Delirium Screening Checklist) scale.

Measure: Delirium assessment

Time: Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days

Description: CRS-R (Coma Recovery Scale-Revised)

Measure: Coma assessment

Time: Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days

Description: Clinical observation

Measure: Pupils characteristics

Time: Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days

Description: Pupilometer assessment

Measure: Pupils characteristics

Time: Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days

Description: Electroencephalogram : epileptic activity (spikes, spike-waves) or encephalopathy activity (triphasic waves))

Measure: Neurological abnormalities

Time: Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days

Description: CT-scan

Measure: Neurological abnormalities

Time: Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days

Description: MRI

Measure: Neurological abnormalities

Time: Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days

HPO Nodes


HPO

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


HPO Nodes


Reports

Data processed on December 13, 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

4,818 reports on interventions/drugs

MeSH

706 reports on MeSH terms

HPO

306 reports on HPO terms

All Terms

Alphabetical index of all Terms

Google Colab

Python example via Google Colab Notebook