Persistent SARS-CoV-2 Infection in Children With Cancer and Impaired Immune Responsiveness

SARS-CoV-2 Infection Clinical Trial

Official title:

Persistent SARS-CoV-2 Infection in Children With Cancer and Impaired Immune Responsiveness

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT05172063
• Other study ID #: CCHE-Persistent SARS-CoV-2
• Status: Not yet recruiting
• Start date: January 2022
• Est. completion date: December 31, 2023

Study information

• Verified date: December 2021
• Source: Children's Cancer Hospital Egypt 57357
• Contact: Mohamed Diaaeldin Hashem, MBBCh, MSc
• Phone: +2-02-25351500
• Email: mohamed.diaaeldin[@]57357.org
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The main goal of this study is to characterize the adaptive immune responses to SARS-CoV-2 infection in a cohort of children with cancer and impaired immune responsiveness and prolonged viral shedding of SARS-CoV-2, and to identify SARS-CoV-2 variants that might arise during poorly controlled virus replication

Description:

Although the adaptive immune response plays an important role in improving clinical outcomes of patients infected with SARS2, variability in clinical disease and outcome in patients with SARS2 infection has not been explained by the variation in qualitative and quantitative antiviral immune responses. It has been observed that immunocompromised children shed the virus from the upper respiratory tract for prolonged periods of time, even after the resolution of clinical symptoms. Thus deficits in adaptive immune responses might lead to ineffective control of virus replication and prolonged virus shedding. The proposed studies will define the relationship between adaptive immunity and virus replication/shedding, including the contribution of viral variants that could arise during poorly controlled virus replication in children with ineffective immune responses. The specific aims of the proposed study are: (a) To measure (quantify and qualify) the adaptive immune responses (humoral and cell-mediated immune responses) after infection with SARS-CoV-2 in a cohort of hospitalized children with cancer and impaired immune response. (b) To define the long-term kinetics of the antibody response, cell-mediated immune responses following infection with SARS-CoV-2 in a cohort of hospitalized children with cancer and impaired immune response, and to estimate the duration of protective immunity.(c) to statistically assess whether impaired humoral immunity is associated with prolonged viral replication and shedding (persistence) following infection with SARS-CoV-2 in a cohort of children with cancer and impaired immune response, (d) To genetically trace SARS-CoV-2 mutations, and statistically assess the association between persistent SARS-CoV-2 infection and the frequency of viral mutations and the emergence of viral variants in a cohort of children with cancer and impaired immune response, after their infection with SARS-CoV-2 This will be a prospective, observational cohort study design. The study population will include pediatric and adolescent patients undergoing cancer chemotherapy with a confirmed SARS-CoV-2 infection (PCR Positive). Eligible subjects will be followed prospectively for three months from the time they tested positive for SARS-CoV-2 by PCR. SARS-CoV-2 RNA, antibody, and cell-mediated immune responses will be assessed at specified time points and compared between the children with persistent SARS-CoV-2 infection, and those who cleared SARS-CoV-2 virus. Sequence viral variants in the persistent SARS-COV-2 infected group Assess the association between the emergence of viral variants and mutations and strain virulence and clinical outcome

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 30
• Est. completion date: December 31, 2023
• Est. primary completion date: March 31, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 1 Year to 18 Years

Eligibility

Inclusion Criteria:

1. Children (<18) of both genders undergoing cancer chemotherapy

2. Symptomatic SARS-CoV-2 infection, confirmed by (positive PCR test).

3. Patients with hematologic malignancies (ALL, AML, HL & NHL) on active treatment or under follow up < 3 months from end of treatment protocol

Exclusion Criteria:

1. Children (<18 years) of both genders undergoing cancer chemotherapy with (PCR negative) test result for SARS-CoV-2.

2. Children who are PCR positive but are diagnosed with an immune disorder that may confound the study results.

Related Conditions & MeSH terms

• Children With Cancer
• Communicable Diseases
• COVID-19
• Infections
• SARS-CoV-2 Infection

Locations

Country	Name	City	State
Egypt	Children's Cancer Hospital Egypt 57357 Cairo, Egypt	Cairo

Sponsors (3)

Lead Sponsor	Collaborator
Children's Cancer Hospital Egypt 57357	National Research Centre, Egypt, Pfizer

