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The SARS-CoV-2 epidemic is leading to a large number of patients in intensive care units due to severe hypoxemic pneumonia. After an acute phase that may require controlled mechanical ventilation and deep sedation, removal of sedation often reveals a pathological awakening in the vast majority of patients. This encephalopathy state remains, to date and to our knowledge, unexplained. Clinical features do not appear to fully correlate with regular delirium. This encephalopathy might be explained by deep and prolonged hypoxemia, a wide use of sedation drugs, systemic inflammation or the hostile ICU environment.
This study is intended to investigate neurological abnormalities associated with SARS-CoV-2 infection. Complete daily neurological examinations will be routinely conducted in intensive care unit patients. Specific biological analyses will also be performed in these patients by collecting additional blood samples from an arterial or central catheter, every 2 days. These clinical and biological examinations will be continued throughout patient's stay in the intensive care unit.
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| Measure | Description | Time Frame |
|---|---|---|
| Dosage of biomarkers typically explored in intensive care unit delirium | Plasminogen activator inhibitor-1 (PAI-1), E-selectin and angiopoietin-2 | Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every 2 days |
| Dosage of neuronal injury markers | S100 β, Neuron Specific Enolase (NSE), GFAP, UCHL1, NFL | Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every 2 days |
| Measure | Description | Time Frame |
|---|---|---|
| Delirium assessment | CAM-ICU (Confusion Assessment Method - Intensive Care Unit) scale | Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days |
| Delirium assessment |
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Inclusion Criteria:
Exclusion Criteria:
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Patients hospitalized in Intensive Care Unit and infected bye SARS-CoV-2
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Lise Laclautre | Contact | +33 4 754 963 | llaclautre_perrier@chu-clermontferrand.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU | Recruiting | Clermont-Ferrand | 63000 | France |
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| ID | Term |
|---|---|
| D000086382 | COVID-19 |
| D009421 | Nervous System Malformations |
| D003693 | Delirium |
| D001927 | Brain Diseases |
| ID | Term |
|---|---|
| D011024 | Pneumonia, Viral |
| D011014 | Pneumonia |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
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ICDSC (Intensive Care Delirium Screening Checklist) scale.
| Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days |
| Coma assessment | CRS-R (Coma Recovery Scale-Revised) | Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days |
| Pupils characteristics | Clinical observation | Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days |
| Pupils characteristics | Pupilometer assessment | Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days |
| Neurological abnormalities | Electroencephalogram : epileptic activity (spikes, spike-waves) or encephalopathy activity (triphasic waves)) | Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days |
| Neurological abnormalities | CT-scan | Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days |
| Neurological abnormalities | MRI | Change from Day 0 (= First day in ICU) until the end of the stay (up to 3 months) - Assessments every days |
| D014777 |
| Virus Diseases |
| D018352 | Coronavirus Infections |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D009422 | Nervous System Diseases |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D003221 | Confusion |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D002493 | Central Nervous System Diseases |