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Monitoring the Efficacy of a Probiotic Dietary Supplement SmartProbio C in Patients With Severe COVID-19 Infection

Primary Purpose

COVID-19

Status
Completed
Phase
Not Applicable
Locations
Czechia
Study Type
Interventional
Intervention
SmartProbio C
Placebo
Sponsored by
Medi Pharma Vision
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for COVID-19 focused on measuring COVID-19, probiotics, probiotic supplementation

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • The subject is willing and able to provide informed consent prior to any study procedure.
  • Age at the time of screening between 18 and 85 years inclusive.
  • Coronavirus (SARS-CoV-2) infection confirmed by polymerase chain reaction (PCR) or immunochromatographic detection of SARS CoV-2 specific antigens no more than three days prior to randomization.
  • COVID-19 symptoms lasting less than or equal to seven days, including.
  • Subject is currently hospitalized and requires medical care due to COVID-19 disease and was admitted at most two days prior to randomization.
  • Peripheral blood oxygen saturation <94% on air (as measured by pulse oximetry or arterial blood sampling) at the time of inclusion in the trial.

Exclusion Criteria:

  • Participation in any other clinical trial of an experimental treatment for COVID-19 disease.
  • Concomitant treatment of COVID-19 with other non-standard-of-care medications less than 24 hours prior to initiation of the study intervention dosing (excluding remdesivir, corticosteroids, casirivimab, imdevimab, or bamlanivimab).
  • Immunosuppressant treatment three months prior to hospital admission (excluding topical and inhaled corticosteroids or systemically administered corticosteroids at a dose equivalent to <40 mg Prednisone)
  • Necessity of invasive pulmonary ventilation.
  • Patients with known primary or secondary immunodeficiency.
  • History of Crohn's disease or ulcerative colitis.
  • Abnormal screening laboratory results - laboratory abnormalities that, in the opinion of the investigator, will interfere with completion of participation in the clinical trial or will interfere with the results of the trial.
  • Participation in another clinical trial of a drug or medical device, or less than 30 days have elapsed since the completion of participation in another trial or use of the investigational drug or device.
  • Other probiotic supplementation.
  • Hypersensitivity to any ingredient of a product administered during a clinical trial.
  • Women who are pregnant or breastfeeding.
  • Patients with preterminal and terminal organ failure (COPD GOLD 3 and 4, CKD G4 and G5, NYHA 3 and 4).
  • Any condition that, in the opinion of the investigator, may compromise the patient's ability to provide informed consent and/or comply with all required study procedures.

Sites / Locations

  • Medi Pharma Vision
  • Brno University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Verum

Placebo

Arm Description

Patients received probiotic supplement SmartProbio C, one capsule twice a day - mornings and evenings before meal - for a period of 2 weeks.

Patients received placebo consisting of purified maltodextrin, one capsule twice a day - mornings and evenings before meal - for a period of 2 weeks.

Outcomes

Primary Outcome Measures

Gut microbiome
Changes in selected parameters of gut microbiome (amount of lactobacilli, bifidobacteria, Akkermansia, Proteobacteria, and Firmicutes/Bacteroidetes ratio) were chosen as the primary endpoint.

Secondary Outcome Measures

Length of hospitalisation
Tracking of time to clinical improvement by two points on a seven-point ordinal scale for clinical improvement according to R&D Blueprint: COVID-19 Therapeutic Trial Synopsis (WHO, 2020), or time to hospital discharge (whichever comes first).
Monitoring the length of oxygen dependence
Measurement of the time it was necessary to provide HFOT (high flow oxygen therapy) to the patient
CRP (C-reactive protein) monitoring
Monitoring of laboratory marker of inflammation - serum peripheral blood CRP levels
Monitoring mortality rates
The percentage of deaths in the placebo group compared to percentage of deaths in the verum group

Full Information

First Posted
July 21, 2022
Last Updated
July 25, 2022
Sponsor
Medi Pharma Vision
Collaborators
Veterinary Research Institute, Brno University Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05474144
Brief Title
Monitoring the Efficacy of a Probiotic Dietary Supplement SmartProbio C in Patients With Severe COVID-19 Infection
Official Title
A Two-arm, Double-blind, Randomized, Placebo-controlled Trial Investigating the Efficacy of the Probiotic Dietary Supplement SmartProbio C in the Supportive Supplementation of Patients With a Complicated Course of COVID-19 Infection
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Completed
Study Start Date
November 12, 2021 (Actual)
Primary Completion Date
April 30, 2022 (Actual)
Study Completion Date
April 30, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medi Pharma Vision
Collaborators
Veterinary Research Institute, Brno University Hospital

