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Ojeda A, Calvo A, Cuñat T, Mellado-Artigas R, Costas-Carrera A, Sánchez-Rodriguez MM, Comino-Trinidad O, Aliaga J, Arias M, Martínez-Pallí G, Dürsteler C, Ferrando C. Effectiveness of a specific follow up program for the management of the mental components of post-intensive care syndrome and chronic pain after COVID-19: results from the PAIN-COVID randomized clinical trial. Rev Esp Anestesiol Reanim (Engl Ed) 2024:S2341-1929(23)00206-8. [PMID: 38242358 DOI: 10.1016/j.redare.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/11/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND Critical COVID-19 survivors are at risk of developing Post-intensive Care Syndrome (PICS) and Chronic ICU-Related Pain (CIRP). We determined whether a specific care program improves the quality of life (QoL) of patients at risk of developing PICS and CIRP after COVID-19. METHODS The PAIN-COVID trial was a parallel-group, single-centre, single-blinded, randomized controlled trial. The intervention consisted of a follow up program, patient education on PICS and pain, and a psychological intervention based on Rehm's self-control model in patients with abnormal depression scores (≥8) in the Hospital Anxiety and Depression Scale (HADS) at the baseline visit. QoL was evaluated with the 5-level EQ 5D (EQ 5D 5 L), mood disorders with the HADS, post-traumatic stress disorder (PTSD) with the PCL-5 checklist, and pain with the Brief Pain Inventory short form, the Douleur Neuropathique 4 questionnaire, and the Pain Catastrophizing Scale. The primary outcome was to determine if the program was superior to standard-of-care on the EQ visual analogue scale (VAS) at 6 months after the baseline visit. The secondary outcomes were EQ VAS at 3 months, and EQ index, CIRP incidence and characteristics, and anxiety, depression, and PTSD at 3 and 6 months after baseline visits. CONCLUSIONS This program was not superior to standard care in improving QoL in critical COVID-19 survivors as measured by the EQ VAS. However, our data can help establish better strategies for the study and management of PICS and CIRP in this population. TRIAL REGISTRATION # NCT04394169, registered on 5/19/2020.
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Affiliation(s)
- A Ojeda
- Department of Anesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain.
| | - A Calvo
- Department of Anesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - T Cuñat
- Department of Anesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - R Mellado-Artigas
- Department of Anesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - A Costas-Carrera
- Neuroscience Institute, Hospital ClÍnic, University of Barcelona, Barcelona, Spain
| | | | - O Comino-Trinidad
- Department of Anesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - J Aliaga
- Department of Anesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - M Arias
- Department of Anesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - G Martínez-Pallí
- Department of Anesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - C Dürsteler
- Department of Anesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Department of Surgery and Surgical Specializations, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - C Ferrando
- Department of Anesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
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Cuñat T, Mejía J, Tatjer I, Comino O, Nuevo-Gayoso M, Martín N, Tió M, Basora M, Sala-Blanch X. Ultrasound-guided genicular nerves block vs. local infiltration analgesia for total knee arthroplasty: a randomised controlled non-inferiority trial. Anaesthesia 2023; 78:188-196. [PMID: 36351436 DOI: 10.1111/anae.15909] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2022] [Indexed: 11/11/2022]
Abstract
Genicular nerves block is a promising technique to treat acute postoperative pain in total knee arthroplasty. Similar to surgeon-administered local infiltration analgesia, it targets sensory branches from the knee capsule, but through a selective ultrasound-guided injection that reduces local anaesthetic dose (150 ml ropivacaine 0.2% with local infiltration analgesia vs. 20 ml with genicular nerves block). This randomised non-inferiority trial compared the analgesic efficacy of genicular nerves block vs. local infiltration analgesia in the first 24 h following total knee arthroplasty. Sixty patients were randomly allocated to receive either ultrasound-guided block of five genicular nerves or local infiltration analgesia. The primary outcome was rest pain numeric rating scale (0-10) at 24 h. Secondary outcomes included pain numeric rating scale (rest and movement) and cumulative opioid consumption during the first 24 h. We analysed 29 patients in the genicular nerves block group and 30 in the local infiltration analgesia group. We found that the median difference (95%CI) in postoperative rest pain at 24 h (non-inferiority criteria, Δ = 1) was -1.0 (-2.0 to 1.0, p < 0.001). Median difference in cumulative opioid consumption was 0.0 mg (-3.0-5.0, p < 0.001) meeting the non-inferiority criteria, Δ = 23 mg. We conclude that genicular nerves block of five nerves provides non-inferior analgesia in the first 24 h following surgery compared with local infiltration analgesia, but with a considerable reduction in the local anaesthetic dose.
