LOng COvid COmorbidities: Endocrine,Metabolic,Neuropsychiatric,Muscle,Cardiovascular,Pulmonary,Dermatologic Dysfunctions

ConditionLong Covid-19
Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18+
SponsorFederico II University

About this trial

Considering the compelling amount of studies focused on patients in the active phase of COVID-19 disease and the scarcity of studies focused on patient cured from disease aimed at evaluating the sequelae of SARS-CoV-2 infection, the purpose of the study is to investigate whether in patients recovered from COVID-19 disease, SARS-CoV-2 infection has induced: 1) endocrine-metabolic function damage; 2) neuro-psychiatric damage; 3) muscle damage; 4) pulmonary damage; 5) cardiological damage; 6) venous vascular damage; 7) dermatological damage. Patients will be evaluated at baseline (at discharge from infectious and/or pneumology unit) and after 3- 12 months. A better definition of the prevalence and type of sequelae after recovery from COVID-19 disease could significantly improve the therapeutic management and long-term follow-up of these patients, with a relevant impact in terms of health resources and public health.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Patients of both sexes recovered from SARS-CoV-2 infection (two negative nasopharyngeal swabs, negative IgM and positive anti SARS-CoV-2 IgG);

Aged over 18 years of age;

Ability to understand protocol procedures

Disqualifiers

Any psychological/psychiatric/other medical conditions compromising the understanding of the nature and purpose of the study, and of its possible consequences

uncooperative attitude of the patient

Trial population

Adults patients of both sexes recovered from SARS-CoV-2 infection

Trial design

Design model

Case-only

Time perspective

Cross-sectional

Treatments tested in this trial

  • Assessments of endocrinological phenotypes of LO-COCO patients

    Diagnostic test

    Assessment of:thyroid-stimulating hormone(TSH),free triiodothyronine (FT3), free thyroxine (FT4),calcitonin,antibodies against thyroglobulin (AbTG) and against thyroperoxidase (AbTPO),adrenocorticotropic hormone (ACTH),cortisol, luteinizing hormone (LH),follicle-stimulating hormone(FSH),Testosterone,17-beta estradiol,sex hormone binding globulin (SHBG),progesterone, prolactin (PRL), growth hormone (GH), insulin growth factor-1 (IGF-1), dehydroepiandrosterone sulphate (DHEAS),delta 4-androstenedione,aldosterone,renin,glycemia, insulinemia, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, HbA1c, vitamin D, adiponectin, irisin, IL-6.Thyroid and ovarian ultrasounds, pituitary and adrenal MRI will be performed as well. Body composition will be assessed with bioimpedance analysis and DXA scans.Female sexual dysfunctions will be evaluated with Female Sexual Function Index (FSFI), Sexual Inhibition and Sexual Excitation Scale (SIS/SES),Body Uneasiness Test (BUT).

  • Assessment of muscular phenotypes of LO-COCO patients

    Diagnostic test

    Questions will be collected regarding the tolerance to physical activity and modifications after diagnosis of Covid. Muscular strength will be assessed by means of tests (Medical Research Council Scale) and dynamometers. Balance will be assessed with a Romberg test, tolerance to stress will be assessed by means of cyclometer.

  • Assessment of neuropsychiatric phenotypes of LO-COCO patients

    Diagnostic test

    Validated questionnaires will be collected to investigate depression (Beck Depression Inventory-II, BDI-II), apathy (Apathy Evaluation Scale, AES), anxiety (Test Anxiety Inventory, TAI), attention and cognitive functions (Montreal Cognitive Assessment and Quick Mild Cognitive Impairment). Fatigue will be assessed by Fatigue Rating Scale (FRS) and Fatigue Severity Scale (FSS). Muscle power will be assessed by six-minute walking test and sit and stand up test. The presence of myopathy will be evaluated by mean electrophysiological study.

  • Muscle biopsy

    Procedure/Surgery

    Muscle biopsy will be performed upon need.

  • Assessment of pulmonary phenotypes of LO-COCO patients

    Diagnostic test

    Modified Medical Research council questionnaire will be administered for evaluating of the dyspnoea level. Complete respiratory status assessment, including global spirometry, CO lung diffusion capacity and arterial gases analysis will be run. HRCT - high resolution CT scan of the chest - will be performed in selected cases to rule out the eventual sequelae of SARS-Cov2 related pneumonia.

  • Assessment of cardiological phenotypes of LO-COCO patients

    Diagnostic test

    Cardiological assessment will be run upon data collected from: Short Form-36 Health Survey (SF36), echocardiogram at rest and during stress tests, six-minute walking test, N-terminal fragment brain natriuretic peptides (NT-proBNP)

  • Assessment of vascular phenotypes of LO-COCO patients

    Diagnostic test

    The assessment of the potential post-thrombotic vascular damage will comprise the investigation of prevalence of previously unknown deep venous thrombosis by ultrasonography.

  • Assessment of dermatological phenotypes of LO-COCO patients

    Diagnostic test

    Dermatology evaluation will account on: thrichoscopy, dermoscopy, onychoscopy and capillaroscopy, confocal microscopy, skin ultrasonography

  • Tissue biopsy

    Procedure/Surgery

    Tissue biopsy will be performed upon need.

Treatment groups

No treatment groups listed

Trial outcomes

Primary outcomes

1

Identification of the most frequent phenotypes of Long-COVID syndrome among for COVID-19 patients recently hospitalized and dismissed

This pilot study will allow identifying the frequency and type of endocrinologic, muscular, cardiovascular, pulmonary, dermatological, metabolic and neuropsychiatric disorders that contribute to the long covid syndrome .

Time frame
Change from baseline at 3-12 months

Secondary outcomes

1

Thyroid dysfunctions

Prevalence of thyroid dysfunctions (hypo, hyper functions; thyroiditis)

Time frame
Change from baseline at 3-12 months
2

Female gonadal dysfunctions

Prevalence of female gonadal dysfunctions (hypogonadism and female sexual dysfunctions)

Time frame
Change from baseline at 3-12 months
3

Adrenal dysfunctions

Prevalence of adrenal dysfunctions (hypocortisolism)

Time frame
Change from baseline at 3-12 months
4

Pituitary dysfunctions

Prevalence of pituitary dysfunctions (hyperprolactinemia, GH deficiency)

Time frame
Change from baseline at 3-12 months

Other outcomes

Sponsors and contacts

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Federico II University

Lead sponsor

Azienda Sanitaria Locale Napoli 2 Nord

Collaborator