4. Oversight

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

5. Study Description

Brief Summary
The aim of the study is to test the efficacy of the probiotic SmartProbio C in patients with a severe course of COVID-19 infection. Patients were randomly divided into two arms between the probiotic group and the placebo group. They were further divided into four groups according to 1) BMI (Body mass index; <=30/>30), 2) age (<=65/>65), 3) CRP (C-reactive protein; <=100/>100), 4) chronic lung disease (yes/no). Gut microbiome analysis and its changes in selected parameters (amount of lactobacilli, bifidobacteria, Akkermansia, Proteobacteria, Firmicutes/Bacteroidetes ratio) were chosen as the primary endpoint. Other assessed indicators include: Tracking of time to clinical improvement by two points on a seven-point ordinal scale for clinical improvement according to R&D Blueprint: COVID-19 Therapeutic Trial Synopsis (WHO, 2020) or time to hospital discharge (whichever comes first) Monitoring the length of oxygen dependence Monitoring of laboratory markers of inflammation - serum peripheral blood CRP levels Monitoring of mortality

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COVID-19
Keywords
COVID-19, probiotics, probiotic supplementation

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderOutcomes Assessor
Allocation
Randomized
Enrollment
83 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Verum
Arm Type
Experimental
Arm Description
Patients received probiotic supplement SmartProbio C, one capsule twice a day - mornings and evenings before meal - for a period of 2 weeks.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Patients received placebo consisting of purified maltodextrin, one capsule twice a day - mornings and evenings before meal - for a period of 2 weeks.
Intervention Type
Dietary Supplement
Intervention Name(s)
SmartProbio C
Intervention Description
Probiotic supplement consisting of 19 strains (Lactobacillus acidophilus NCFM, Bifidobacterium lactis, subsp. Infantis Bi-07, Lactobacillus rhamnosus LR22, Lactobacillus acidophilus LA14, Lactobacillus rhamnosus LGG, Bifidobacterium lactis HN019, Bifidobacterium lactis Bl-04, Lactobacillus acidophilus LA 11 ONLLY, Lactobacillus rhamnosus HN001, Lactobacillus plantarum LP ONLLY, Lactobacillus casei LC18, Bifidobacterium breve BB8, Lactobacillus reuteri LE16, Bifidobacterium lactis BI516, Streptococcus thermophilus ST6, Bifidobacterium animalis BA77, Bifidobacterium bifidum BB47, Bifidobacterium longum BL88 ONLLY, Bifidobacterium infantis BI211) in different ratios. Probiotic mixture enclosed in HPMC (hydroxypropylmethylcelulose) capsule, 25 billion CFU (colony-forming units) in each capsule. As a filling agent mix of inulin and maltodextrin was used. Dosage twice a day.
Intervention Type
Dietary Supplement
Intervention Name(s)
Placebo
Intervention Description
Placebo. HPMC (hydroxypropylmethylcelulose) capsule filled with maltodextrin. Dosage twice a day.
Primary Outcome Measure Information:
Title
Gut microbiome
Description
Changes in selected parameters of gut microbiome (amount of lactobacilli, bifidobacteria, Akkermansia, Proteobacteria, and Firmicutes/Bacteroidetes ratio) were chosen as the primary endpoint.
Time Frame
The first sample was taken at the beginning of hospitalization before the start of supplementation, the second at discharge from the hospital, but not later than on the 14th day of hospitalization.
Secondary Outcome Measure Information:
Title
Length of hospitalisation
Description
Tracking of time to clinical improvement by two points on a seven-point ordinal scale for clinical improvement according to R&D Blueprint: COVID-19 Therapeutic Trial Synopsis (WHO, 2020), or time to hospital discharge (whichever comes first).
Time Frame
From the date of admission to hospital until discharge from hospital or above defined two point improvement, whichever comes first
Title
Monitoring the length of oxygen dependence
Description
Measurement of the time it was necessary to provide HFOT (high flow oxygen therapy) to the patient
Time Frame
From the beginning of the provision of HFOT (high flow oxygen therapy) to the end of the provision of HFOT
Title
CRP (C-reactive protein) monitoring
Description
Monitoring of laboratory marker of inflammation - serum peripheral blood CRP levels
Time Frame
On the first day of admission to hospital and on the day of hospital discharge, but no later than 14th day
Title
Monitoring mortality rates
Description
The percentage of deaths in the placebo group compared to percentage of deaths in the verum group
Time Frame
From the date of admission to hospital until discharge from hospital or death, whichever comes first