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Affiliation(s)
- T Cuñat
- Anatomy and Embryology Department, School of Medicine, Universitat de Barcelona, Spain.,Department of Anesthesiology, Hospital Clínic de Barcelona, Spain
| | - J Mejía
- Department of Anesthesiology, Hospital Clínic de Barcelona, Spain
| | - I Tatjer
- Department of Anesthesiology, Hospital Clínic de Barcelona, Spain
| | - O Comino
- Department of Anesthesiology, Hospital Clínic de Barcelona, Spain
| | | | - N Martín
- Department of Anesthesiology, Hospital Clínic de Barcelona, Spain
| | - M Tió
- Department of Anesthesiology, Hospital Clínic de Barcelona, Spain
| | - M Basora
- Department of Anesthesiology, Hospital Clínic de Barcelona, Spain
| | - X Sala-Blanch
- Department of Anesthesiology, Hospital Clínic de Barcelona, Spain.,Anatomy and Embryology Department, School of Medicine, Universitat de Barcelona, Spain
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Pujol R, Rivas E, Gracia I, Caballero A, Matute P, Cuñat T, Basora M, Fábregas N, Arguis MJ, Forne DL, Balibrea JM, Besa A, Laguna G, Monsalve C, Lacy AM, Martinez-Pallí G. Preoperative triage to detect SARS-CoV-2 infection in surgical patients: lessons learned for resuming surgery. Surg Today 2022; 53:709-717. [PMID: 36266480 PMCID: PMC9589600 DOI: 10.1007/s00595-022-02610-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/24/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To define the impact of the COVID-19 outbreak on hospital surgical activity and assess the incidence of perioperative COVID-19 within two protocolized screening pathways for elective and non-elective surgery. METHODS We conducted a prospective cohort study of adults undergoing surgery during the COVID-19 outbreak. The elective pathway included telephone surveys and a quantitative polymerase-chain-reaction test (RT-PCR) only for patients who were asymptomatic and at low risk of infection. Only patients with negative screening underwent surgery. In the non-elective pathway, preoperative screening was performed during the hospital admission. RESULTS Among 835 patients considered for the elective pathway, 725 had negative RT-PCR results and underwent surgery. This reflects an 83% reduction in surgical activity from 2019. Moreover, 596 patients underwent non-elective surgery, representing a 28% reduction. Preoperatively, 39 patients (6.5%) tested positive for SARS-CoV-2 and underwent surgery through the non-elective pathway, vs. none in the elective pathway (p < 0.001). Postoperatively, 1.4% of elective surgery patients and 2.2% of non-elective surgery patients tested positive (p > 0.05). Mortality was higher in non-elective surgery (0.6% vs. 2.9%, p < 0.001) and in patients with COVID-19 (0% vs. 14%, p < 0.001). CONCLUSIONS The low incidence of COVID-19 in elective surgeries during the outbreak demonstrates the importance and effectiveness of preoperative screening, combining surveys and RT-PCR.
