HOME-CoV: Hospitalization or Outpatient ManagEment of Patients With a SARS-CoV-2 Infection

NCT ID: NCT04338841

Last Updated: 2020-09-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

3133 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-04-09

Study Completion Date

2020-06-17

Brief Summary

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COVID-19 pandemic has developed worldwide in less than 4 months. The clinical presentations are variable widely, ranging from simple rhinitis to major lung damage that can lead to death.

In many countries involved in the ongoing health disaster due to SARS-CoV-2 infection, hospital are overloaded. In this context, the decision to hospitalize or to manage COVID-19 patients at home is crucial and defining reliable and consensual criteria is a major issue.

HOME-CoV study is a multicentre quasi-experimental interventional study, before and after implementation of a help-decision making rule (HOME-CoV rule), developed via the Delphi method.

Our main hypothesis is that a strategy based on the consensual HOME-CoV rule compared to current practice is at least as safe as regards the 7-day-rate of adverse events (safety criterion) and more effective as regards the rate of patients eventually managed as outpatients (efficacy criterion).

Detailed Description

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Definition of HOME-CoV rule:

The Delphi method is used to reach a consensus of a large panel of experts and to define an easy-to-use clinical rule aiming to help emergency physicians in hospitalisation or outpatient management decision making : the HOME-CoV rule.

The impact of the rule implementation is evaluated in a before and after study:

* before period: observational assessment of current practices
* implementation period : educational lectures, posters, and pocket cards showing and explaining HOME-CoV rule are communicated to participating Emergency Departments.
* after period : observational assessment of practices

In each period, patients consulting Emergency Departments with suspected or probable COVID-19 are evaluated for potential inclusion. Clinical, biological and imaging data that may be involved in decision-making about hospitalization are collected as well as the physician final decision (hospitalization or outpatient management) and its main determinants.

A phone-call follow-up is performed and the clinical status according to the Ordinal Scale for Clinical Improvement of COVID-19 from the World Heath Organization is collected on day 7 and day 28 following inclusion.

Conditions

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Coronavirus Infection

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Quasi-experimental before and after multicentre prospective study
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Phase1: Before HOME-CoV rule implementation

Observational assessment of current practices: no recommendation is performed.

Patients consulting Emergency Departments with suspected or probable COVID-19 are evaluated for potential inclusion.

Clinical, biological and imaging data that may be involved in decision-making about hospitalization are collected as well as the physician final decision (hospitalization or outpatient management) and its main determinants.

A phone-call follow-up is performed and the clinical status according to the Ordinal Scale for Clinical Improvement of COVID-19 from the World Heath Organization is collected on day 7 and day 28 following inclusion.

Group Type NO_INTERVENTION

No interventions assigned to this group

Phase 2: After HOME-CoV rule implementation

Observational assessment of practices after implementation of the rule: physicians are recommended to apply the HOME-CoV rule but still free to use other determinants in their decision.

Patients consulting Emergency Departments with suspected or probable COVID-19 are evaluated for potential inclusion. Clinical, biological and imaging data that may be involved in decision-making about hospitalization are collected as well as the physician final decision (hospitalization or outpatient management) and its main determinants.

A phone-call follow-up is performed and the clinical status according to the Ordinal Scale for Clinical Improvement of COVID-19 from the World Heath Organization is collected on day 7 and day 28 following inclusion.

Group Type EXPERIMENTAL

HOME-CoV rule implementation

Intervention Type OTHER

HOME-CoV rule is an easy-to-use clinical rule aiming to help emergency physicians in hospitalisation or outpatient management decision making. The definition of the rule is performed using the Delphi method to reach a consensus of a large panel of experts.

Between before and after period, educational lectures, posters, and pocket cards showing and explaining HOME-CoV rule are communicated to participating Emergency Departments.

Interventions

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HOME-CoV rule implementation

HOME-CoV rule is an easy-to-use clinical rule aiming to help emergency physicians in hospitalisation or outpatient management decision making. The definition of the rule is performed using the Delphi method to reach a consensus of a large panel of experts.

