Convalescent Plasma for the Treatment of Patients With Severe COVID-19 Infection

COVID-19 Infection Clinical Trial

Official title:

Convalescent Plasma for the Treatment of Patients With Severe COVID-19 Infection - A Multicenter Phase II Trial

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04408209
• Other study ID #: 245-14-4-20
• Status: Recruiting
• Phase: N/A
• Start date: April 23, 2020
• Est. completion date: December 15, 2023

Study information

• Verified date: September 2022
• Source: National and Kapodistrian University of Athens
• Contact: Aikaterini Niarchou
• Phone: +30 6949124743
• Email: aniarchou[@]med.uoa.gr
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a multicenter, Phase 2 study, to assess the efficacy of the treatment with convalescent plasma in patients with severe COVID-19 infection.

Description:

Convalescent plasma will be collected by plasmapheresis from patients fully recovered from COVID-19 infection and will be administered in patients with severe COVID-19 infection. The results will be compared with an historical matched control.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 60
• Est. completion date: December 15, 2023
• Est. primary completion date: August 30, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Age >18 years

2. Confirmed SARS-CoV2 infection by PCR of the nasal/pharyngeal swab, sputum, BAL

3. Onset of the disease symptoms no more than 12 days before the inclusion of the patients in the trial

4. Severe COVID-19 infection as determined with one of the following:

• Respiratory rate 30/min
• Oxygen Hemoglobin Saturation SAT 93
• CRP >1.5 (upper normal limit <0.5)
• Ferritin value >100
• Ratio of PaO2:FiO2 <300mmHg
• Pulmonary infiltrates in Chest X-Ray or Chest CT scan >50% during 24-48 hours

5. Life threatening infection as determined by one of the following:

• Respiratory failure
• Septic Shock
• Multiple organ failure

6. Signature of informed consent by the patient or legal representative Patients fulfilling criteria 1, 2, 3, 6 and one of criteria 4 or 5 will be eligible for the study.

Exclusion Criteria:

1. Critical illness due to progressive COVID-19 with expected survival time <48 hours

2. Intubated patients >72 hours

3. Chronic Heart failure NYHA 3 and/or preexisting left ventricular ejection fraction 30%

4. Cardiovascular failure requiring 0.5µg/Kg/min nor-adrenaline or equivalent or more than 2 types of vasopressor medication

5. Liver Cirrhosis Child C

6. Liver failure with bilirubin >5X ULN and increase of ALT/AST (at least one >10X ULN)

7. Previous history of allergic reaction to blood or blood products transfusion

8. Known IgA deficiency

9. Pregnancy

10. Breast feeding women

11. Pulmonary edema

Related Conditions & MeSH terms

• Communicable Diseases
• COVID-19
• COVID-19 Infection
• Infections

Intervention

Procedure:
• Convalescent Plasma
Convalescent Plasma - early treatment of patients with severe COVID-19. Clinical and laboratory data of patients will be collected before initiation of the procedure, 30 minutes after the first dose, 30 minutes after the second dose and 30 minutes after the third plasma dose and then on days 1-7, 14, 21, 28, 35 from the start of treatment. In case of adverse reactions during transfusion such as acute shortness of breath, haemodynamic instability or high pre-existing and non-disease-related fever, the transfusion will be interrupted and detailed recording of the event as well as updating the Adverse Events Management Committee will be performed. In addition to the standard assessments, the titer of neutralizing anti-SARS-CoV-2 antibodies will be measured in a sample drawn prior to plasmapheresis. All donors will be tested for: the titer of IgG anti-SARS-CoV-2 antibodies (Pasteur Institute) the titer of neutralizing anti-SARS-CoV-2 antibodies (Pasteur Institute)

Locations

Country	Name	City	State
Greece	"Agios Savas" Oncology Hospital	Athens	Attiki
Greece	"Alexandra" General Hospital	Athens	Attiki
Greece	"Evangelismos" General Hospital	Athens	Attiki
Greece	"Sotiria" General Hospital	Athens	Attiki
Greece	Attikon" University General Hospital	Athens	Chaidari
Greece	University General Hospital of Patras	Patra	Rio

Sponsors (2)

Lead Sponsor	Collaborator
National and Kapodistrian University of Athens	Hellenic Society of Hematology

Country where clinical trial is conducted

Greece, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Survival	The primary endpoint of this trial is the survival on day 21. The primary endpoint, as a dichotomous composite of survival (yes/no) and no longer fulfilling criteria of severe COVID-19, will be analyzed according their classification. Specifically, categorical variables will be analyzed by means of absolute and relative frequencies, and all continuous variables will be described using arithmetic mean, standard deviation, median, quartiles. Also, geometric means, variance and 95% confidence intervals (CI), will be calculated for all pharmacokinetics parameters.	Day 21
Primary	Survival	The primary endpoint of this trial is the survival on day 35.	Day 35
Primary	Survival	The primary endpoint of this trial is the survival on day 60.	Day 60
Secondary	Clinical improvement ie percentage of patients not fulfilling the criteria for severe disease	The secondary endpoint of this trial is that no longer fulfilling criteria of severe COVID-19 within 21 days after inclusion. This will be assessed on the basis of respiratory rate and ventilation support.	Day 21