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Affiliation(s)
- Roger Pujol
- Department of Anesthesia, Hospital Clinic of Barcelona, Universidad de Barcelona, Barcelona, Spain
| | - Eva Rivas
- Department of Anesthesia, Hospital Clinic of Barcelona, Universidad de Barcelona, Barcelona, Spain.,Department of Outcomes Research, Cleveland Clinic, Cleveland, OH, USA
| | - Isabel Gracia
- Department of Anesthesia, Hospital Clinic of Barcelona, Universidad de Barcelona, Barcelona, Spain
| | - Angel Caballero
- Department of Anesthesia, Hospital Clinic of Barcelona, Universidad de Barcelona, Barcelona, Spain
| | - Purificación Matute
- Department of Anesthesia, Hospital Clinic of Barcelona, Universidad de Barcelona, Barcelona, Spain
| | - Tomas Cuñat
- Department of Anesthesia, Hospital Clinic of Barcelona, Universidad de Barcelona, Barcelona, Spain
| | - Misericordia Basora
- Department of Anesthesia, Hospital Clinic of Barcelona, Universidad de Barcelona, Barcelona, Spain
| | - Neus Fábregas
- Department of Anesthesia, Hospital Clinic of Barcelona, Universidad de Barcelona, Barcelona, Spain
| | - Maria José Arguis
- Department of Anesthesia, Hospital Clinic of Barcelona, Universidad de Barcelona, Barcelona, Spain
| | - Daniel Luis Forne
- Department of Anesthesia, Hospital Clinic of Barcelona, Universidad de Barcelona, Barcelona, Spain
| | - José Maria Balibrea
- Department of Gastrointestinal Surgery, Hospital Clinic of Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Anais Besa
- Department of Gastrointestinal Surgery, Hospital Clinic of Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Guillermo Laguna
- Department of Anesthesia, Hospital Clinic of Barcelona, Universidad de Barcelona, Barcelona, Spain
| | - Concepción Monsalve
- Department of Anesthesia, Hospital Clinic of Barcelona, Universidad de Barcelona, Barcelona, Spain
| | - Antonio M Lacy
- Department of Gastrointestinal Surgery, Hospital Clinic of Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, Spain
| | - Graciela Martinez-Pallí
- Department of Anesthesia, Hospital Clinic of Barcelona, Universidad de Barcelona, Barcelona, Spain. .,August Pi i Sunyer Biomedical Research Institute - IDIBAPS, University of Barcelona (UB), Barcelona, Spain. .,Biomedical Networking Research Center On Respiratory Diseases (CIBERES), Barcelona, Spain.
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Cuñat T, Martínez-Pastor JC, Dürsteler C, Hernández C, Sala-Blanch X. Perioperative medicine role in painful knee prosthesis prevention. Rev Esp Anestesiol Reanim (Engl Ed) 2022; 69:411-420. [PMID: 35869007 DOI: 10.1016/j.redare.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 03/25/2021] [Indexed: 06/15/2023]
Abstract
Total knee arthroplasty is one of the most frequently performed orthopaedic surgeries. However, up to 20% of patients develop persistent postoperative pain. Persistent postoperative pain may be an extension of acute postoperative pain, but can also occur after more than 3 months without symptoms. Risk factors associated with persistent postoperative pain after arthroplasty have now been characterised within the patient's perioperative context (preoperative, intraoperative and postoperative), and can be grouped under genetic, demographic, clinical, surgical, analgesic, inflammatory and psychological factors. Identification and prevention of persistent postoperative pain through a multimodal and biopsychosocial approach is essential in the context of perioperative medicine, and has been shown to prevent or ameliorate postoperative pain.
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Affiliation(s)
- T Cuñat
- Servicio de Anestesiología, Reanimación y Tratamiento del dolor, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - J C Martínez-Pastor
- Servicio de Traumatología y Cirugía Ortopédica, Hospital Clinic de Barcelona, Barcelona, Spain
| | - C Dürsteler
- Servicio de Anestesiología, Reanimación y Tratamiento del dolor, Hospital Clínic de Barcelona, Barcelona, Spain
| | - C Hernández
- Servicio de Anestesiología y Reanimación, Hospital Sant Joan de Déu de Barcelona, Esplugues de Llobregat, Barcelona, Spain
| | - X Sala-Blanch
- Servicio de Anestesiología, Reanimación y Tratamiento del dolor, Hospital Clínic de Barcelona, Barcelona, Spain
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Ojeda A, Calvo A, Cuñat T, Mellado-Artigas R, Comino-Trinidad O, Aliaga J, Arias M, Ferrando C, Martinez-Pallí G, Dürsteler C. Characteristics and influence on quality of life of new-onset pain in critical COVID-19 survivors. Eur J Pain 2021; 26:680-694. [PMID: 34866276 PMCID: PMC9015597 DOI: 10.1002/ejp.1897] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 12/02/2021] [Accepted: 12/04/2021] [Indexed: 01/07/2023]