Country where clinical trial is conducted

Egypt, 

References & Publications (10)

Avanzato VA, Matson MJ, Seifert SN, Pryce R, Williamson BN, Anzick SL, Barbian K, Judson SD, Fischer ER, Martens C, Bowden TA, de Wit E, Riedo FX, Munster VJ. Case Study: Prolonged Infectious SARS-CoV-2 Shedding from an Asymptomatic Immunocompromised Indi — View Citation

Aydillo T, Gonzalez-Reiche AS, Aslam S, van de Guchte A, Khan Z, Obla A, Dutta J, van Bakel H, Aberg J, García-Sastre A, Shah G, Hohl T, Papanicolaou G, Perales MA, Sepkowitz K, Babady NE, Kamboj M. Shedding of Viable SARS-CoV-2 after Immunosuppressive Th — View Citation

Baang JH, Smith C, Mirabelli C, Valesano AL, Manthei DM, Bachman MA, Wobus CE, Adams M, Washer L, Martin ET, Lauring AS. Prolonged Severe Acute Respiratory Syndrome Coronavirus 2 Replication in an Immunocompromised Patient. J Infect Dis. 2021 Jan 4;223(1) — View Citation

Choi B, Choudhary MC, Regan J, Sparks JA, Padera RF, Qiu X, Solomon IH, Kuo HH, Boucau J, Bowman K, Adhikari UD, Winkler ML, Mueller AA, Hsu TY, Desjardins M, Baden LR, Chan BT, Walker BD, Lichterfeld M, Brigl M, Kwon DS, Kanjilal S, Richardson ET, Jonsso — View Citation

Gomaa MR, El Rifay AS, Shehata M, Kandeil A, Nabil Kamel M, Marouf MA, GabAllah M, El Taweel A, Kayed AE, Kutkat O, Moatasim Y, Mahmoud SH, Abo Shama NM, El Sayes M, Mostafa A, El-Shesheny R, McKenzie PP, Webby RJ, Kayali G, Ali MA. Incidence, household t — View Citation

Gomaa MR, Kandeil A, Mostafa A, Roshdy WH, Kayed AE, Shehata M, Kutkat O, Moatasim Y, El Taweel A, Mahmoud SH, Kamel MN, Abo Shama NM, El Sayes M, El-Shesheny R, Bakheet OH, Elgohary MA, Elbadry M, Nassif NN, Ahmed SH, Abdel Messih IY, Kayali G, Ali MA. P — View Citation

Schmidt F, Weisblum Y, Muecksch F, Hoffmann HH, Michailidis E, Lorenzi JCC, Mendoza P, Rutkowska M, Bednarski E, Gaebler C, Agudelo M, Cho A, Wang Z, Gazumyan A, Cipolla M, Caskey M, Robbiani DF, Nussenzweig MC, Rice CM, Hatziioannou T, Bieniasz PD. Measu — View Citation

Sethuraman N, Jeremiah SS, Ryo A. Interpreting Diagnostic Tests for SARS-CoV-2. JAMA. 2020 Jun 9;323(22):2249-2251. doi: 10.1001/jama.2020.8259. — View Citation

Truong TT, Ryutov A, Pandey U, Yee R, Goldberg L, Bhojwani D, Aguayo-Hiraldo P, Pinsky BA, Pekosz A, Shen L, Boyd SD, Wirz OF, Röltgen K, Bootwalla M, Maglinte DT, Ostrow D, Ruble D, Han JH, Biegel JA, Li M, Huang C, Sahoo MK, Pannaraj PS, O'Gorman M, Jud — View Citation

Turner JS, Day A, Alsoussi WB, Liu Z, O'Halloran JA, Presti RM, Patterson BK, Whelan SPJ, Ellebedy AH, Mudd PA. SARS-CoV-2 Viral RNA Shedding for More Than 87 Days in an Individual With an Impaired CD8+ T Cell Response. Front Immunol. 2021 Jan 8;11:618402 — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	SARS-CoV-2 antibody titers		Three months
Primary	Different subsets of immune cells (neutrophils, dendritic cells, B- and T- lymphocytes)		Three months
Secondary	Sequence viral variants in the persistent SARS-COV-2 infected group		Three months
Secondary	Assess the association between the emergence of viral variants and mutations and strain virulence and clinical outcome		Three months