Learn about Research & Clinical Trials

Comparison Between Positive and Negative COVID-19 Pneumonia

Study Purpose

In the late 2019 a new Coronavirus was identified as the cause of a group of atypical interstitial pneumonia cases in Wuhan, a city in the Chinese province of Hubei. In February 2020, the World Health Organization designated COVID-19 disease, which stands for Coronavirus 2019 disease. Following the progressive spread of the infection in other countries of the world, WHO declared the Pandemic on 11 March 2020. Italy was the first European country involved in the spread of the infection and among those with the highest number of victims. The Coronavirus responsible for COVID-19 has, as its main target organ, the respiratory system, being able to determine a serious acute respiratory syndrome similar to that of the cases found during the SARS epidemic of 2003: hence the name of the virus as SARS-CoV-2. The diagnosis of SARS-COV-2 infection is made by direct detection by PCR of viral RNA on different biological materials from patients with suspicious symptoms, and the first level diagnostic test is generally the nasopharyngeal swab. However, even if the specificity of the nasopharyngeal swab is high, its sensitivity can be affected by technical causes (sampling mode), as well as by intrinsic factors related to the method. The purpose of the study is to identify the clinical, laboratory and imaging characteristic which are similar or which can differentiate the hospitalized patients affected by COVID-19 pneumonia (with positive PCR on naso-pharyngeal swab) and patients with pneumonia with negative PCR for COVID-19. To do this, the investigators will compare the clinical, laboratory and imaging characteristics between interstitial pneumonia secondary to SARS-COV-2 infection, confirmed by molecular biology investigations (viral RNA research by PCR on nasopharyngeal swab) and cases of interstitial pneumonia negative to the nasopharyngeal swab.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Observational
Eligible Ages 18 Years - 95 Years
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

All consecutive patients referred to the Emergency Unit of the "V. Cervello" Hospital, in Palermo, Italy, for clinical symptoms suggestive of suspected COVID-19 infection. In details, we consider patients referred for one or more of the following manifestations: respiratory symptoms, fever, taste or smell loss. To be included their records must include:
  • - detailed clinical history.
  • - radiological findings (High-resolution CT, HRCT) - results of viral RNA research for SARS-COV2, by PCR on nasopharyngeal swab, repeated two times (at the admission and again after 48 hours from the admission in the Emergency Unit) - laboratory results regarding routine hemato-chemical assays.
  • - oxygen therapy.
  • - treatment used.

Exclusion Criteria:

  • - age <18 years.
- incomplete medical records with respect to the parameters sought

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT04507893
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

University of Palermo
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Antonio Carroccio, MD
Principal Investigator Affiliation University of Palermo
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Other
Overall Status Recruiting
Countries Italy
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Covid19, Interstitial Pneumonia
Additional Details

In the late 2019 a new Coronavirus was identified as the cause of a group of atypical interstitial pneumonia cases in Wuhan, a city in the Chinese province of Hubei. In February 2020, the World Health Organization designated COVID-19 disease, which stands for Coronavirus 2019 disease. Following the progressive spread of the infection in other countries of the world, WHO declared the Pandemic on 11 March 2020. Italy was the first European country involved in the spread of the infection and among those with the highest number of victims. The Coronavirus responsible for COVID-19 has, as its main target organ, the respiratory system, being able to determine a serious acute respiratory syndrome similar to that of the cases found during the SARS epidemic of 2003: hence the name of the virus as SARS-CoV-2. Multisystem involvement and hyperinflammatory organ and systemic response are responsible for the patient's death. Overall, hospital mortality from COVID-19 is approximately 15% to 20%, but up to 40% among patients requiring ICU admission. The diagnosis of SARS-COV-2 infection is made by direct detection of viral RNA on different biological materials from patients with suspicious symptoms, and the first level diagnostic test is generally the nasopharyngeal swab; molecular investigations can also be carried out on samples from the distal respiratory tract (BronchoAlveolar Lavage, BAL). However, even if the specificity of the nasopharyngeal swab is high, its sensitivity can be affected by technical causes (sampling mode), as well as by intrinsic factors related to the method. The sensitivity data available are around 40-70%. The result is the possibility of a consistent series of false negatives (at least one third), represented by patients which have clinical characteristics compatible with SARS-COV-2 infection, but resulted, however, negative to the nasopharyngeal swab. These cases are framed as COVID-19-like cases and constitute a serious problem for the risk of not to recognize hospitalized patients suffering from COVID-19 infection. The purpose of the study is to identify the clinical, laboratory and imaging characteristic which are similar or which can differentiate the hospitalized patients affected by COVID-19 pneumonia (with positive PCR on naso-pharyngeal swab) and patients with pneumonia with negative PCR for COVID-19. To do this, the investigators will compare the clinical, laboratory and imaging characteristics between interstitial pneumonia secondary to SARS-COV-2 infection, confirmed by molecular biology investigations (viral RNA research by PCR on nasopharyngeal swab) and cases of interstitial pneumonia negative to the nasopharyngeal swab. The cases studied will be represented by patients hospitalized for interstitial pneumonia in the participating hospital centers in the period between mid-March 2020 and end of May 2020. For these cases, all available data contained in the medical records of patients, enrolled within the time frame indicated above, will be retrospectively analyzed. Due to relative lack of sensitivity of COVID-19 PCR assay in nasopharyngeal swab, patients affected with COVID-19 infection can be mixed with other hospitalized patients and with unprotected health staff. On the basis of the comparison of the clinical, laboratory and imaging data the study would identify the characteristics which can differentiate patients with SARS-COV-2 pneumonia, confirmed by nasopharyngeal swab, and interstitial pneumonia and negative COVID-19 PCR on swab. The investigators aim to highlight any similarities or differences or the need for differentiated treatments.

Arms & Interventions

Arms

: SARS-COV-2 PNEUMONIA CONFIRMED BY PCR ON NASOPHARYNGEAL SWAB

Hospitalized patients affected by COVID-19 interstitial pneumonia (with positive PCR on naso-pharyngeal swab)

: NEGATIVE SARS-COV-2 PNEUMONIA

Hospitalized patients affected by negative COVID-19 interstitial pneumonia (with negative PCR on naso-pharyngeal swab)

Interventions

Other: - Clinical, laboratory and imaging characteristics of pneumonia

Evaluation of the clinical, laboratory and imaging characteristics in patients with clinical presentation suggestive of COVID-19 infection, classified according to the results of PCR assay for COVID-19 on naso-pharyngeal swab as "COVID-19 patients" and "negative COVID-19 patients".

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

International Sites

Palermo, PA, Italy

Status

Recruiting

Address

Infectious diseases Unit of the "Cervello-Villa Sofia" Hospital

Palermo, PA, 90146

Site Contact

Enzo M Farinella, MD

acarroccio@hotmail.com

3395665437

Palermo, PA, Italy

Status

Completed

Address

Internal Medicine Division of the "Cervello-Villa Sofia" Hospital

Palermo, PA, 90146

Palermo, PA, Italy

Status

Recruiting

Address

Pulmonology Unit Dedicated to COVID-19 Patients

Palermo, PA, 90146

Site Contact

Giuseppe Arcoleo, MD

acarroccio@gmail.com

3385665437