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The containment associated with the VIDOC-19 pandemic creates an unprecedented societal situation of physical and social isolation. Our hypothesis is that in patients with chronic diseases, confinement leads to changes in health behaviours, adherence to pharmacological treatment, lifestyle rules and increased psychosocial stress with an increased risk of deterioration in their health status in the short, medium and long term.
Some messages about the additional risk/danger associated with taking certain drugs in the event of COVID disease have been widely disseminated in the media since March 17, 2020, the date on which containment began in France. This is the case, for example, for corticosteroids, non-steroidal anti-inflammatory drugs but also for converting enzyme inhibitors (ACE inhibitors) and angiotensin II receptor antagonists (ARBs2). These four major classes of drugs are widely prescribed in patients with chronic diseases, diseases specifically selected in our study (corticosteroids: haematological malignancies, multiple sclerosis, Horton's disease; ACE inhibitors/ARAs2: heart failure, chronic coronary artery disease). Aspirin used at low doses as an anti-platelet agent in coronary patients as a secondary prophylaxis after a myocardial infarction can be stopped by some patients who consider aspirin to be a non-steroidal anti-inflammatory drug. Discontinuation of this antiplatelet agent, which must be taken for life after an infarction, exposes the patient to a major risk of a new cardiovascular event.
The current difficulty of access to care due to travel restrictions (a theoretical limit in the context of French confinement but a priori very real), the impossibility of consulting overloaded doctors, or the cancellation of medical appointments, medical and surgical procedures due to the reorganization of our hospital and private health system to better manage COVID-19 patients also increases the risk of worsening the health status of chronic patients who by definition require regular medical monitoring.
Eight Burgundian cohorts of patients with chronic diseases (chronic coronary artery disease, heart failure, multiple sclerosis, Horton's disease, AMD, haemopathic malignancy, chronic respiratory failure (idiopathic fibrosis, PAH) haemophilia cohort) will study the health impact of the containment related to the COVID-19 pandemic.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Register of haematological malignancies |
| ||
| Idiopathic Pulmonary Fibrosis and PAH Cohort |
| ||
| Giant Cell Arteritis Cohort |
| ||
| AMD and Macular Edema Cohort |
| ||
| Multiple Sclerosis Cohort |
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| Myocardial Infarction Observatory RICO |
| ||
| Heart Failure Cohort |
| ||
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| life questionnaires | Other | Telephone survey during the confinement period (common questionnaire and a questionnaire specific to the patient's pathology) |
|
| Measure | Description | Time Frame |
|---|---|---|
| % adherence to each pharmacological class | increase in dose, decrease in dose, discontinuation or no change for each drug class) | during the period from 20 April 2020 to 7 May 2020 |
| number of occurrence of medical events at 1 year | (mortality, hospitalizations and relevant criteria for each pathology all related to the chronic disease) | throughout the study for 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Expressed in %: Non-pharmacological treatment/lifestyle: | Smoking/Smoking/sweetening, Alcohol consumption/recovery, Decreased physical activity, Weight change | during the period from 20 April 2020 to 7 May 2020 |
| Expressed in %: Difficulties accessing care: medical appointments, prescriptions, medication |
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Inclusion Criteria:
Exclusion Criteria:
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patients from existing registries or cohorts
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Dijon Bourgogne | Dijon | 21079 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35409640 | Result | Boulin M, Cransac-Miet A, Maynadie M, Volot F, Creuzot-Garcher C, Eicher JC, Chague F, Ksiazek E, Beltramo G, Bonniaud P, Moreau T, Bonnotte B, Sales-Wuillemin E, Soudry-Faure A, Zeller M, Cottin Y. COVID-19 Lockdown in Patients with Chronic Diseases: A Cross-Sectional Study. Int J Environ Res Public Health. 2022 Mar 26;19(7):3957. doi: 10.3390/ijerph19073957. | |
| 35238436 |
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| ID | Term |
|---|---|
| D006333 | Heart Failure |
| D008269 | Macular Edema |
| D006467 | Hemophilia A |
| D009103 | Multiple Sclerosis |
| D013700 | Giant Cell Arteritis |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D008268 | Macular Degeneration |
| D012162 | Retinal Degeneration |
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| ID | Term |
|---|---|
| D011795 | Surveys and Questionnaires |
| ID | Term |
|---|---|
| D003625 | Data Collection |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D017531 | Health Care Evaluation Mechanisms |
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| Hemophilia Cohort |
|
| questionnaire | Other | 1-year telephone diary to identify complications resulting in hospitalization related to the patient's chronic disease |
|
| during the period from 20 April 2020 to 7 May 2020 |
| Measurement of psychological distress: Kessler's specific questionnaire (score between 0 and 24) | during the period from 20 April 2020 to 7 May 2020 |
| Volot F, Soudry-Faure A, Callegarin A, Ksiazek E, Delienne S, Cottin Y, Maynadie M, Boulin M. Impact of first COVID-19 lockdown on paediatric and adult haemophilia patients treated in a French Haemophilia Comprehensive Care Centre. Haemophilia. 2022 May;28(3):462-471. doi: 10.1111/hae.14526. Epub 2022 Mar 3. |
| D012164 |
| Retinal Diseases |
| D005128 | Eye Diseases |
| D025861 | Blood Coagulation Disorders, Inherited |
| D001778 | Blood Coagulation Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D020147 | Coagulation Protein Disorders |
| D006474 | Hemorrhagic Disorders |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D020278 | Demyelinating Autoimmune Diseases, CNS |
| D020274 | Autoimmune Diseases of the Nervous System |
| D009422 | Nervous System Diseases |
| D003711 | Demyelinating Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D020293 | Vasculitis, Central Nervous System |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D014652 | Vascular Diseases |
| D001167 | Arteritis |
| D014657 | Vasculitis |
| D017445 | Skin Diseases, Vascular |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |