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Trial registered on ANZCTR
Registration number
ACTRN12621001300864
Ethics application status
Approved
Date submitted
10/08/2021
Date registered
27/09/2021
Date last updated
27/09/2021
Date data sharing statement initially provided
27/09/2021
Date results provided
27/09/2021
Type of registration
Retrospectively registered
Titles & IDs
Public title
Consequences of COVID-19 on the respiratory, coagulation, immune and endocrine system and association with bacterial infections among patients treated in the intensive care unit.
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Scientific title
Assessment of the impact of SARS-CoV-2 infection on the respiratory, coagulation, immune and endocrine system and the frequency of bacterial infections in patients hospitalized in the intensive care unit.
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Secondary ID [1]
304998
0
None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
COVID-19
323157
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Respiratory infection
323158
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Coagulation disorders
323159
0
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Renin-angiotensin-aldosterone system dysfunction
323346
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Acute kidney injury
323347
0
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Condition category
Condition code
Infection
320739
320739
0
0
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Other infectious diseases
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Respiratory
320740
320740
0
0
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Other respiratory disorders / diseases
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Blood
320742
320742
0
0
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Clotting disorders
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Metabolic and Endocrine
320743
320743
0
0
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Metabolic disorders
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Metabolic and Endocrine
320744
320744
0
0
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Other endocrine disorders
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Inflammatory and Immune System
320745
320745
0
0
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Other inflammatory or immune system disorders
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Renal and Urogenital
320918
320918
0
0
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Kidney disease
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Intervention/exposure
Study type
Observational
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Patient registry
True
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Target follow-up duration
28
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Target follow-up type
Days
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Description of intervention(s) / exposure
The study aimed to determine the correlation between the infection of SARS-CoV-2 and the occurrence of respiratory, coagulation, immune and endocrine system disorders. The study will be a retrospective observational design; therefore, no active involvement by participants is required. The study will include adult patients hospitalized for SARS-CoV-2 infection in the Intensive Care Unit of the 4th Military Hospital of Wroclaw in Poland. Audit of medical records of adult patients hospitalized for SARS-CoV-2 infection in the Intensive Care Unit of the 4th Military Hospital of Wroclaw in Poland between June 1st, 2021 to July 31st, 2021.
Demographics, blood type, and mechanical ventilation parameters will be analyzed during the study. Additionally, coagulation tests, blood morphology, markers of kidney injury, thromboelastometry, inflammatory markers such as CRP and PCT (procalcitonin) will be evaluated. Kidney function and the rate of thromboembolic complications will be assessed. The frequency of bacterial and fungal co-infections will be recorded. Additionally, information on chronic diseases (diabetes, hypertension, kidney failure, and nicotine addiction) and medications will be collected.
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Intervention code [1]
321393
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Diagnosis / Prognosis
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Intervention code [2]
321394
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Early Detection / Screening
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
328554
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Mortality in patients with COVID-19 hospitalized in ICU using medical records and medical documentation
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Assessment method [1]
328554
0
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Timepoint [1]
328554
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From the time of ICU admission to discharge from ICU
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Primary outcome [2]
328555
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The course of infections in patients with COVID-19 using medical records and medical documentation (time of symptoms and markers of infection: white cells count, C-reactive protein, procalcitonin, culture results, and body temperature measurements will be assessed as a composite outcome)
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Assessment method [2]
328555
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Timepoint [2]
328555
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Monitored continuously during ICU admission
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Primary outcome [3]
328556
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The course of coagulation disorders in patients with COVID-19 using medical records and medical documentation (prothrombin time, activated partial thromboplastin time, international normalized ratio, platelet count, thrombin time, antithrombin III, thromboelastography, level of fibrinogen, d-dimer measurements will be assessed as a composite outcome)
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Assessment method [3]
328556
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Timepoint [3]
328556
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Monitored continuously during ICU admission
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Secondary outcome [1]
399407
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The course of acute kidney injury (AKI) in patients with COVID-19 using medical records and medical documentation (inflammatory and renal parameters)
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Assessment method [1]
399407
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Timepoint [1]
399407
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Monitored continuously during ICU admission
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Secondary outcome [2]
399408
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The course of acute respiratory distress syndrome (ARDS) in patients with COVID-19 using medical records and medical documentation (chest x-ray findings, oxygen saturation, ventilation parameters, ventilation mode)
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Assessment method [2]
399408
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Timepoint [2]
399408
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Monitored continuously during ICU admission
