Serial measurements in COVID-19-induced acute respiratory disease to unravel heterogeneity of the disease course: design of the Maastricht Intensive Care COVID cohort;MaastrICCht
Authors:   Maastricht Intensive Care COVID Study Group; MaastrICCht Collaborators, Tas Jeanette , van Gassel Rob J.J. , Heines Serge J.H. , Mulder Mark M.G. , Heijnen Nanon F.L. , Jong Melanie J. Acampo-de , Bels Julia L.M. , Bennis Frank C. , Koelmann Marcel , Groven Rald V.M. , Donkers Moniek A. , van Rosmalen Frank , Hermans Ben J.M. , Meex Steven J.R. , Mingels Alma M.A. , Bekers Otto , Savelkoul Paul H.M. , Oude Lashof Astrid M.L , Wildberger Joachim E. ,   Maastricht Intensive Care COVID Study Group, Tijssen Fabian H. , Buhre Wolfgang F.F.A. , Sels Jan-Willem E.M. , Ghossein-Doha Chahinda , Driessen Rob G.H. , Kubben Pieter L. , Janssen Marcus L.F. , Nicolaes Gerry A.F. , Strauch Uli , Geyik Zafer , Delnoy Thijs S.R. , Walraven Kim H.M. , Stehouwer Coen D.A. , Verbunt Jeanine A.M.C.F. , van Mook Walther N.K.A , Santen Susanne van , Schnabel Ronny M. , Aries Marcel J.H. , van de Poll Marcel C.G. , Bergmans Dennis C.J.J , van der Horst Iwan C.C. , van Kuijk Sander M.J. , van Bussel Bas C.T. 
Published: May 2020

Background

The course of the disease in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in mechanically ventilated patients is unknown. To unravel the clinical heterogeneity of the SARS-CoV-2 infection in these patients, we designed the prospective observational Maastricht Intensive Care COVID cohort;MaastrICCht. We incorporated serial measurements that harbour aetiological, diagnostic and predictive information. The study aims to investigate the heterogeneity of the natural course of critically ill patients with SARS-CoV-2 infection.

Study population

Mechanically ventilated patients admitted to the Intensive Care with SARS- CoV-2 infection.

Main message

We will collect clinical variables, vital parameters, laboratory variables, mechanical ventilator settings, chest electrical impedance tomography, electrocardiograms, echocardiography as well as other imaging modalities to assess heterogeneity of the natural course of SARS-CoV-2 infection in critically ill patients. TheMaastrICChtcohort is, also designed to foster various other studies and registries and intends to create an open-source database for investigators. Therefore, a major part of the data collection is aligned with an existing national Intensive Care data registry and two international COVID-19 data collection initiatives. Additionally, we create a flexible design, so that additional measures can be added during the ongoing study based on new knowledge obtained from the rapidly growing body of evidence.

Conclusion

The spread of the COVID-19 pandemic requires the swift implementation of observational research to unravel heterogeneity of the natural course of the disease of SARS- CoV-2 infection in mechanically ventilated patients. Our design is expected to enhance aetiological, diagnostic and prognostic understanding of the disease. This paper describes the design of theMaastrICChtcohort.

Strengths and limitations of this study

Serial measurements that characterize the disease course of SARS-CoV-2 infection in mechanically ventilated patients

Data collection and analysis according to a predefined protocol

Flexible, evolving design enabling the study of multiple aspects of SARS-CoV-2 infection in mechanically ventilated patients

Single centre, including only ICU patients