The Use of Exosomes for the Treatment of Acute Respiratory Distress Syndrome or Novel Coronavirus Pneumonia Caused by COVID-19 (ARDOXSO)
Covid19, Novel Coronavirus Pneumonia, Acute Respiratory Distress Syndrome
About this trial
This is an interventional treatment trial for Covid19 focused on measuring Novel Corona Virus Pneumonia, Exosomes, MSC, Acute Respiratory Distress Syndrome
Eligibility Criteria
Inclusion Criteria:
- Informed Consent given
- Male and female patients age 18 years or older
- Patients with coronavirus (SARS-CoV-2) infection confirmed prior to enrollment by any test with local regulatory approval
Patients who require intensive care as determined by the following objective criteria:
- Respiratory rate>25/minute
- Oxygen saturation <93% on room air; or the
- Use of high flow oxygen by nasal cannula at a rate ≥ 4L/minute.
- Patients with lung imaging demonstrating bilateral or diffuse pulmonary infiltrates on chest X-ray or CT scan.
- Patients with moderate to severe ARDS as defined by Berlin Criteria
- Patients who require invasive mechanical ventilation (IMV)
Exclusion Criteria:
Patients will be excluded from the study if ONE of the following applies:
- History of hypersensitivity to any drugs of similar classes to exosomes
- Suspected active uncontrolled bacterial, fungal, or viral (besides SARS-CoV-2) infection
- Currently receiving ECMO, nitric oxide therapy, or high-frequency oscillatory ventilation
- In the option of the investigator, the patient is unlikely to survive for more than 24 hours post-enrollment
- Patients who are on long-term use of select oral or injectable anti-rejection or immunomodulatory drugs
- Pregnant or nursing (lacking) women
Sites / Locations
- Mission Community Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Placebo Comparator
Escalating Dose First Cohort
Escalating Dose Second Cohort
Escalating Dose Third Cohort
Treatment Dose Fourth Cohort Randomized control ratio 1:3
First Cohort: Five patients will receive an escalating dose every other day for a period of 5 days, with a minimum of 24 hours between doses recorded. Dose escalation will begin at 2 x 10^9 exosomes
Second Cohort: Five patients will receive an escalating dose every other day for a period of 5 days, with a minimum of 24 hours between doses recorded. Dose escalation will begin at 4 x 10^9 exosomes.
Five patients will receive a treatment dose of 8 X 10^9 exosomes every other day for a period of 5 days, with a minimum of 24 hours between doses recorded.
Fourth Cohort: Randomized Cohort Up to 40 patients may be enrolled in this phase of the trial. For those receiving the placebo (~25%), 3 doses will be given over the 5 day period, dispensed from identical vials with physician and patient blinded. The full dose of 8 X 10^9 exosomes will be given to 75% of the patients in 3 doses over the course of 5 days, with one dose occurring every other day.