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Acute MyocarditisMYOCOVIDNCT04375748

Hospital Registry of Acute Myocarditis: Evolution of the Proportion of Positive SARS-COV-2 (COVID19) Cases

An observational study of Acute Myocarditis, run by University Hospital, Toulouse at 65 sites in 4 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

To date, the effects of SARS-Cov-2 (Covid-19) on the myocardium and the role it plays in the evolution towards an acute myocarditis are badly understood. The current pandemic of this emerging virus is an opportunity to assess the proportion of acute myocarditis attributable to SARS-Cov-2(Covid-19) and to assess the… Read more about this study

Who is it for?
Any age
Conditions the study is for
Acute Myocarditis
What is being tested?
Performing routine care (clinical and paraclinical tests) and Examinations for the research:
How many people
756 participants
Where
65 sitesin 4 countries
Study dates
15 Apr 2020to 28 Dec 2021
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Study population: Patients treated in ICCU or ICU (polyvalent, surgical or medical), in one of the participating hospitals

Who may be able to join

  • Patients treated in ICCU or ICU (polyvalent, surgical or medical), in one of the participating hospitals, for symptoms of acute myocarditis confirmed by a myocardial MRI and/or a CT scan and/or a myocardial biopsy. It seems important to include elderly patients who may be under guardianship or curatorship since these patients seem to present the most severe forms. Additionally, the populations most affected by viral myocarditis are generally adolescents and young adults,which justifies including them in the study too. Pregnant women are a population at potentially greater risk, particularly during the third trimester because of the neuro-hormonal changes inherent in pregnancy. This justifies trying to implement the investigator's knowledge through this observational study.

Who cannot join

  • Refusal to participate.

Trial locations and contacts

65 sites in 4 countries.