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The subject is willing and able to provide informed consent prior to any study procedure. Age at the time of screening between 18 and 85 years inclusive. Coronavirus (SARS-CoV-2) infection confirmed by polymerase chain reaction (PCR) or immunochromatographic detection of SARS CoV-2 specific antigens no more than three days prior to randomization. COVID-19 symptoms lasting less than or equal to seven days, including. Subject is currently hospitalized and requires medical care due to COVID-19 disease and was admitted at most two days prior to randomization. Peripheral blood oxygen saturation <94% on air (as measured by pulse oximetry or arterial blood sampling) at the time of inclusion in the trial. Exclusion Criteria: Participation in any other clinical trial of an experimental treatment for COVID-19 disease. Concomitant treatment of COVID-19 with other non-standard-of-care medications less than 24 hours prior to initiation of the study intervention dosing (excluding remdesivir, corticosteroids, casirivimab, imdevimab, or bamlanivimab). Immunosuppressant treatment three months prior to hospital admission (excluding topical and inhaled corticosteroids or systemically administered corticosteroids at a dose equivalent to <40 mg Prednisone) Necessity of invasive pulmonary ventilation. Patients with known primary or secondary immunodeficiency. History of Crohn's disease or ulcerative colitis. Abnormal screening laboratory results - laboratory abnormalities that, in the opinion of the investigator, will interfere with completion of participation in the clinical trial or will interfere with the results of the trial. Participation in another clinical trial of a drug or medical device, or less than 30 days have elapsed since the completion of participation in another trial or use of the investigational drug or device. Other probiotic supplementation. Hypersensitivity to any ingredient of a product administered during a clinical trial. Women who are pregnant or breastfeeding. Patients with preterminal and terminal organ failure (COPD GOLD 3 and 4, CKD G4 and G5, NYHA 3 and 4). Any condition that, in the opinion of the investigator, may compromise the patient's ability to provide informed consent and/or comply with all required study procedures.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Petr Rysavka, Ph.D.
Organizational Affiliation
Medi Pharma Vision
Official's Role
Principal Investigator
Facility Information:
Facility Name
Medi Pharma Vision
City
Brno
ZIP/Postal Code
61200
Country
Czechia
Facility Name
Brno University Hospital
City
Brno
ZIP/Postal Code
62500
Country
Czechia

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
30099133
Citation
Adler Sorensen C, Fuglsang E, Jorgensen CS, Laursen RP, Larnkjaer A, Molgaard C, Ritz C, Michaelsen KF, Krogfelt KA, Frokiaer H. Probiotics and the immunological response to infant vaccinations; a double-blind randomized controlled trial. Clin Microbiol Infect. 2019 Apr;25(4):511.e1-511.e7. doi: 10.1016/j.cmi.2018.07.031. Epub 2018 Aug 9.
Results Reference
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PubMed Identifier
32574290
Citation
Baud D, Dimopoulou Agri V, Gibson GR, Reid G, Giannoni E. Using Probiotics to Flatten the Curve of Coronavirus Disease COVID-2019 Pandemic. Front Public Health. 2020 May 8;8:186. doi: 10.3389/fpubh.2020.00186. eCollection 2020. No abstract available.
Results Reference
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PubMed Identifier
32787470
Citation
Bottari B, Castellone V, Neviani E. Probiotics and Covid-19. Int J Food Sci Nutr. 2021 May;72(3):293-299. doi: 10.1080/09637486.2020.1807475. Epub 2020 Aug 12.
Results Reference
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PubMed Identifier
25922398
Citation
Doron S, Snydman DR. Risk and safety of probiotics. Clin Infect Dis. 2015 May 15;60 Suppl 2(Suppl 2):S129-34. doi: 10.1093/cid/civ085.
Results Reference
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Citation
Li KJ, Chen ZL, Huang Y, Zhang R, Luan XQ, Lei TT, Chen L. Dysbiosis of lower respiratory tract microbiome are associated with inflammation and microbial function variety. Respir Res. 2019 Dec 3;20(1):272. doi: 10.1186/s12931-019-1246-0.
Results Reference
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PubMed Identifier
32391658
Citation
Xu K, Cai H, Shen Y, Ni Q, Chen Y, Hu S, Li J, Wang H, Yu L, Huang H, Qiu Y, Wei G, Fang Q, Zhou J, Sheng J, Liang T, Li L. [Management of COVID-19: the Zhejiang experience]. Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020 Feb 21;49(2):147-157. doi: 10.3785/j.issn.1008-9292.2020.02.02. Chinese.
Results Reference
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Nguyen QV, Chong LC, Hor YY, Lew LC, Rather IA, Choi SB. Role of Probiotics in the Management of COVID-19: A Computational Perspective. Nutrients. 2022 Jan 10;14(2):274. doi: 10.3390/nu14020274.
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Monitoring the Efficacy of a Probiotic Dietary Supplement SmartProbio C in Patients With Severe COVID-19 Infection

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