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Convalescent Plasma for COVID-19 Close Contacts

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СтатусРекрутинг
Спонсоры
Columbia University

Ключевые слова

абстрактный

This is a double-blinded, randomized control trial to assess the efficacy and safety of anti-SARS-CoV-2 convalescent plasma in two groups, RT PCR-positive and asymptomatic or mildly symptomatic at baseline (group B) and PCR-negative at baseline (group C). Both groups will be randomized 1:1 to receive either convalescent plasma qualitatively positive for SARS-CoV-2 antibody (anti-SARS-CoV-2 plasma) or control (albumin 5%).

Описание

There are no approved therapies for Coronavirus disease 2019 (COVID-19), also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). 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). In recent work in China, an open label safety trial of CP in patients with COVID-19 suggested a substantive benefit.

Даты

Последняя проверка: 04/30/2020
Первый отправленный: 05/13/2020
Предполагаемая регистрация отправлена: 05/13/2020
Первое сообщение: 05/14/2020
Последнее обновление отправлено: 05/13/2020
Последнее обновление опубликовано: 05/14/2020
Фактическая дата начала исследования: 04/30/2020
Предполагаемая дата завершения начальной школы: 03/31/2021
Предполагаемая дата завершения исследования: 03/31/2021

Состояние или болезнь

SARS-CoV 2
COVID-19

Вмешательство / лечение

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

Biological: Control (albumin 5%)

Фаза

Фаза 2

Группы рук

РукаВмешательство / лечение
Experimental: Convalescent Plasma (anti-SARS-CoV-2 plasma)
Participants randomized to the experimental arm will receive 1 unit (approximately 200 to 250 mL) of convalescent plasma that was collected from a volunteer who recovered from COVID-19 disease.
Biological: Convalescent Plasma (anti-SARS-CoV-2 plasma)
Convalescent Plasma that contains antibody titers against SARS-CoV-2.
Active Comparator: Control (albumin 5%)
Participants randomized to the control arm will receive 250 mL of albumin (human) 5% infusion. The albumin will be prepared in bags that are identical to the bags used for plasma. The similar appearance of albumin and plasma will facilitate maintaining the blinded status of subjects and most of the study staff.
Biological: Control (albumin 5%)
Albumin (Human) 5% is a sterile aqueous solution for intravenous use containing the albumin component human plasma.

Критерии приемлемости

Возраст, имеющий право на обучение 18 Years Чтобы 18 Years
Полы, имеющие право на обучениеAll
Принимает здоровых добровольцевда
Критерии

Inclusion Criteria:

Group B: SARS-CoV-2 PCR positive but asymptomatic or mild symptoms at screening

- Subjects must be 18 years of age or older

- Close contact* of a person with COVID-19 within the last 7 days. It is anticipated that most contacts will be household contacts with extensive interaction. All must meet the CDC criteria for close contacts.

- Evidence of infection by nasopharyngeal swab PCR that is positive for SARS-CoV-2

- No symptoms or no more than 5 days of mild symptoms at the time of screening. Mild symptoms+ may include:

- Mild rhinorrhea

- Mild sore throat or throat irritation

- Mild nonproductive cough

- Mild fatigue (able to perform Activities of Daily Living (ADLs))

- High risk for severe COVID-19 based on a risk score of ≥ 2 Calculated Risk Score of ≥ 2 points, with risk factors based on Center for Disease Control and Prevention (CDC) description

- Age 65-74: 1 point

- Age ≥ 75: 2 points

- Known cardiovascular disease (including hypertension): 1 point

- Diabetes mellitus: 1 point

- Pulmonary disease (COPD, moderate to severe asthma, current smoking or other): 1 point

- Morbid obesity: 1 point

- Immunocompromised state: 1 point Received a bone marrow or solid organ transplant at any time, received chemotherapy for a malignancy within the past 6 months, has an acquired or congenital immunodeficiency, currently receiving immunosuppressive or immune modulating medications, HIV with non-suppressed viral load and/or cluster of differentiation 4 (CD4+) T cell count <200 cells/mL).

- Mild symptoms are rated by participant as mild and not interfering with normal daily activities

Group C: SARS-CoV-2 PCR negative (uninfected) at time of screening but asymptomatic or mildly symptomatic at screening

- Subjects must be 18 years of age or older

- Close contact* of a person with COVID-19 within the last 7 days. It is anticipated that most contacts will be household contacts with extensive interaction. All must meet the CDC criteria for close contacts.

