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Convalescent Plasma for Treating Patients With COVID-19 Pneumonia Without Indication of Ventilatory Support

Phase 2
Conditions
COVID-19
Interventions
Biological: Convalescent plasma
Registration Number
NCT04528368
Lead Sponsor
D'Or Institute for Research and Education
Brief Summary

The COVID-19 pandemic has been spreading continuously, and in Brazil, until August 18, 2020, there have been more than 3,359,000 cases with more than 108,536 deaths, with daily increases. The present study proposes to evaluate the efficacy and safety of using convalescent plasma for treating patients with COVID-19 pneumonia without indication of ventilatory support.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
60
Inclusion Criteria
  • Confirmed diagnosis of COVID-19 by RT-PCR;
  • Time between symptom onset and inclusion ≤ 7 days;
  • Chest tomography with <50% involvement of the lung parenchyma;
  • No indication of ventilatory support at the time of randomization;
  • Sign the consent form.

Recipient

Exclusion Criteria
  • Contraindication to transfusion or history of previous reactions to blood products for transfusion;
  • Pregnant women;
  • Limiting comorbidity for administering the therapies provided for in this protocol in the opinion of the investigator.

Donor Inclusion Criteria for Plasmapheresis:

  • Convalescent plasma donation will be eligible for patients ≥ 18 years old who had previously confirmed COVID-19 by RT-PCR, which met the criteria adopted by technical notes n13 and 21/2020-CGSH/DAET/SAES/MS;
  • SARS-COV-2 negative RT-PCR;
  • Asymptomatic for at least 14 days;
  • SARS-CoV-2 anti-peak titre with dilution ≥ 1: 320;
  • Sign the consent form.

Donor Exclusion Criteria:

  • Female gender with previous pregnancy;
  • Absence of peripheral venous network compatible with the apheresis procedure;
  • Positive or indeterminate result in any of the infectious screening tests;
  • Presence of intellectual incapacity to understand the guidelines regarding the risks and benefits of participating in the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Convalescent Plasma + Standard treatmentConvalescent plasmaParticipants will receive the standard treatment and convalescent plasma
Primary Outcome Measures
NameTimeMethod
Area under the curve of SARS-COV-2 viral load obtained from nasopharyngeal and /or oropharyngeal swabs.0, 3, 6, 9, 12, 15, 18 and 21 days

To evaluate the area under the curve of SARSCoV-2 viral load in nasopharyngeal and or oropharyngeal samples on days 0, 3, 6, 9, 12, 15, 18 and 15 after randomization.

Secondary Outcome Measures
NameTimeMethod
Length of stay in intensive care21 days
Assess the rate of orotracheal intubation21 days
Evaluate the PaO2 / FiO2 ratio (for patients on mechanical mechanisms)0, 3, 6, 9, 12, 15, 18 and 21 days
Change in the profile of cytokines/chemokines in both groups0, 3, 6, 9, 12, 15, 18 and 21 days

Quantification by ELISA the levels of 36 molecules determined simultaneously using the Human Cytokine Array Kit da R\&D Systems (C5a, IL-4, IL-32 alpha, CD40 ligand, IL-5, CXCL10 / IP-10, G-CSF, IL-6, CXCL11 / I-TAC, GM-CSF, IL-8, CCL2 / MCP-1, CXCL1 / GRO alpha, IL-10, MIF, CCL1 / I-309, IL-12 p70, CCL3 / MIP-1 alpha, ICAM-1, IL-13, CCL4 / MIP-1 beta, IFN -gamma, IL-16, CCL5 / RANTES, IL-1 alpha, IL-17, CXCL12 / SDF-1, IL-1 beta, IL-17E, Serpin E1 / PAI-1, IL-1ra, IL-23, TNF-alpha, IL-2, IL-27 and TREM-1)

Assessment of clinical improvement using an Ordinal Severity Scale0, 7, 10, 14, 21 and 28 days

The seven-point scale is as follows:

* Death 7 points;

* Hospital admission for mechanical ventilation plus additional organ support (eg, pressors, RRT, ECMO) = 6 points;

* Hospital admission for mechanical ventilation = 5 points;

* Hospital admission for non-invasive ventilation or high-flow oxygen therapy = 4 points;

* Hospital admission for oxygen therapy (but not requiring high-flow or non-invasive ventilation) = 3 points;

* Hospital admission but not requiring oxygen therapy = 2 points;

* Discharged with limitations of activities = 1 point;

* Discharged with no limitations of activities = 0 point;

Assess respiratory rate0, 3, 6, 9, 12, 15, 18 and 21 days
Presence of antibodies against SARS-CoV-2 in serum after convalescent plasma administration0, 3, 6, 9, 12, 15, 18 and 21 days
Death rate7, 10, 14, 21 and 28 days
Evaluate oxygen saturation0, 3, 6, 9, 12, 15, 18 and 21 days
Evaluate oxygen supplementation0, 3, 6, 9, 12, 15, 18 and 21 days
Length of hospital stay21 days
Rate of transfusion reactions to convalescent plasma infusion21 days

Trial Locations

Locations (1)

D'Or Institute for Research and Education

🇧🇷

Rio de Janeiro, Brazil

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