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Secondary outcome [3]
399409
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Assessment of renin-angiotensin-aldosterone system (RAAS) abnormalities in patients with COVID-19 using medical records and medical documentation (aldosterone levels)
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Assessment method [3]
399409
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Timepoint [3]
399409
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Monitored continuously during ICU admission
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Secondary outcome [4]
399410
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Prevalence of thromboembolic complications in patients with COVID-19 using medical records and medical documentation
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Assessment method [4]
399410
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Timepoint [4]
399410
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Monitored continuously during ICU admission
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Secondary outcome [5]
400036
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Assessment of body mass index in patients with COVID-19 using medical records and medical documentation (height determined by stadiometer, and weight determined using balance scales)
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Assessment method [5]
400036
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Timepoint [5]
400036
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Assessed systematically during ICU stay
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Secondary outcome [6]
400037
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Assessment of the effectiveness of the prone position in patients with COVID-19 using medical records and medical documentation
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Assessment method [6]
400037
0
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Timepoint [6]
400037
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Assessed systematically during ICU stay
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Secondary outcome [7]
400038
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Assessment of medications administration in patients with COVID-19 using medical records and medical documentation (pharmacological treatment card)
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Assessment method [7]
400038
0
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Timepoint [7]
400038
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Assessed systematically during ICU stay
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Secondary outcome [8]
400206
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Clinical assessment using Sequential Organ Failure Assessment (SOFA) scale to assess organ dysfunction in six organ systems such as respiratory, coagulatory, liver, cardiovascular, renal, and neurologic (assessed as a composite secondary outcome)
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Assessment method [8]
400206
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Timepoint [8]
400206
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Assessed only once after ICU admission
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Secondary outcome [9]
400207
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Clinical assessment using Acute Physiology and Chronic Health Evaluation II (APACHE II) scale to quantify disease severity and to stratify the hospital mortality risk
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Assessment method [9]
400207
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Timepoint [9]
400207
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Assessed systematically during ICU stay
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Eligibility
Key inclusion criteria
1. Aged between 18 and 90 years
2. Patients with confirmed COVID-19 hospitalized in the ICU
3. The obtained consent to participate in the study
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Minimum age
18
Years
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Maximum age
90
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
None
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Study design
Purpose
Screening
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Retrospective
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Statistical methods / analysis
Analyses will be performed using Statistica v.10 (TIBCO Software Inc., USA). Continuously distributed data will be tested for normality using the Shapiro-Wilk and Kolmogorov-Smirnov tests. The critical significance level will be assumed at p<0.05. Qualitative variables (infection type) will be presented as counts (n) and proportions (%). Pearson's chi-square test of independence will be used to assess the association between infection type and 28-day survival. Quantitative variables will be presented in tables as mean values (M) and standard deviations (SD). The significance of differences between mean parameter levels in groups differing in 28-day survival will be verified using Student's t-test. Kaplan-Meier method will be used to evaluate overall survival (OS). The log-rank test will be used to compare the survival curves of the patient group. The results will be considered statistically significant when the p-values were lower than 0.05.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
1/06/2021
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Date of last participant enrolment
Anticipated
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Actual
31/07/2021
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Date of last data collection
Anticipated
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Actual
31/07/2021
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Sample size
Target
140
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Accrual to date
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Final
132
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Recruitment outside Australia
Country [1]
24034
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Poland
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State/province [1]
24034
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Lower Silesia
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Funding & Sponsors
Funding source category [1]
309381
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Hospital
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Name [1]
309381
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4th Military Hospital of Wroclaw, Poland
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Address [1]
309381
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4th Military Hospital of Wroclaw, Weigla 5, 50-981 Wroclaw, Poland
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Country [1]
309381
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Poland
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Primary sponsor type
Individual
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Name
Patrycja Lesnik, MD, PhD
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Address
Department of Anesthesiology and Intensive Care, 4th Military Hospital of Wroclaw, Weigla 5, 50-981 Wroclaw, Poland
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Country
Poland
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Secondary sponsor category [1]
310357
