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Plasma Therapy of COVID-19 in Severely Ill Patients

Primary Purpose

SARS-CoV-2 Infection

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Convalescent Plasma (anti-SARS-CoV-2 plasma)
Non-convalescent Plasma (control plasma)
Sponsored by
Max O'Donnell
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for SARS-CoV-2 Infection focused on measuring COVID-19, COVID, Coronavirus, Convalescent plasma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Willing and able to provide written informed consent prior to performing study procedures or have a legally authorized representative available to do so.
  • Age ≥18 years
  • Evidence of SARS-CoV-2 infection by PCR test of naso-/oro-pharyngeal swab or tracheal aspirate sample within 14 days of randomization
  • Peripheral capillary oxygen saturation (SpO2) ≤ 94% on room air or requiring supplemental oxygen, non-invasive or invasive mechanical ventilation at screening
  • Evidence of infiltrates on chest radiography
  • Females of childbearing age and males, must be willing to practice an effective contraceptive method or remain abstinent during the study period.

Exclusion Criteria:

  • Participation in another clinical trial of anti-viral agent(s) for COVID-19
  • Receipt of any anti-viral agent(s) with possible activity against SARS-CoV-2 <24 hours prior to study drug administration [1]
  • Mechanically ventilated (including veno-venous (VV)-ECMO) ≥ 5 days
  • Severe multi-organ failure
  • History of prior reactions to transfusion blood products meeting definitive case definition criteria, at least severe severity, and probable or definite imputability per National Healthcare Safety Network (NHSN)/Centers for Disease Control and Prevention (CDC) criteria
  • Known Immunoglobulin A (IgA) deficiency
  • Females who are pregnant

    1. Use of remdesivir as treatment for COVID-19 is permitted.

Sites / Locations

  • Columbia University Irving Medical Center/NYP
  • Hospital Federal dos Servidores do Estado
  • Hospital Geral de Nova Iguaçu
  • Instituto Nacional de Infectologia Evandro Chagas

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Convalescent Plasma (anti-SARS-CoV-2 plasma)

Non-convalescent Plasma (control plasma)

Arm Description

Convalescent plasma (1 unit; ~200-250 mL) collected from a volunteer who recovered from COVID-19 disease

Non-convalescent plasma (1 unit; ~200-250 mL) of standard plasma collected prior to December 2019

Outcomes

Primary Outcome Measures

Day 28 severity outcome
Compare the day 28 severity outcome amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups using a 7-point ordinal scale of clinical status.

Secondary Outcome Measures

Proportion of SARS-CoV-2 PCR Positivity
Compare the proportion and duration of SARS-CoV-2 PCR positivity (via RT-PCR) amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups at days 0, 7, and 14.
Levels of SARS-CoV-2 RNA
Compare levels of SARS-CoV-2 RNA amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups at days 0, 7, and 14.
Duration of Need for Supplemental Oxygen
Compare duration of need for supplemental oxygen and/or mechanical ventilation amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups.
Duration of Hospitalization
Compare duration of hospitalization amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups.
In-hospital and 28-day mortality
Compare in-hospital and 28-day mortality amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups.
Time-to-clinical improvement in-hospital
Compare time-to-clinical improvement in-hospital amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups, defined as the time to either an improvement of one point on a 7-point ordinal scale of clinical status or alive discharge from the hospital, whichever comes first.
Host genetic differences at day 0
To assess for host genetic differences at Day 0 amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups.
Host transcriptomic differences at days 0,7,14
To assess for host transcriptomic differences at Day 0,7,14 amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups.

Full Information

First Posted
April 21, 2020
Last Updated
May 16, 2021
Sponsor
Max O'Donnell
Collaborators
New York Blood Center, Amazon.com, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04359810
Brief Title
Plasma Therapy of COVID-19 in Severely Ill Patients
Official Title
A Phase 2, Multi-Center, Randomized Clinical Trial to Evaluate the Efficacy and Safety of Human Anti-SARS-CoV-2 Convalescent Plasma in Severely Ill Adults With COVID-19
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Completed
Study Start Date
April 21, 2020 (Actual)
Primary Completion Date
December 30, 2020 (Actual)
Study Completion Date
December 30, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Max O'Donnell
Collaborators
New York Blood Center, Amazon.com, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This randomized blinded multi-center phase 2 trial will assess the efficacy and safety of anti-SARS-CoV-2 convalescent plasma among adults with severe COVID-19. Adults ≥18 years of age may participate. A total of 219 eligible subjects will be randomized in a 2:1 ratio to receive either high-titer anti-SARS-CoV-2 plasma or non-convalescent fresh frozen plasma (control plasma).
Detailed Description
There are few effective therapies for coronavirus disease 2019 (COVID-19) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Exposure to viruses results in an adaptive immune response that commonly include antibodies with neutralization activity. Plasma from subjects who have recovered from viral infections has been used to both prevent or treat disease. Notable examples of the successful use of convalescent plasma (CP) include influenza, measles, Argentine hemorrhagic fever, Middle East respiratory syndrome (MERS), Ebola and severe acute respiratory syndrome (SARS-CoV). Small clinical trials and observational studies of CP therapy in patients with COVID-19 have suggested a possible clinical benefit.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
SARS-CoV-2 Infection
Keywords
COVID-19, COVID, Coronavirus, Convalescent plasma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
A total of 219 eligible subjects will be randomized in a 2:1 ratio to receive either convalescent plasma qualitatively positive for SARS-CoV-2 antibody (anti-SARS-CoV-2 plasma) or non-convalescent fresh frozen plasma (control plasma).
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
223 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Convalescent Plasma (anti-SARS-CoV-2 plasma)
Arm Type
Experimental
Arm Description
Convalescent plasma (1 unit; ~200-250 mL) collected from a volunteer who recovered from COVID-19 disease
Arm Title
Non-convalescent Plasma (control plasma)
Arm Type
Active Comparator
Arm Description
Non-convalescent plasma (1 unit; ~200-250 mL) of standard plasma collected prior to December 2019
Intervention Type
Biological
Intervention Name(s)
Convalescent Plasma (anti-SARS-CoV-2 plasma)
Intervention Description
Convalescent Plasma that contains antibody titers against SARS-CoV-2
Intervention Type
Biological
Intervention Name(s)
Non-convalescent Plasma (control plasma)
Intervention Description
Non-convalescent plasma (does not contain antibody titers against SARS-CoV-2)
Primary Outcome Measure Information:
Title
Day 28 severity outcome
Description
Compare the day 28 severity outcome amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups using a 7-point ordinal scale of clinical status.
Time Frame
Up to 28 days
Secondary Outcome Measure Information:
Title
Proportion of SARS-CoV-2 PCR Positivity
Description
Compare the proportion and duration of SARS-CoV-2 PCR positivity (via RT-PCR) amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups at days 0, 7, and 14.
Time Frame
Up to 14 days
Title
Levels of SARS-CoV-2 RNA
Description
Compare levels of SARS-CoV-2 RNA amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups at days 0, 7, and 14.
Time Frame
Up to 14 days
Title
Duration of Need for Supplemental Oxygen
Description
Compare duration of need for supplemental oxygen and/or mechanical ventilation amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups.
Time Frame
Up to 28 days
Title
Duration of Hospitalization
Description
Compare duration of hospitalization amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups.
Time Frame
Up to 28 days
Title
In-hospital and 28-day mortality
Description
Compare in-hospital and 28-day mortality amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups.
Time Frame
Up to 28 days
Title
Time-to-clinical improvement in-hospital
Description
Compare time-to-clinical improvement in-hospital amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups, defined as the time to either an improvement of one point on a 7-point ordinal scale of clinical status or alive discharge from the hospital, whichever comes first.
Time Frame
Up to 28 days
Title
Host genetic differences at day 0
Description
To assess for host genetic differences at Day 0 amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups.
Time Frame
Day 0
Title
Host transcriptomic differences at days 0,7,14
Description
To assess for host transcriptomic differences at Day 0,7,14 amongst the anti-SARS-CoV-2 convalescent plasma and non-convalescent plasma groups.
Time Frame
Up to 14 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Willing and able to provide written informed consent prior to performing study procedures or have a legally authorized representative available to do so. Age ≥18 years Evidence of SARS-CoV-2 infection by PCR test of naso-/oro-pharyngeal swab or tracheal aspirate sample within 14 days of randomization Peripheral capillary oxygen saturation (SpO2) ≤ 94% on room air or requiring supplemental oxygen, non-invasive or invasive mechanical ventilation at screening Evidence of infiltrates on chest radiography Females of childbearing age and males, must be willing to practice an effective contraceptive method or remain abstinent during the study period. Exclusion Criteria: Participation in another clinical trial of anti-viral agent(s) for COVID-19 Receipt of any anti-viral agent(s) with possible activity against SARS-CoV-2 <24 hours prior to study drug administration [1] Mechanically ventilated (including veno-venous (VV)-ECMO) ≥ 5 days Severe multi-organ failure History of prior reactions to transfusion blood products meeting definitive case definition criteria, at least severe severity, and probable or definite imputability per National Healthcare Safety Network (NHSN)/Centers for Disease Control and Prevention (CDC) criteria Known Immunoglobulin A (IgA) deficiency Females who are pregnant Use of remdesivir as treatment for COVID-19 is permitted.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Max O'Donnell, MD
Organizational Affiliation
Columbia University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Columbia University Irving Medical Center/NYP
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Hospital Federal dos Servidores do Estado
City
Rio De Janeiro
Country
Brazil
Facility Name
Hospital Geral de Nova Iguaçu
City
Rio De Janeiro
Country
Brazil
Facility Name
Instituto Nacional de Infectologia Evandro Chagas
City
Rio De Janeiro
Country
Brazil

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
The data-sharing plans for this study will be made available at a later date.
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Plasma Therapy of COVID-19 in Severely Ill Patients

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