Abstract
Background Pain is a clinical feature of COVID‐19, however, data about persistent pain after hospital discharge, especially among ICU survivors is scarce. The aim of this study was to explore the incidence and characteristics of new‐onset pain and its impact on Health‐Related Quality of Life (HRQoL), and to quantify the presence of mood disorders in critically ill COVID‐19 survivors. Methods This is a preliminary report of PAIN‐COVID trial (NCT04394169) presenting a descriptive analysis in critically ill COVID‐19 survivors, following in person interview 1 month after hospital discharge. Pain was assessed using the Brief Pain Inventory, the Douleur Neuropathique 4 questionnaire and the Pain Catastrophizing Scale. HRQoL was evaluated with the EQ 5D/5L, and mood disorders with the Hospital Anxiety and Depression Scale (HADS). Results From 27 May to 19 July 2020, 203 patients were consecutively screened for eligibility, and 65 were included in this analysis. Of these, 50.8% patients reported new‐onset pain; 38.5% clinically significant pain (numerical rating score ≥3 for average pain intensity); 16.9% neuropathic pain; 4.6% pain catastrophizing thoughts, 44.6% pain in ≥2 body sites and 7.7% widespread pain. Patients with new‐onset pain had a worse EQ‐VAS and EQ index value (p < 0.001). Pain intensity was negatively correlated to both the former (Spearman ρ: −0.546, p < 0.001) and the latter (Spearman ρ: −0.387, p = 0.001). HADS anxiety and depression values equal or above eight were obtained in 10.8% and 7.7% of patients, respectively. Conclusion New‐onset pain in critically ill COVID‐19 survivors is frequent, and it is associated with a lower HRQoL. Trial registration No.: NCT04394169. Registered 19 May 2020. https://clinicaltrials.gov/ct2/show/NCT04394169. Significance A substantial proportion of severe COVID‐19 survivors may develop clinically significant persistent pain, post‐intensive care syndrome and chronic ICU‐related pain. Given the number of infections worldwide and the unprecedented size of the population of critical illness survivors, providing information about the incidence of new‐onset pain, its characteristics, and its influence on the patients’ quality of life might help establish and improve pain management strategies.
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Affiliation(s)
- Antonio Ojeda
- Department of Anaesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Andrea Calvo
- Department of Anaesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Tomas Cuñat
- Department of Anaesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Ricard Mellado-Artigas
- Department of Anaesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Oscar Comino-Trinidad
- Department of Anaesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Jorge Aliaga
- Department of Anaesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Marilyn Arias
- Department of Anaesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
| | - Carlos Ferrando
- Department of Anaesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain.,Institut D'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Graciela Martinez-Pallí
- Department of Anaesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain.,Institut D'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Christian Dürsteler
- Department of Anaesthesiology, Critical Care and Pain Medicine, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain
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Cuñat T, Martínez-Pastor JC, Dürsteler C, Hernández C, Sala-Blanch X. Perioperative medicine role in painful knee prosthesis prevention. Rev Esp Anestesiol Reanim (Engl Ed) 2021; 69:S0034-9356(21)00142-0. [PMID: 34325900 DOI: 10.1016/j.redar.2021.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 01/07/2021] [Accepted: 03/25/2021] [Indexed: 11/25/2022]
Abstract
Total knee arthroplasty is one of the most frequently performed orthopaedic surgeries. However, up to 20% of patients develop persistent postoperative pain. Persistent postoperative pain may be an extension of acute postoperative pain, but can also occur after more than 3 months without symptoms. Risk factors associated with persistent postoperative pain after arthroplasty have now been characterised within the patient's perioperative context (preoperative, intraoperative and postoperative), and can be grouped under genetic, demographic, clinical, surgical, analgesic, inflammatory and psychological factors. Identification and prevention of persistent postoperative pain through a multimodal and biopsychosocial approach is essential in the context of perioperative medicine, and has been shown to prevent or ameliorate postoperative pain.
