AzTrials
AzTrials

Acute Respiratory Distress SyndromeNCT04457505

One Year Follow-ups of Patients Admitted to Spanish Intensive Care Units Due to COVID-19

An observational study of Acute Respiratory Distress Syndrome and Severe Pneumonia, run by Consorcio Centro de Investigación Biomédica en Red (CIBER) at 31 sites in Spain.

Completed

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

Official record
Search all trials

Trial summary

The latest epidemiological data published from Chine reports that up to 30% of hospital-admitted patients required admission to intensive care units (ICU). The cause for ICU admission for most patients is very severe respiratory failure; 80% of the patients present with severe acute respiratory distress syndrome… Read more about this study

Who is it for?
Any age
How many people
8,500 participants
Where
31 sitesSpain
Study dates
8 May 2020to 31 Dec 2021
How long will I take part?
1 Year
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 admitted to Spanish ICUs.

Who may be able to join

  • 1. Laboratory-confirmed COVID-19 infection with either real-time PCR or Next Generation Sequencing (NGS)
  • 2. Admission to intensive care unit

Who cannot join

  • 1. Patients admitted to COVID-19-negative ICU

Trial locations and contacts

31 sites in 1 country.

31 sites in 1 country

Spain31 sites
  • Hospital Universitario Sant Joan d'Alacant

    Alicante, 03550

  • Clínica Sagrada Família

    Barcelona, 08022

  • Hospital Sagrat Cor

    Barcelona, 08029

  • Hospital Universitari Vall d'Hebron

    Barcelona, 08035

  • Vall d'Hebron University Hospital, Barcelona

    Barcelona, 08035

  • Hospital Clinic

    Barcelona, 08036

  • Hospital Burgos

    Burgos, 09006

  • Hospital Infanta Margarita de Cabra

    Cabra, Córdoba, 14940

  • Hospital San Pedro de Alcantara

    Cáceres, 10003

  • Hospital Universitario de Bellvitge

    L'Hospitalet de Llobregat, Barcelona, 08907

  • Hospital de León

    León, 24008

  • Hospital Arnau de Vilanova Lleida

    Lleida, 25198

  • Hospital Universitario Lucus Augusti

    Lugo, Galicia, 27003

  • Hospital Infanta Leonor de Madrid

    Madrid, 28031

  • Hospital Universitario La Paz

    Madrid, 28046

  • Hospital de Mataró

    Mataró, Barcelona, 08304

  • Complexo Hospitalario Universitario de Ourense

    Ourense, 32005

  • Hospital Universitario Central de Asturias

    Oviedo, Principality of Asturias, 30011

  • Complejo Asistencial Universitario de Palencia

    Palencia, 34005

  • Hospital Son Llatzer

    Palma de Mallorca, Mallorca, 07198

  • Hospital Montecelo

    Pontevedra, 36071

  • Hospital Universitario Salamanca

    Salamanca, 37007

  • Hospital General de Cataluña

    Sant Cugat del Vallès, Barcelona, 08195

  • Hospital Universitari Virgen de Valme

    Seville, 41014

  • Hospital Universitari de Tarragona Joan XXIII

    Tarragona, 43005

  • Hospital Verge de la Cinta

    Tortosa, Tarragona, 43500

  • Hospital Clínic Universitari de València

    Valencia, 46010

  • Hospital Universitari i Politècnic La Fe

    Valencia, 46026

  • Hospital Universitario Valladolid

    Valladolid, 47003

  • Hospital Álvaro Cunqueiro

    Vigo, Pontevedra, 36213

  • Hospital Nuestra Señora de Gracia

    Zaragoza, 50004

Other trials in Spain

About this study

Official title: Risk Factors, Personalized Prognoses and 1-year Follow-ups of Patients Admitted to Spanish Intensive Care Units Due to COVID-19

The latest epidemiological data published from Chine reports that up to 30% of hospital-admitted patients required admission to intensive care units (ICU). The cause for ICU admission for most patients is very severe respiratory failure; 80% of the patients present with severe acute respiratory distress syndrome (SARS) that requires protective mechanical ventilation.

Five percent of patients with SARS require extracorporeal circulation (ECMO) techniques. Global mortality data has been thus far reported in different individual publications from China. Without accounting for those patients still admitted to hospital, bona fide information (from a hospital in Wuhan) received by the PI of this project estimates that mortality of hospitalized patients is more than 10%. Evidently, mortality is concentrated in patients admitted to the ICU and those patients who require mechanical ventilation and present with SARS. As data in China was globally reported, risk factors and prognosis of patients with and without SARS who require mechanical ventilation are not definitively known. The efficacy of different treatments administered empirically or based on small, observation studies is also not known. With many still admitted at the time of publication, a recent study in JAMA about 1500 patients admitted to the ICU in the region of Lombardy (Italy) reported a crude mortality rate of 25%. The data published until the current date is merely observational, prospective or retrospective. Data has not been recorded by analysis performed with artificial intelligence (machine learning) in order to report much more personalized results. Furthermore, as it concerns patients admitted to the ICU who survive, respiratory and cardiovascular consequences, as well as quality of living are completely unknown.

