Short-term Physical Function Outcomes in Severe COVID-19 Patients Admitted to ICU for Invasive Mechanical Ventilation

April 12, 2021 updated by: Maria Natividad Seisdedos Nunez, Fundacion para la Investigacion Biomedica del Hospital Universitario Ramon y Cajal

Short-term Physical Function Outcomes in Severe COVID-19 Patients Admitted to ICU for Invasive Mechanical Ventilation: an Observational Cohort Study

Little is known about the physical function outcomes in patients with severe COVID-19 patients who are admitted to Intensive Care Unit (ICU) for invasive mechanical ventilation. The purpose of this study is to evaluate the short-term impact on physical function before hospital discharge in subjects with severe COVID-19 who have survived ICU admission for invasive mechanical ventilation.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

DESIGN: An observation cohort study conducted in a tertiary hospital.

METHODS: Data will be collected from patients along the ICU-hospital discharge continuum, will be analysed and non-parametric tests will be used to explore association between variables.

Outcome measures: Muscle strength, as a component of physical function, will be evaluated with the Medical Research Council sum score (MRC- SS) at discharge from ICU and at hospital discharge; the Functional Status Score for the ICU (FSS-ICU) will also be assessed at hospital discharge. Data on participants' demographics, ICU admission and hospital admission will also be collected.

SIGNIFICANCE OF THE RESEARCH: Understanding how physical function is affected in patients with severe COVID-19 may help develop future prevention, therapeutic and follow-up strategies that improve quality of care and outcomes in this specific group of patients. Findings from this study may be useful to design future larger cohort studies and experimental trials.

Study Type

Observational

Enrollment (Actual)

71

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Madrid, Spain, 28034
        • Medical ICU. Hospital Universitario Ramón y Cajal
      • Madrid, Spain, 28034
        • Surgical ICU. Hospital Universitario Ramón y Cajal

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 80 years (Adult, Older Adult)

Accepts Healthy Volunteers

N/A

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Subjects diagnosed with COVID-19 who require admission to the ICU for invasive mechanical ventilation.

Description

Inclusion Criteria:

  • subjects diagnosed with COVID-19 who have required admission to ICU for invasive mechanical ventilation;
  • have received invasive ventilation > 24 hours;
  • have been successfully weaned from mechanical ventilation > 48 hours;
  • were independently able to mobilise prior to current hospital admission (this includes subjects who used a walking stick or another gait aid to mobilise.

Exclusion Criteria:

  • subjects or proxies with inability to communicate in Spanish fluently;
  • cognitive impairment prior to ICU admission;
  • proven neurological impairment or neuromuscular disorder;
  • Cerebrovascular Accident during hospital stay;
  • previous organ transplant;
  • pregnancy;
  • unstable fractures or any other injuries that would require medical bed rest.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Medical Research Council sum score (MRC- SS).
Time Frame: < 48 hours before ICU discharge
Physical examination will be performed to carry out manual muscle testing of strength in 6 different muscle groups of the upper limb and lower limb on both sides of the body.
< 48 hours before ICU discharge
Medical Research Council sum score (MRC- SS).
Time Frame: < 24 hours before hospital discharge
Physical examination will be performed to carry out manual muscle testing of strength in 6 different muscle groups of the upper limb and lower limb on both sides of the body.
< 24 hours before hospital discharge
The Functional Status Score for the ICU (FSS-ICU)
Time Frame: < 24 hours before hospital discharge
The Functional Status Score for the ICU (FSS-ICU) will be used to evaluate 5 functional tasks. Each task is evaluated using an 8-point ordinal scale ranging from 0 (not able to perform) to 7 (complete independence).The total FSS-ICU score ranges from 0 to 35, with higher scores indicating better physical functioning.
< 24 hours before hospital discharge

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Age
Time Frame: Through study completion, up to 6 months
Age in years
Through study completion, up to 6 months
Sex
Time Frame: Throughout study completion , up to 6 month
Male vs Female
Throughout study completion , up to 6 month
Body Mass Index
Time Frame: Throughout study completion, up to 6 months
kg/m2
Throughout study completion, up to 6 months
Baseline mobility
Time Frame: First day the patient can cooperate with assessment according to the ' 5 Standard Questions' test.
Baseline mobility
First day the patient can cooperate with assessment according to the ' 5 Standard Questions' test.
APACHE II score
Time Frame: <24 hours after ICU admission
Acute Physiology and Chronic Health Evaluation II score.The APACHE II score ranges from 0 to 71 points. Higher scores correspond to more severe disease and a higher risk of death.
<24 hours after ICU admission
Length of stay in ICU
Time Frame: Throughout the study completion, up to 6 months
Number of days of stay in ICU
Throughout the study completion, up to 6 months
Number of days on mechanical ventilation
Time Frame: Throughout the study completion, up to 6 months
Number of days on mechanical ventilation
Throughout the study completion, up to 6 months
Polyneuropathy diagnosis
Time Frame: Throughout the study completion, up to 6 months
Clinical or EMG polyneuropathy diagnosis confirmation
Throughout the study completion, up to 6 months
Number of days on Neuromuscular Blockers
Time Frame: Throughout the study completion, up to 6 months
Number of days on NMB during mechanical ventilation
Throughout the study completion, up to 6 months
Episodes of prone positioning
Time Frame: Throughout the study completion, up to 6 months
Number of prone positioning episodes during ICU stay
Throughout the study completion, up to 6 months
Length of stay in hospital
Time Frame: Throughout the study completion, up to 6 months
Total number of days admitted to hospital
Throughout the study completion, up to 6 months
Continuation of care
Time Frame: Throughout the study completion, up to 6 months
Home with no follow-up physiotherapy, home with domiciliary or out-patient physiotherapy, rehabilitation facility, care home, transfer to another acute hospital.
Throughout the study completion, up to 6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 15, 2020

Primary Completion (Actual)

February 25, 2021

Study Completion (Actual)

March 1, 2021

Study Registration Dates

First Submitted

May 20, 2020

First Submitted That Met QC Criteria

May 21, 2020

First Posted (Actual)

May 22, 2020

Study Record Updates

Last Update Posted (Actual)

April 13, 2021

Last Update Submitted That Met QC Criteria

April 12, 2021

Last Verified

April 1, 2021

More Information

Terms related to this study

Other Study ID Numbers

  • 165/20

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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