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Affiliation(s)
- T Cuñat
- Servicio de Anestesiología, Reanimación y Tratamiento del dolor, Hospital Clínic de Barcelona, Barcelona, España.
| | - J C Martínez-Pastor
- Servicio de Traumatología y Cirugía Ortopédica, Hospital Clínic de Barcelona, Barcelona, España
| | - C Dürsteler
- Servicio de Anestesiología, Reanimación y Tratamiento del dolor, Hospital Clínic de Barcelona, Barcelona, España
| | - C Hernández
- Servicio de Anestesiología y Reanimación, Hospital Sant Joan de Déu de Barcelona, Esplugues de Llobregat, Barcelona, España
| | - X Sala-Blanch
- Servicio de Anestesiología, Reanimación y Tratamiento del dolor, Hospital Clínic de Barcelona, Barcelona, España
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Ojeda A, Calvo A, Cuñat T, Artigas RM, Comino-Trinidad O, Aliaga J, Arias M, Ahuir M, Ferrando C, Dürsteler C. Rationale and study design of an early care, therapeutic education, and psychological intervention program for the management of post-intensive care syndrome and chronic pain after COVID-19 infection (PAIN-COVID): study protocol for a randomized controlled trial. Trials 2021; 22:486. [PMID: 34303381 PMCID: PMC8310406 DOI: 10.1186/s13063-021-05463-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 07/16/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Critically ill patients with COVID-19 are an especially susceptible population to develop post-intensive care syndrome (PICS) due to acute respiratory distress syndrome (ARDS). Patients can suffer acute severe pain and may have long-term mental, cognitive, and functional health deterioration after discharge. However, few controlled trials are evaluating interventions for the prevention and treatment of PICS. The study hypothesis is that a specific care program based on early therapeutic education and psychological intervention improves the quality of life of patients at risk of developing PICS and chronic pain after COVID-19. The primary objective is to determine whether the program is superior to standard-of-care on health-related quality of life at 6 months after hospital discharge. The secondary objectives are to determine whether the intervention is superior to standard-of-care on health-related quality of life, incidence of chronic pain and degree of functional limitation, incidence of anxiety, depression, and post-traumatic stress syndrome at 3 and 6 months after hospital discharge. METHODS The PAINCOVID trial is a unicentric randomized, controlled, patient-blinded superiority trial with two parallel groups. The primary endpoint is the health-related quality of life at 6 months after hospital discharge, and randomization will be performed with a 1:1 allocation ratio. This paper details the methodology and statistical analysis plan of the trial and was submitted before outcome data were available. The estimated sample size is 84 patients, 42 for each arm. Assuming a lost to follow-up rate of 20%, a sample size of 102 patients is necessary (51 for each arm). DISCUSSION This is the first randomized clinical trial assessing the effectiveness of an early care therapeutic education, and psychological intervention program for the management of PICS and chronic pain after COVID-19. The intervention will serve as proof of the need to implement early care programs at an early stage, having an incalculable impact given the current scenario of the pandemic. TRIAL REGISTRATION This study is being conducted in accordance with the tenets of the Helsinki Declaration and has been approved by the authors' institutional review board Comité Ético de Investigación Clínica del Hospital Clínic de Barcelona (approval number: HCB/2020/0549) and was registered on May 9, 2020, at clinicaltrials.gov ( NCT04394169 ).
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Affiliation(s)
- Antonio Ojeda
- Pain Medicine Section, Department of Anaesthesiology, Critical Care and Pain Treatment, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Andrea Calvo
- Surgical Intensive Care Unit, Department of Anesthesiology, Critical Care and Pain Treatment, Hospital Clínic, Institut d’investigació August Pi i Sunyer, 08036 Barcelona, Spain
| | - Tomas Cuñat
- Pain Medicine Section, Department of Anaesthesiology, Critical Care and Pain Treatment, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Ricard Mellado Artigas
- Surgical Intensive Care Unit, Department of Anesthesiology, Critical Care and Pain Treatment, Hospital Clínic, Institut d’investigació August Pi i Sunyer, 08036 Barcelona, Spain
| | - Oscar Comino-Trinidad
- Department of Anaesthesiology, Critical Care and Pain Treatment, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Jorge Aliaga
- Department of Anaesthesiology, Critical Care and Pain Treatment, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Marilyn Arias
- Department of Anaesthesiology, Critical Care and Pain Treatment, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Maribel Ahuir
- Department of clinical Psychology, Clinical Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Carlos Ferrando
- Surgical Intensive Care Unit, Department of Anesthesiology, Critical Care and Pain Treatment, Hospital Clínic, Institut d’investigació August Pi i Sunyer, 08036 Barcelona, Spain
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Christian Dürsteler
- Pain Medicine Section, Department of Anaesthesiology, Critical Care and Pain Treatment, Hospital Clínic de Barcelona, Barcelona, Spain
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