Antiviral Agents Against COVID-19 Infection (REVOLUTIOn)
COVID-19
About this trial
This is an interventional treatment trial for COVID-19 focused on measuring covid-19, antivirals, atazanavir, daclatasvir, sofosbuvir, multiarm multistage study, adaptive
Eligibility Criteria
Inclusion Criteria:
Adults (≥ 18 years) hospitalized with COVID-19:
- SARS-CoV-2 positive RT-PCR or Antigen test
- Typical clinical history and chest CT with typical findings, pending RT-PCR for SARS-CoV-2
- Symptom duration <= 9 days
- SpO2 <= 94% in room air or need for supplemental oxygen to maintain SpO2> 94%
- The patient consents to participate in the study and is willing to comply with all study procedures, including the collection of virology samples
Exclusion Criteria:
- Patients in need of respiratory support with invasive mechanical ventilation;
- Alanine Transaminase (ALT) or Aspartate Transaminase (AST) > 5 times the upper limit of normal;
- Total bilirubin > 2 mg/dL;
- Platelets <50,000 cel/L;
- Total neutrophil count <750 cell/L;
- Renal dysfunction (estimated glomerular filtration rate [eGFR] <30 mL / min / 1.73 m2, using the MDRD or CKD-EPI method); and pre-defined renal failure stage 3 according to AKINx classification with serum creatinine> 4 mg / dl or patient already on renal replacement therapy;
- Previously known liver disease (liver cirrhosis), defined as a report by the participant or written in the respective cirrhosis chart, esophageal varices, or the presence of clinical ascites on examination;
- Decompensated congestive heart failure defined as the presence of dyspnea, edema of the lower limbs or rales on pulmonary auscultation, jugular turgency or chest X-ray with signs of pulmonary congestion;
- Pregnant or breast feeding patients;
- Known allergy or hypersensitivity to any study drug;
- Hepatitis C carrier (HCV RNA positive), active Hepatitis B (positive surface antigen in the past), or HIV (ELISA and confirmatory Western Blot in the past). New screening tests are NOT required;
- Patients currently using nucleoside or nucleotide analog drugs for any indication;
- Corrected Q interval T> 480 on the electrocardiogram;
- Heart rate <55 bpm;
- Patients in use or who recently used (<90 days) amiodarone;
- Women of childbearing potential and men with a partner of childbearing potential who do NOT agree to use two contraceptive methods (including barrier method) for 100 days.
Sites / Locations
- Hospital do Coracao
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Experimental
Experimental
Experimental
Placebo Comparator
Placebo Comparator
Placebo Comparator
Atazanavir
Daclatasvir 60 mg
Sofusbuvir + Daclatasvir 60 mg
Placebo Atazanavir
Placebo Daclatasvir
Placebo Sofusbuvir + Daclatasvir
600 mg (2 capsules) twice daily on the first day and 300 mg (1 capsule) twice daily for the subsequent 9 days.
initial dose of 120mg (2 capsules), followed by 60mg (1 capsule) once daily for 9 days.
400 mg twice daily (2 capsules) on the first day and 400 mg (1 capsules) once daily for the subsequent 9 days (sofosbuvir) + initial dose of 120mg (2 capsules), followed by 60mg (1 capsule) once a day for 9 days (daclastavir)
2 capsules twice daily on the first day and 1 capsule twice daily for the subsequent 9 days.
2 capsules twice daily on the first day and 1 capsule twice daily for the subsequent 9 days.
2 capsules twice daily on the first day and 1 capsule twice daily for the subsequent 9 days.