65 sites in 4 countries

France62 sites
  • Cardiology

    Aix-en-Provence

  • Reanimation

    Amiens

  • Cardiology

    Angers

  • Reanimation

    Angers

  • Cardiology

    Avignon

  • Cardiology

    Bordeaux

  • Pediatric cardiology

    Bordeaux

  • Reanimation

    Bordeaux

  • Cardiology

    Brest

  • Cardiology

    Caen

  • Pediatric Cardiology

    Caen

  • Cardiology

    Clermont-Ferrand

  • Pediatric cardilogy

    Clermont-Ferrand

  • Reanimation

    Clermont-Ferrand

  • Pediatric cardiology

    Dijon

  • Cardiology

    Grenoble

  • Pediatric cardiology

    Grenoble

  • Reanimation

    Grenoble

  • Cardiology

    Lille

  • Pediatric cardiology

    Lille

  • Pediatric cardiology

    Limoges

  • Cardiology

    Lyon

  • Pediatric cardiology

    Lyon

  • Cardiology

    Marseille

  • Pediatric cardiology

    Marseille

  • Cardiology

    Metz

  • Cardiology

    Montpellier

  • Millénaire Clinical - Cardiology

    Montpellier

  • Pediatric cardiology

    Montpellier

  • Reanimation

    Montpellier

  • Cardiology

    Nancy

  • Pediatric cardiology

    Nancy

  • Cardiology

    Nantes

  • Pediatric cardiology

    Nantes

  • Cardiology

    Nice

  • Pediatric cardiology

    Nice

  • Cardiology

    Nîmes

  • Cardiology, Henri Mondor Hospital

    Paris

  • Cardiology

    Paris

  • Henri Mondor Hospital Reanimation

    Paris

  • Marie Lannelongue Hospital - Pediatric Cardiology

    Paris

  • Marie Lannelongue Hospital Cardiology

    Paris

  • Reanimation

    Paris

  • Robert Debré Hospital - Pediatric cardiology

    Paris

  • Saint Antoine Hospital - Cardiology

    Paris

  • Cardiology

    Poitiers

  • Reanimation

    Poitiers

  • Pediatric cardiology

    Reims

  • Cardiology

    Rennes

  • Pediatric reanimation

    Rennes

  • Cardiology

    Rouen

  • Pediatric cardiology

    Rouen

  • Pédiatric cardiology

    Strasbourg

  • Reanimation

    Strasbourg

  • CHU de TOULOUSE

    Toulouse, 31000

  • Croix du Sud Clinical

    Toulouse

  • Pasteur Clinical - Cardiology

    Toulouse

  • Pasteur Clinical - Pediatric cardiology

    Toulouse

  • Pediatric Cardiology

    Toulouse

  • Cardiolgy

    Tours

  • Pediatric Cardiology

    Tours

  • Cardiology

    Valenciennes

Other trials in France

Martinique1 site
  • Cardiology

    Martinique

Other trials in Martinique

Mayotte1 site
  • Cardiology

    Mamoudzou

Reunion1 site
  • Pédiatric cardiology

    Réunion

Other trials in Reunion

About this study

Official title: Hospital Registry of Acute Myocarditis: Evolution of the Proportion of Positive SARS-COV-2 Cases During the Covid-19 Pandemic, Case Characteristics and Prognoses

To date, the effects of SARS-Cov-2 (Covid-19) on the myocardium and the role it plays in the evolution towards an acute myocarditis are badly understood. The current pandemic of this emerging virus is an opportunity to assess the proportion of acute myocarditis attributable to SARS-Cov-2(Covid-19) and to assess the clinical, biological and imaging presentations, by means of a national prospective multicentre hospital registry of cases of acute myocarditis.

Read the detailed description

Although research on the subject has only recently started developing, the links have already been described between SARS-Cov-2 infection, the severity of the clinical status, and the presence of risk factors or a history of cardiovascular disease (hypertension, diabetes, stroke, etc.). Additionally, depending on the series and definition used for cardiac injury (troponin elevation and/or natriuretic peptides), this concerns 7-29% of patients with a clear predominance in severe patients. The mechanisms behind these troponin elevations and cardiac injury are likely to be multiple and variable depending on clinical presentation,severity and patient history. A significant association was found between troponin elevation, and that of CRP and NtproBNP, suggesting an inflammatory part to this cardiac damage. As with other coronaviruses, SARS-Cov-2 infection can cause massive release of proinflammatory cytokines which can lead to inflammation of the vascular wall. This can be the cause of true instability or even rupture of plaque(type1 infarction) but can also be responsible for tissue hypoxia without rupture of plaque causing myocardial pain (infarction type 2). In addition, there may be areal myocardial inflammation causing acute myocarditis, secondary to the cytokine storm or direct damage to the myocardium by the virus itself. In case of acute coronary syndrome presentation, a coronary exploration should be realized to highlight or eliminate a type 1 infarction, but it is clearly difficult to distinguish between a type 2 suffering (no viral attack direct but suffering from hypotension or hypoxia for example) and inflammatory myocardial damage with or without direct viral myocardial damage (myocarditis). In the context of the viral pandemic at Covid19, although few data exist,it is legitimate to consider the possibility of true arrays of acute inflammatory myocarditis or by direct viral attack which could thus modify the natural history and the prognosis of patients, thus justifying a dedicated diagnosis and treatment. The primary objective was to assess the proportion of positive SARS-Cov-2 cases among the patients included (hospitalized for acute myocarditis). During the study period, this proportion will be assessed at regular intervals, for example every month, or more frequently if the number of patients included varies substantially from one week to another. This will make it possible to trace a development curve for the entire period of the pandemic.

The secondary objectives were (1) to describe the clinical, biological and imaging characteristics of the acute myocarditis among the positive and negative SARS-Cov-2 patients of the myocarditis cohort; (2) to assess the short-term (30 days) and long-term (1 year) prognosis of the acute myocarditis among the positive and negative SARS-Cov-2 patients of the myocarditis cohort and (3) to identify the factors associated with a 30-day and 1-year prognosis of cases of acute myocarditis.

