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: Tas Jeanette , van Gassel Rob J J , Heines Serge J H , Mulder Mark M G , Heijnen Nanon F L , Acampo-de Jong Melanie J , 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 JR , Mingels Alma , Bekers Otto , Savelkoul Paul , Oude Lashof Astrid M L , Wildberger Joachim , Tijssen Fabian H , Buhre Wolfgang , Sels Jan-Willem E M , Ghossein-Doha Chahinda , Driessen Rob G H , Kubben Pieter L , Janssen Marcus L F , Nicolaes Gerry A F , Strauch Ulrich , Geyik Zafer , Delnoij Thijs S R , Walraven Kim H M , Stehouwer Coen DA , Verbunt Jeanine A M C F , Van Mook Walther N.K.A , van Santen Susanne , Schnabel Ronny M , Aries Marcel J H , van de Poll Marcel C G , Bergmans Dennis , van der Horst Iwan C C , van Kuijk Sander , van Bussel Bas C T 
Published: September 2020

IntroductionThe course of the disease in 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 a SARS-CoV-2 infection.Methods and analysisMechanically ventilated patients admitted to the intensive care with a SARS-CoV-2 infection will be included. We will collect clinical variables, vital parameters, laboratory variables, mechanical ventilator settings, chest electrical impedance tomography, ECGs, echocardiography as well as other imaging modalities to assess heterogeneity of the course of a SARS-CoV-2 infection in critically ill patients. The MaastrICCht 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. 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 study design is expected to enhance aetiological, diagnostic and prognostic understanding of the disease. This paper describes the design of the MaastrICCht.Ethics and disseminationEthical approval has been obtained from the medical ethics committee (Medisch Ethische Toetsingscommissie 2020-1565/3 00 523) of the Maastricht University Medical Centre+ (Maastricht UMC+), which will be performed based on the Declaration of Helsinki. During the pandemic, the board of directors of Maastricht UMC+ adopted a policy to inform patients and ask their consent to use the collected data and to store serum samples for COVID-19 research purposes. All study documentation will be stored securely for fifteen years after recruitment of the last patient. The results will be published in peer-reviewed academic journals, with a preference for open access journals, while particularly considering deposition of the manuscripts on a preprint server early.Trial registration numberThe Netherlands Trial Register (NL8613).