Read more

The study further aims to investigate quality of life and different respiratory and cardiovascular outcomes at 6 months, as well as crude mortality within 1 year after discharge of patients with COVID-19 who survive following ICU admission. Lastly, with the objective to help personalize treatment in accordance with altered biological pathways in each patient, two types of studies will be performed: 1) epigenetics and 2) predictive enrichment of biomarkers in plasma.

Hypothesis

  • A significant percentage of patients (20%) admitted to the hospital with COVID-19 infection is expected to require ICU admission, and need mechanical ventilation (80%) and, in a minor percentage (5%), ECMO.
  • Patients who survive an acute episode during ICU hospitalization will have a yearly accumulated mortality of 40%. Those who then survive will have respiratory consequences, cardiovascular complications and poor quality of life (6 months).
Read the detailed description

Objective and Purpose of Study

  1. The main objective is to determine risks factors and prognosis of patients with COVID-19 infection who have been admitted to Spanish ICUs between the beginning and end of the pandemic in Spain. Special attention will be placed on identifying differential expression of prognostic factors based on sex.
  2. The second objective is to perform a follow-up of patients within 6 months after discharge from ICU and hospital in order to determine mortality (including at 1-year mark), functional respiratory and cardiovascular consequences, and quality of life.
  3. The third objective is to perform an epigenetic study in cases, in which a blood sample can be drawn. The aim of such undertaking is to define molecular signatures in liquid biopsies that can provide information regarding prognosis, and treatment monitoring and response to therapy.
  4. Lastly, predictive ability of response to therapy and mortality will be assessed from a panel of protein biomarkers that participate in key physiological pathways of the disease's pathogenesis. This could, in turn, help select prospective treatments with greater potential of being successful in each patient.

Principal and Secondary Variables

  1. Prior epidemiological data of the patient
  2. Biological and clinical data, including treatment administered upon hospital admission
  3. Biological and clinical data, including treatments administered upon and during ICU admission until either discharge from ICU or hospital, or death
  4. Specific data regarding artificial ventilation and ECMO since the beginning, as well as sequentially, from intubation to either extubation or death
  5. Biological and clinical data upon hospital discharge
  6. Clinical follow-up of patients who survive within 6 months, including: functional respiratory tests, echocardiograms and surveys regarding quality of life
  7. Intrahospital and intra-ICU mortality will be registered at 28- and 90-day marks, as well as within 6 months and 1 year
  8. 1000 blood samples will be drawn for the epigenetic study The molecular profile of a non-coding RNA (ncRNA), specifically the microRNA (miRNA) pattern in liquid biopsy, will be analyzed. A circulating miRNA signature is closer to the phenotype than genomic markers and can provide information regarding epigenetic regulation, cell activation, tissue repair, and metabolic processes in addition to that afforded by clinical predictors and classic risk factors. miRNAs offer appropriate biochemical properties that are highly stable; have a long half-life in biological samples used in clinical laboratories (serum/plasma); can be efficiently and relatively rapidly quantified with high sensitivity and specificity by RT-qPCR; and can serve as a profitable tool for the assessment of risks and disease control.

All of these characteristics have led distinct authors to propose the clinical application of miRNA in either the short or medium term.

The experimental design comprises two phases. In the first approximation, a screening of non-coding RNA (ncRNA) will be performed in a sub-population of patients (n=200). The number of samples surpasses the quantity recommended for this type of studies. (Schurch y cols., RNA, 2016). A quotation will be requested for the screening of ncRNA by HTG EdgeSeq miRNA Whole Transcriptome Assay system (HTG). Using next generation sequencing (NGS), this method allows for the quantification of 2083 human candidates. All of the procedure steps will be completed in suitable physical locations in accordance with code OP No. 0028. All of the samples will be prepared in accordance with code No. 0036.

Screening results will be validated in the validation cohort (n=800) with RT-qPCR, a gold-standard technique. The budget includes material necessary for RNA extraction (miRNeasy Serum/Plasma isolation kits, Qiagen; spike-in; carrier RNA; consumables) and expression quantification of ncRNA in biofluids (RT-qPCR miRCURY LNA Universal RT microRNA PCR System kits, Qiagen; endogenous controls; consumables. Studies will be carried out at the TRRM Group facilities in the IRBLleida. The laboratory has the necessary team and material to isolate and quantify RNA, and store reagents and samples (cold stores, freezers of 20ºC and -80ºC).

9.- For the study of prognostic biomarkers, concentration of biomarkers in plasma that are key to potentially useful drugs' mechanism of action in this disease will be assessed. This quantification could provide guidance on drug usage (lymphocyte count will be obtained from a blood count):

Medical subject headings
Respiratory Distress Syndrome, Pneumonia, Respiratory Insufficiency

What is being measured

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

  1. One year mortality

    People who died after one year of follow up

    Measured: At 12 months of ICU admission

  2. Six month mortality

    People who died after one year of follow up

    Measured: At 6 month of ICU admission

Timeline

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

  1. First posted7 Jul 2020
  2. Study start8 May 2020
  3. Primary completion30 Sep 2021
  4. Study completion31 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
8,500 participants (actual)
Target duration
1 Year
IDs, dates and publications
ClinicalTrials.gov ID
NCT04457505
Sponsor's protocol ID
CIBERESUCICOVID
Status last verified
Jul 2022
First submitted
1 Jul 2020
Last updated
21 Jul 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: All IPD anonymized that underlie results in a publication will be available after publication.

Publications

  • Estella A, Tedim AP, Hader A, Ortega A, Garcia-Mateo N, de la Fuente A, Postigo T, Recuerda Nunez M, Sanchez Calvo JM, de Gonzalo-Calvo D, Torres A, Barbe F, Deinhardt-Emmer S, Bermejo-Martin JF. Poor control of pulmonary viral replication in COVID-19 patients with early respiratory failure. Anaesth Crit Care Pain Med. 2026 Jul;45(4):101779. doi: 10.1016/j.accpm.2026.101779. Epub 2026 Feb 25.

    PubMed 41759657
  • Wendel-Garcia PD, Ceccato A, Motos A, Franch-Llasat D, Perez-Moreno MO, Domenech-Spanedda MF, Chamarro-Marti E, Ferrer R, Fernandez-Barat L, Riera J, Alvarez-Napagao S, Penuelas O, Lorente JA, Almansa R, Gabarrus A, de Gonzalo-Calvo D, Gonzalez J, Anon JM, Barbera C, Barberan J, Blandino-Ortiz A, Bustamante-Munguira E, Caballero J, Carbajales-Perez C, Carbonell N, Catalan-Gonzalez M, Barral-Segade P, Manez R, de la Torre MC, Diaz E, Estella A, Gallego E, Garcia-Garmendia JL, Garnacho-Montero J, Amaya-Villar R, Gomez JM, Huerta A, Jorge-Garcia RN, Loza-Vazquez A, Marin-Corral J, Martin-Delgado MC, de la Gandara AM, Martinez-Varela IY, Lopez-Messa J, Muniz-Albaiceta G, Novo MA, Penasco Y, Pozo-Laderas JC, Ricart P, Sanchez-Miralles A, Sancho S, Socias L, Sole-Violan J, Suarez-Sipmann F, Tamayo L, Trenado J, Barbe F, Torres A, Roche-Campo F; CIBERESUCICOVID Investigators. Empirical antibiotic therapy improves outcomes in mechanically ventilated patients with COVID-19: An emulated targeted trial within a prospective, multicentre cohort study. J Infect. 2025 Feb;90(2):106411. doi: 10.1016/j.jinf.2025.106411. Epub 2025 Jan 13.

    PubMed 39814268
  • Garcia-Hidalgo MC, Gonzalez J, Benitez ID, Carmona P, Santisteve S, Perez-Pons M, Moncusi-Moix A, Gort-Paniello C, Rodriguez-Jara F, Molinero M, Belmonte T, Torres G, Labarca G, Nova-Lamperti E, Caballero J, Bermejo-Martin JF, Ceccato A, Fernandez-Barat L, Ferrer R, Garcia-Gasulla D, Menendez R, Motos A, Penuelas O, Riera J, Torres A, Barbe F, de Gonzalo-Calvo D; CIBERESUCICOVID Project (COV20/00110, ISCIII). Identification of circulating microRNA profiles associated with pulmonary function and radiologic features in survivors of SARS-CoV-2-induced ARDS. Emerg Microbes Infect. 2022 Dec;11(1):1537-1549. doi: 10.1080/22221751.2022.2081615.

    PubMed 35603455

Questions about this trial

What is this clinical trial studying?

An observational study of Acute Respiratory Distress Syndrome and Severe Pneumonia, run by Consorcio Centro de Investigación Biomédica en Red (CIBER) at 31 sites in Spain.

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 2 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 21 Jul 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 31 sites in Spain. 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?

One year mortality (time frame: At 12 months of ICU admission). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04457505, which also lists 3 linked publications.

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 21 Jul 2022.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in