Being tested
Performing routine care (clinical and paraclinical tests), Examinations for the research:
Keywords
Covid19, Myocarditis, Epidemiology, Prognosis, Mortality
Medical subject headings
COVID-19, Myocarditis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Performing routine care (clinical and paraclinical tests)Diagnostic test

    ECG, standard biology and cardiology tests, and routine transthoracic echocardiography (TTE), MRI

  • Examinations for the research:Diagnostic test

    Systematic research by polymerase chain reaction (PCR) for Covid-19 in the blood and in an oro-pharyngeal swab, in addition to the usual immunologic, bacteriological, viral and parasitic tests carried out as part of the routine care of all patients with suspected myocarditis.

    A 30-days phone call follow-up (vital status) and a systematic 1-year follow-up will be realized (clinic, biology, ECG, TTE, +/- MRI)

Study groups in NCT04375748
Study groupRoleWhat they receive
Patients treated for symptoms of acute myocarditis.Patients treated in intensive coronary care unit (ICCU) or intensive care unit (ICU), in one of the participating hospitals, for symptoms of acute myocarditis confirmed by a myocardial MRI and/or a CT scan and/or a myocardial biopsy.
Receives: Diagnostic Test: Performing routine care (clinical and paraclinical tests); Diagnostic Test: Examinations for the research:

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Evolution of the proportion of positive SARS-COV-2 cases.

    Estimate at hospital discharge, over a period of 6 months, the evolution of the proportion of positive SARS-COV-2 cases among patients hospitalized for acute myocarditis in Intensive Cardiac Care Unit or Intensive Care Unit (polyvalent, surgical or medical), in the 19 hospitals participating in the study.

    Measured: 6 months.

Secondary outcomes (26)
  1. Ultrasound characteristics.

    Describe at the admission and during the treatment ultrasound characteristics of the acute myocarditis among the positive and negative SARS-Cov-2 patients of the myocarditis cohort; Echocardiographic parameters: Volumes (mm3)

    Measured: 1 year

  2. Ultrasound characteristics.

    Describe at the admission and during the treatment ultrasound characteristics of the acute myocarditis among the positive and negative SARS-Cov-2 patients of the myocarditis cohort ; Echocardiographic parameters: diameters (mm)

    Measured: 1 year

  3. Ultrasound characteristics.

    Describe at the admission and during the treatment ultrasound characteristics of the acute myocarditis among the positive and negative SARS-Cov-2 patients of the myocarditis cohort (Echocardiographic parameters: ventricular diastolic function (mm);

    Measured: 1 year

  4. Ultrasound characteristics.

    Describe at the admission and during the treatment ultrasound characteristics of the acute myocarditis among the positive and negative SARS-Cov-2 patients of the myocarditis cohort (Echocardiographic parameters: ventricular systolic function (mm);

    Measured: 1 year

  5. Ultrasound characteristics.

    Describe at the admission and during the treatment ultrasound characteristics of the acute myocarditis among the positive and negative SARS-Cov-2 patients of the myocarditis cohort ; Echocardiographic parameters: Left atrium volume (mm3);

    Measured: 1 year

  6. Ultrasound characteristics.

    Describe at the admission and during the treatment ultrasound characteristics of the acute myocarditis among the positive and negative SARS-Cov-2 patients of the myocarditis cohort ; Echocardiographic parameters: Maximum velocity of tricuspid valve insufficiency;

    Measured: 1 year

  7. Ultrasound characteristics.

    Describe at the admission and during the treatment ultrasound characteristics of the acute myocarditis among the positive and negative SARS-Cov-2 patients of the myocarditis cohort ; Echocardiographic parameters: Presence and quantification of a valvular regurgitation

    Measured: 1 year

  8. Ultrasound characteristics.

    Describe at the admission and during the treatment ultrasound characteristics of the acute myocarditis among the positive and negative SARS-Cov-2 patients of the myocarditis cohort ; Echocardiographic parameters: Presence of a pericardial effusion

    Measured: 1 year

  9. Assess prognosis of the acute myocarditis .

    Assess the short-term (30 days) and long-term (1 year) prognosis of the acute myocarditis among the positive and negative SARS-Cov-2 patients of the myocarditis cohort. The 30-day prognosis will be defined in function to the outcome: A death, whatever the cause, A cardiovascular arrest with recovery, A cardiogenic shock, An acute lung oedema or One of the events cited above.