Between before and after period, educational lectures, posters, and pocket cards showing and explaining HOME-CoV rule are communicated to participating Emergency Departments.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Adult patient (≥ 18 years old)
* Admitted for COVID-19 infection confirmed by a positive SARS-CoV2 RT-PCR or considered probable by the physician in charge of the patient.
* Not requiring care in intensive care unit or resuscitation unit or
* No subject of a limitation decision of active therapies,
* Free informed express consent to participate in the study orally given or signed by the patient according to local legislation,
* Insurance cover according to local legislation;

Exclusion Criteria

* Patient whose main diagnostic hypothesis in the emergency room is not a SARS-CoV-2 infection but another differential diagnosis,
* Patient admitted to the emergency room for 18 hours or more,
* Patient whose follow-up on D28 is impossible, whatever the reason,
* Patient with a poor understanding of the French language,
* Patient already included in the study,
* Person deprived of their liberty by judicial or administrative decision,
* Person under psychiatric care under duress,
* Person subject to a legal protection measure,
* Person unable to express consent.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Angers

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Delphine DOUILLET

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Angers

Locations

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Clinique Universitaire Saint-Luc

Brussels, , Belgium

Site Status

CHU de Liège

Liège, , Belgium

Site Status

Ch Argenteuil

Argenteuil, , France

Site Status

CH Cholet

Cholet, , France

Site Status

CHU Clermont Ferrand

Clermont-Ferrand, , France

Site Status

Ch Colmar

Colmar, , France

Site Status

CH Alpes Lemant

Contamine-sur-Arve, , France

Site Status

CHU Dijon

Dijon, , France

Site Status

CH Le Mans

Le Mans, , France

Site Status

CH Libourne

Libourne, , France

Site Status

CH Limoges

Limoges, , France

Site Status

Ch Longjumeau

Longjumeau, , France

Site Status

Chu Montpellier

Montpellier, , France

Site Status

Centre Hospitalier Universitaire de Nantes

Nantes, , France

Site Status

CH Niort

Niort, , France

Site Status

Hopital Paris Saint Joseph

Paris, , France

Site Status

Hopital Saint Antoine

Paris, , France

Site Status

Hôpital Bichat

Paris, , France

Site Status

Hôpital Lariboisière

Paris, , France

Site Status

CHU de Poitiers

Poitiers, , France

Site Status

CH Reims

Reims, , France

Site Status

Ch Remiremont

Remiremont, , France

Site Status

Chu Rennes

Rennes, , France

Site Status

CHU de Rouen

Rouen, , France

Site Status

CH de Saint-Brieuc

Saint-Brieuc, , France

Site Status

CHU de St Etienne

Saint-Etienne, , France

Site Status

Ch Troyes

Troyes, , France

Site Status

CH VICHY

Vichy, , France

Site Status

CH Princesse Grace

Monaco, , Monaco

Site Status

Countries

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Belgium France Monaco

References

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Douillet D, Penaloza A, Mahieu R, Morin F, Chauvin A, Gennai S, Schotte T, Montassier E, Thiebaud PC, Ghuysen Francois A, Dall'acqua D, Benhammouda K, Bissokele P, Violeau M, Joly LM, Andrianjafy H, Soulie C, Savary D, Riou J, Roy PM; Hospitalization or Outpatient Management of Patients With SARS-CoV-2 Infection Study Group. Outpatient Management of Patients With COVID-19: Multicenter Prospective Validation of the Hospitalization or Outpatient Management of Patients With SARS-CoV-2 Infection Rule to Discharge Patients Safely. Chest. 2021 Oct;160(4):1222-1231. doi: 10.1016/j.chest.2021.05.008. Epub 2021 May 15.

Reference Type DERIVED
PMID: 34004154 (View on PubMed)

Douillet D, Mahieu R, Boiveau V, Vandamme YM, Armand A, Morin F, Savary D, Dubee V, Annweiler C, Roy PM; HOME-CoV expert group. Outpatient management or hospitalization of patients with proven or suspected SARS-CoV-2 infection: the HOME-CoV rule. Intern Emerg Med. 2020 Nov;15(8):1525-1531. doi: 10.1007/s11739-020-02483-0. Epub 2020 Sep 4.

Reference Type DERIVED
PMID: 32888112 (View on PubMed)

Other Identifiers

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2020-A00831-38

Identifier Type: -

Identifier Source: org_study_id

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