- Nasopharyngeal swab negative for SARS-Cov-2 at screening

- No symptoms or no more than 5 days of mild symptoms at the time of screening. Mild symptoms+ may include:

- Mild rhinorrhea

- Mild sore throat or throat irritation

- Mild nonproductive cough

- Mild fatigue (able to perform ADLs)

- High risk for severe COVID-19 based on a risk score of ≥ 2, as above.*

- Close contact is defined by CDC as being within approximately 6 feet (2 meters) of a COVID-19 case for a prolonged period of time (without PPE); close contact can occur while caring for, living with, visiting, or sharing a healthcare waiting area or room with a COVID-19 case.

- Mild symptoms are rated by participant as mild and not interfering with normal daily activities

Exclusion Criteria:

Group B: SARS-CoV-2 PCR positive but asymptomatic or mild symptoms at screening

- Receipt of any blood product in past 120 days.

- Psychiatric or cognitive illness or recreational drug/alcohol use that in the opinion of the principal investigator, would affect subject safety and/or compliance.

- Confirmed or self-reported presumed COVID-19 at least one week before index case first became ill with COVID-19.

- Symptoms consistent with COVID--‐19 infection that are more than mild (as defined above) at time of screening. Subjects who report fever (Tmax > 100.4 F) are not eligible for enrollment.

- Symptoms that have worsened in the period between screening and enrollment such that the subject is deemed to be medical unstable on the day of planned enrollment.

- History of allergic reaction to transfusion blood products

- Inability to complete infusion of the product within 48 hours after randomization.

- Pregnancy (or planning for pregnancy in next three months) or breastfeeding.

- Resident of a long term or skilled nursing facility

- Known prior diagnosis of immunoglobulin A (IgA) deficiency

- Oxygen saturation that is < 95% at the screening visit

- Participation in another clinical trial of anti-viral agent(s) for COVID-19

Group C: SARS-CoV-2 PCR negative (uninfected) at time of screening

- Receipt any blood product in past 120 days.

- Psychiatric or cognitive illness or recreational drug/alcohol use that in the opinion of the principle investigator, would affect subject safety and/or compliance.

- Confirmed or self-reported presumed COVID-19 at least one week before index case first became ill with COVID-19.

- Symptoms consistent with severe COVID-19 infection that are more than mild (as defined above) at time of screening. Subjects who report fever (Tmax > 100.4 F) are not eligible for enrollment.

- Symptoms that have worsened in the period between screening and enrollment such that the subject is deemed to be medically unstable on the day of planned enrollment.

- Laboratory evidence of SARs-CoV-2 infection (i.e. RT-PCR) at time of screening

- History of allergic reaction to blood products

- Inability to complete infusion of the product within 48 hours after randomization.

- Pregnancy (or planning for pregnancy in next three months) or breastfeeding.

- Resident of a long term or skilled nursing facility

- Known history of immunoglobulin A (IgA) deficiency

- Oxygen saturation that is < 95% at the screening visit

- Participation in another clinical trial of anti-viral agent(s) for COVID-19

Результат

Основные показатели результатов

1. Rate of Severe Disease [Up to 28 days]

The efficacy of treatment will be determined by rating disease severity on Day 28, or last rating evaluated, using a seven-category severity scale.

Меры вторичного результата

1. Rate of measurable anti-SARS-CoV-2 titers [Up to 90 days]

To compare the rate of measurable anti-SARS-CoV-2 titers between recipients of CP (anti-SARS-CoV-2 plasma) versus control (albumin 5%).

2. Rate of SARS-CoV-2 PCR Positivity [Up to 28 days]

Compare the rates of SARS-CoV-2 PCR positivity (RT PCR) amongst the anti-SARS-CoV-2 convalescent plasma and control (albumin 5%).

3. Duration of SARS-CoV-2 PCR Positivity [Up to 28 days]

Compare the duration of SARS-CoV-2 PCR positivity (RT PCR) amongst the anti-SARS-CoV-2 convalescent plasma and control (albumin 5%).

4. Levels of SARS-CoV-2 RNA [Up to 28 days]

Compare the levels of SARS-CoV-2 RNA between the recipients of antiSARS-CoV-2 plasma and control (albumin 5%)

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