Glucocorticoid Therapy for COVID-19 Critically Ill Patients With Severe Acute Respiratory Failure
Glucocorticoid Therapy for Critically Ill Patients With Severe Acute Respiratory Infections Caused by COVID-19: a Prospective, Randomized Controlled Trial
調査の概要
詳細な説明
COVID-19 is a novel coronavirus that was initially outbreak in Wuhan, China. Severe acute respiratory infection with COVID-19 causes severe acute respiratory failure with substantial mortality. Currently, the standard care is supportive care, and no treatment is proven to be effective for this condition.
Glucocorticoid therapy is widely used among critically ill patients with other coronavirus infection such as SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome). However, whether glucocorticoid improved the outcome of COVID-19 remains unknown. We hypothesized that glucocorticoid would improve the prognosis of patietns with COVID-19.
In this study, critically ill patients with COVID-19 were enrolled and randomized to receive ether standard care or standard care in combination with methylprednisolone therapy. The primary outcome is the difference of Murray lung injury score between two groups.
研究の種類
入学 (実際)
段階
- フェーズ2
- フェーズ 3
連絡先と場所
研究場所
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Beijing
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Beijing、Beijing、中国、010
- Medical ICU,Peking Union Medical College Hospital
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Adult
- PCR confirmed COVID-19 infection
- Symptoms developed more than 7 days
- PaO2/FiO2 < 200 mmHg
- Positive pressure ventilation (non-invasive or invasive) or high flow nasal cannula (HFNC) higher than 45 L/min for less than 48 hours
- Requiring ICU admission
Exclusion Criteria:
- pregnancy;
- patients currently taking corticosteroids (cumulative 400 mg prednisone or equivalent);
- Severe underlying disease, i.e. end stage of malignancy disease or end stage of pulmonary disease;
- Severe adverse events before ICU admission, i.e. cardiac arrest;
- Underlying disease requiring corticosteroids;
- Contraindication for corticosteroids;
- Recruited in other clinical intervention trial
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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プラセボコンパレーター:standard care
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標準ケア
|
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実験的:standard care + methylprednisolone therapy
Methylprednisolone 40 mg q12h for 5 days
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Methylprednisolone 40 mg q12h for 5 days
他の名前:
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Lower Murray lung injury score
時間枠:7 days after randomization
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Murray lung injury score decreased more than one point means better outcome.The Murray scoring system range from 0 to 4 according to the severity of the condition.
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7 days after randomization
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Lower Murray lung injury score
時間枠:14 days after randomization
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Murray lung injury score decreased more than one point means better outcome.The Murray scoring system range from 0 to 4 according to the severity of the condition.
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14 days after randomization
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
The difference of PaO2/FiO2 between two groups
時間枠:7 days after randomization
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PaO2/FiO2 denotes ratio of arterial partial pressure of O2 and the fraction of inspired oxygen, with a higher PaO2/FiO2 means favorable outcome.
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7 days after randomization
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Lower Sequential Organ Failure Assessment (SOFA) score
時間枠:7 days after randomization
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Lower SOFA score means better outcome.
The SOFA score system range from 0 to 24 according to the severity of the condition.
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7 days after randomization
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Mechanical ventilation support
時間枠:7 days after randomization
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Percentage of patients requiring Mechanical ventilation support
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7 days after randomization
|
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The difference of PaO2/FiO2 between two groups
時間枠:14 days after randomization
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PaO2/FiO2 denotes ratio of arterial partial pressure of O2 and the fraction of inspired oxygen, with a higher PaO2/FiO2 means favorable outcome.
|
14 days after randomization
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Lower Sequential Organ Failure Assessment (SOFA) score
時間枠:14 days after randomization
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Lower SOFA score means better outcome.
The SOFA score system range from 0 to 24 according to the severity of the condition.
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14 days after randomization
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Mechanical ventilation support
時間枠:14 days after randomization
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Percentage of patients requiring Mechanical ventilation support
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14 days after randomization
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Clearance of noval coronavirus
時間枠:14 days after randomization
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Clearance of noval coronavirus in upper respiratory tract or lower respiratory tract
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14 days after randomization
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All-cause mortality
時間枠:30 days after randomization
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All-cause mortality
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30 days after randomization
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協力者と研究者
出版物と役立つリンク
一般刊行物
- Arabi YM, Mandourah Y, Al-Hameed F, Sindi AA, Almekhlafi GA, Hussein MA, Jose J, Pinto R, Al-Omari A, Kharaba A, Almotairi A, Al Khatib K, Alraddadi B, Shalhoub S, Abdulmomen A, Qushmaq I, Mady A, Solaiman O, Al-Aithan AM, Al-Raddadi R, Ragab A, Balkhy HH, Al Harthy A, Deeb AM, Al Mutairi H, Al-Dawood A, Merson L, Hayden FG, Fowler RA; Saudi Critical Care Trial Group. Corticosteroid Therapy for Critically Ill Patients with Middle East Respiratory Syndrome. Am J Respir Crit Care Med. 2018 Mar 15;197(6):757-767. doi: 10.1164/rccm.201706-1172OC.
- Auyeung TW, Lee JS, Lai WK, Choi CH, Lee HK, Lee JS, Li PC, Lok KH, Ng YY, Wong WM, Yeung YM. The use of corticosteroid as treatment in SARS was associated with adverse outcomes: a retrospective cohort study. J Infect. 2005 Aug;51(2):98-102. doi: 10.1016/j.jinf.2004.09.008.
- Raghavendran K, Napolitano LM. Definition of ALI/ARDS. Crit Care Clin. 2011 Jul;27(3):429-37. doi: 10.1016/j.ccc.2011.05.006.
- Vincent JL, de Mendonca A, Cantraine F, Moreno R, Takala J, Suter PM, Sprung CL, Colardyn F, Blecher S. Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on "sepsis-related problems" of the European Society of Intensive Care Medicine. Crit Care Med. 1998 Nov;26(11):1793-800. doi: 10.1097/00003246-199811000-00016.
- Sultana J, Crisafulli S, Gabbay F, Lynn E, Shakir S, Trifiro G. Challenges for Drug Repurposing in the COVID-19 Pandemic Era. Front Pharmacol. 2020 Nov 6;11:588654. doi: 10.3389/fphar.2020.588654. eCollection 2020.
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- Glucocorticoid COVID-19
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
新型コロナウイルス感染症の臨床試験
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Pfizer積極的、募集していないCOVID-19(新型コロナウイルス感染症) | コロナウイルス病 2019 (COVID-19) | COVID-19 感染 | COVID-19 ワクチン | SARS-CoV-2 感染、COVID19 | COVID-19 ワクチン接種 | SARS-CoV-2 感染、COVID-19 | COVID-19 (コロナウイルス病 2019) | COVID-19 SARS-CoV-2 感染症アメリカ
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Pfizer募集気道疾患 | COVID-19(新型コロナウイルス感染症) | 肺炎 | 肺疾患 | コロナウイルス 病気 2019年 | コロナウイルス病 2019 (COVID-19) | COVID-19 感染 | 上気道感染症 | 気道感染症 | COVID-19 (コロナウイルス病 2019) | COVID-19 SARS-CoV-2 感染症ベルギー
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