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Individual
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Name [1]
310357
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Jaroslaw Janc, MD, PhD
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Address [1]
310357
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Department of Anesthesiology and Intensive Care, 4th Military Hospital of Wroclaw, Weigla 5, 50-981 Wroclaw, Poland
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Country [1]
310357
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Poland
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Other collaborator category [1]
281934
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Individual
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Name [1]
281934
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Lidia Lysenko, MD, PhD
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Address [1]
281934
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Department of Anaesthesiology and Intensive Therapy, Wroclaw Medical University, Borowska 213, 50-529 Wroclaw, Poland
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Country [1]
281934
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Poland
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Other collaborator category [2]
281935
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Individual
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Name [2]
281935
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Michal Suchanski, MD
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Address [2]
281935
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Department of Anesthesiology and Intensive Care, 4th Military Hospital of Wroclaw, Weigla 5, 50-981 Wroclaw, Poland
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Country [2]
281935
0
Poland
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
309196
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Bioethics Committee at The Military Medical Chamber in Warsaw, Poland
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Ethics committee address [1]
309196
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Jelinka 48, 01-646 Warsaw, Poland
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Ethics committee country [1]
309196
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Poland
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Date submitted for ethics approval [1]
309196
0
07/05/2021
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Approval date [1]
309196
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21/05/2021
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Ethics approval number [1]
309196
0
3/21
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Summary
Brief summary
Assessment of the impact of SARS-CoV-2 infection on the respiratory, coagulation, immune and endocrine system and the frequency of bacterial infections in patients hospitalized in the intensive care unit. This is a retrospective and cross-sectional study among patients who were treated in ICU for COVID-19. Clinical records and medical documentation obtained during hospitalization of patients in the Department of Anaesthesiology and Intensive Care in the 4th Military Clinical Hospital in Wroclaw in the period from June 1st, 2021 to July 31st, 2021 due to COVID-19 will be evaluated. Apart from the assessment of Sequential Organ Failure Assessment (SOFA), Acute Physiology and Chronic Health Evaluation II (APACHE II), and Simplified Acute Physiology Score II (SAPS II) scales, the selected parameters of the coagulation, hematopoietic, endocrine systems as well as inflammatory and renal parameters will be analyzed. These examinations were taken routinely every day. Ventilation parameters and modes according to the type of ARDS (type H or L) and the effectiveness of the prone position was evaluated. In addition, the study is designed to assess the incidence of bacterial infections, particularly with multi-drug resistant strains, and fungal infections. Medications administered and the incidence of thromboembolic complications were recorded. Additionally, demographic data, BMI, blood group, and the presence of co-morbidities and actual medications will be studied. Symptomatic respiratory distress in COVID-19 often leads to the development of acute respiratory distress syndrome (ARDS) and the need for mechanical ventilation. In addition, bacterial superinfection occurs in patients with immunological disorders and in the course of steroid therapy. Increasingly, co-infections with multidrug-resistant strains are observed, which further worsen prognosis. Thus, patients infected with SARS-CoV-2 have an excessive susceptibility to activation of the coagulation system, hypertension, insulin resistance, alveolar edema, and ARDS. We would like to ensure that participants received interventions regardless of their involvement in the study.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
113310
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Dr Patrycja Lesnik, MD, PhD
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Address
113310
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Department of Anesthesiology and Intensive Care, 4th Military Hospital of Wroclaw, Weigla 5, 50-981 Wroclaw, Poland
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Country
113310
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Poland
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Phone
113310
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+48 71 712 89 39
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Fax
113310
0
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Email
113310
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[email protected]
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Contact person for public queries
Name
113311
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Patrycja Lesnik, MD, PhD
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Address
113311
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Department of Anesthesiology and Intensive Care, 4th Military Hospital of Wroclaw, Weigla 5, 50-981 Wroclaw, Poland
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Country
113311
0
Poland
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Phone
113311
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+48 71 712 89 39
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Fax
113311
0
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Email
113311
0
[email protected]
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Contact person for scientific queries
Name
113312
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Patrycja Lesnik, MD, PhD
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Address
113312
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Department of Anesthesiology and Intensive Care, 4th Military Hospital of Wroclaw, Weigla 5, 50-981 Wroclaw, Poland
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Country
113312
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Poland
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Phone
113312
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+48 71 712 89 39
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Fax
113312
0
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Email
113312
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
12805
Ethical approval
382563-(Uploaded-10-08-2021-08-56-28)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF