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The purpose of the present study is to determine whether there is a decrease in the emotional response to experimental induction of dyspnea by hypoxic stimulation in subjects with a "neurological" form of COVID-19, compared to healthy controls.
SARS CoV-2 infection causes lung damage that can be severe enough to require artificial ventilation. Clinicians taking care of these patients are surprised by the scant respiratory sensations and emotional responses described by patients. This attenuation of respiratory interoception deprives clinicians of the usual warning signs during respiratory decompensation of dyspnea and its aggravation. It may be the result of central nerve damage. This hypothesis is bolstered by the observation that within the multiple clinical forms of COVID-19 infection there are some "neurological" forms (headache, anosmia, agueusia, dizziness, without respiratory signs and with little or no fever), that are most likely the consequence of olfactory penetration of the virus into the central nervous system (mechanism described for SARS CoV-1).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 15 COVID positive patients | Experimental | dyspnea rating to various dyspneic stimulus |
|
| 15 healthy controls | Active Comparator | dyspnea rating to various dyspneic stimulus |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| hypoxia : 14.3 and 12.7% FIO2, hypercapnia 7% CO2, inspiratory mechanical constraint | Other | the fraction of inspired oxygen is reduced from ~21% (room air) to 14.3 and 12.7% allowing the SpO2 to decrease to ~75%, rebreathing test allowing the PCO2 to rise to 65 mmHg, inspiratory mechanical constraint with 50 to 75% of maximum inspiratory pressure |
| Measure | Description | Time Frame |
|---|---|---|
| Intensity of the emotional response to hypoxic exposure (14.3 et 12.7% FIO2) | Slope of the relation between the intensity of a hypoxic stimulus to the intensity of the emotional response (visual analog scale, VAS : 0 is no pain and 10 is the worst pain) | 10 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Perception of a hypoxic stimulus induced dyspnea (14.3 et 12.7% FIO2) | ratings of dyspnea immediately after a hypoxic stimulus: Multidisciplinary Dyspnea Profile, MDP : 0 is no change and 10 is unbearable | 5 minutes |
| Perception of a hypercapnic stimulus induced dyspnea (7% CO2) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Département R3S, hôpital de la pitié-salpêtrière | Paris | 75013 | France |
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| ID | Term |
|---|---|
| D000086382 | COVID-19 |
| D004417 | Dyspnea |
| ID | Term |
|---|---|
| D011024 | Pneumonia, Viral |
| D011014 | Pneumonia |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
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|
ratings of dyspnea intensity and unpleasantness during a hypercapnic stimulus (visual analog scale, VAS : 0 is no pain and 10 is the worst pain) |
| 10 minutes |
| Perception of a hypercapnic stimulus induced dyspnea (7% CO2) | ratings of dyspnea immediately after a hypercapnic stimulus: Multidisciplinary Dyspnea Profile, MDP : 0 is no change and 10 is unbearable | 5 minutes |
| Perception of a inspiratory mechanical constraint induced dyspnea | ratings of dyspnea intensity and unpleasantness during an inspiratory mechanical constraint (visual analog scale, VAS: 0 is no pain and 10 is the worst pain) | 10 min |
| Perception of a inspiratory mechanical constraint induced dyspnea | ratings of dyspnea immediately after an inspiratory mechanical constraint induced dyspnea(Multidisciplinary Dyspnea Profile, MDP: 0 is no change and 10 is unbearable) | 5 minutes |
| brain MRI | Multimodal MRI (including anatomical MRI, resting-state functional MRI) | 1,5 hours |
| D014777 |
| Virus Diseases |
| D018352 | Coronavirus Infections |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D012120 | Respiration Disorders |
| D012818 | Signs and Symptoms, Respiratory |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |