Role of Co-trimoxazole in Severe COVID-19 Patients
Covid19, Severe COVID-19 Patients
About this trial
This is an interventional treatment trial for Covid19
Eligibility Criteria
Inclusion Criteria:
- Diagnosed COVID-19 patients ( RT-PCR positive for COVID-19)
- Age > 18 years
- Hypoxic respiratory failure (saturation <90% on air at rest or increasing oxygen requirement)
- Chest examination findings of bilateral crackles on auscultation or chest x-ray showing bilateral infiltrates
- C-Reactive Protein > 50mg/L
Exclusion Criteria:
- Multi-organ failure
- Severe ARDS (requiring ventilator support on presentation in the form of invasive or non-invasive ventilation)
- Septic Shock
- Severe liver disease
- Acute Kidney Injury (where GFR< 15 and plasma-sulfamethoxazoleconcentration cannot be monitored)
- Drug allergy/intolerance to co-trimoxazole / Sulphar sensitivity
- Pregnancy
- Already receiving Tocilizumab or convalescent therapy
Sites / Locations
- Bangabandhu Sheikh Mujib Medical UniversityRecruiting
Arms of the Study
Arm 1
Arm 2
No Intervention
Experimental
Control
intervention /experimental
Arm A :No Intervention/control: Standard treatment Antibiotics for secondary bacterial infection as per institutional guidelines Supplemental oxygen (to keep saturations between 90% to 96%) Intravenous hydration (to maintain euvolumia) Thrombo-prophylaxis as per local guidelines Paracetamol (oral or I/V 1gram QDS as required or regular) To consider steroids if indicated (i.e. acute exacerbation of COPD or acute severe asthma)
Arm B: Experimental Arm received oral co-trimoxazole + standard therapy The following treatments are recommended as standard therapy: Antibiotics for secondary bacterial infection as per institutional guidelines Supplemental oxygen (to keep saturations between 90% to 96%) Intravenous hydration (to maintain euvolumia) Thrombo-prophylaxis as per local guidelines Paracetamol (oral or I/V 1gram QDS as required or regular) To consider steroids if indicated (i.e. acute exacerbation of COPD or acute severe asthma)