    The 1-year prognosis will be defined in function to the outcome: A death, whatever the cause, The need to resort to transplantation and/or chronic assistance, A rehospitalization for cardiovascular reasons (heart failure, painful relapse, recovered cardiac arrest, myocarditis relapse, ACS), A myocarditis relapse, or one of the events cited above. The 1-year prognosis will also be defined in function to the New York Heart Association

    (NYHA) class.

    Measured: The short-term (30 days) and long-term (1 year).

  10. The factors associated with acute myocarditis cases .

    Identify the factors associated with a 30-day and 1-year prognosis of cases of acute myocarditis cardiovascular (Terminal heart failure, Acute edema of the lung, Cardiogenic shock, Sudden death / Ventricular rhythm disorder Pulmonary embolism, Aortic dissection Infectious endocarditis Stroke) or no cardiovascular (Acute respiratory syndrome, septic shock of non-cardiac origin, cancer, Public road accident, end-stage respiratory failure, insufficiency, end-stage renal Failure)

    Measured: The short-term (30 days) and long-term (1 year).

  11. Biological characteristics

    Describe the biological parameters on admission and during the treatment (troponinemia (ng/ml)

    Measured: 1 year

  12. Biological characteristics

    Describe the biological parameters on admission and during the treatment NtproBNP(pg/ml)

    Measured: 1 year

  13. Biological characteristics

    Describe the biological parameters on admission and during the treatment CRP(mg/ml)

    Measured: 1 year

  14. Describe at the admission and during the treatment cardiac MRI parameters

    Ventricular volumes (ml)

    Measured: 1 year

  15. Describe at the admission and during the treatment cardiac MRI parameters

    Systole Diameter

    Measured: 1 year

  16. Describe at the admission and during the treatment cardiac MRI parameters

    Diastole Diameter

    Measured: 1 year

  17. Describe at the admission and during the treatment cardiac MRI parameters

    Longitudinal deformation of left ventricle;

    Measured: 1 year

  18. Describe at the admission and during the treatment cardiac MRI parameters

    Longitudinal deformation of right ventricle;

    Measured: 1 year

  19. Describe at the admission and during the treatment cardiac MRI parameters

    Total volume of left ventricular oedema

    Measured: 1 year

  20. Describe at the admission and during the treatment cardiac MRI parameters

    Quantification of T2 before contrast agent

    Measured: 1 year

  21. Describe at the admission and during the treatment cardiac MRI parameters

    Quantification of T1 before contrast agent

    Measured: 1 year

  22. Describe at the admission and during the treatment cardiac MRI parameters

    Perfusion anomalies

    Measured: 1 year

  23. Describe at the admission and during the treatment cardiac MRI parameters

    Total volume of early left ventricular alteration

    Measured: 1 year

  24. Describe at the admission and during the treatment cardiac MRI parameters

    Total volume of late left ventricular alteration

    Measured: 1 year

  25. Describe at the admission and during the treatment cardiac MRI parameters

    Quantification of T1 after contrast agent

    Measured: 1 year

  26. Describe at the admission and during the treatment cardiac MRI parameters

    Presence of a pericardial effusion

    Measured: 1 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 May 2020
  2. Study start15 Apr 2020
  3. Primary completion28 Dec 2021
  4. Study completion28 Dec 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
756 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04375748
Sponsor's protocol ID
RC31/20/0139
Acronym
MYOCOVID
Status last verified
Jul 2023
First submitted
21 Apr 2020
Last updated
24 Jul 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

An observational study of Acute Myocarditis, run by University Hospital, Toulouse at 65 sites in 4 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 Jul 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 65 sites in France, Martinique, Mayotte, Reunion. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Evolution of the proportion of positive SARS-COV-2 cases. (time frame: 6 months.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Jul 2023.

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