ovel Experimental COVID Therapies Affecting Host Response (NECTAR)

Recruitment & Eligibility

Status: ot Recruiting

Sex: All

Target Recruitment: 800

Inclusion Criteria

1. Hospitalized for COVID-19
2. =18 years of age
3. SARS-CoV-2 infection, documented by:
a. a nucleic acid test (NAT) or equivalent testing within 3 days prior to randomization OR
b. documented by NAT or equivalent testing more than 3 days prior to randomization AND progressive disease suggestive of ongoing SARS-CoV-2 infection per the responsible investigator (For non-NAT tests, only those deemed with equivalent specificity to NAT by the protocol team will be allowed. A central list of allowed non-NAT tests is maintained in Appendix G.)
4. Hypoxemia, defined as SpO2 <92% on room air, new receipt of supplemental oxygen to maintain SpO2 =92%, or increased supplemental oxygen to maintain SpO2 =92% for a patient on chronic oxygen therapy
5. Symptoms or signs of acute COVID-19, defined as one or more of the following:
a. Cough
b. Reported or documented body temperature of 100.4o F or greater
c. shortness of breath
d. chest pain
e. infiltrates on chest imaging (x-ray, CT scan, lung ultrasound)
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 400
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 400

Exclusion Criteria

1. COVID-19 symptom onset >14 days prior to randomization
2. Hospitalized for >72 hours prior to randomization
3. Pregnancy
4. Breastfeeding
5. Prisoners
6. End-stage renal disease (ESRD) on dialysis
7. Patient and/or clinical team is not pursuing full medical management (if a patient has a Do Not Resuscitate order that precludes chest compressions in the event of a cardiac arrest but is otherwise pursuing full medical management, he/she is eligible for this trial).
8. The treating clinician expects inability to participate in study procedures or participation would not be in the best interests of the patient

Fostamatinib Arm-Specific Exclusion Criteria:
1. Randomized in another trial evaluating fostamatinib in the prior 30 days
Fostamatinib Arm-Specific Exclusion Criteria measured within 24-hours prior to randomisation:
1. AST or ALT = 5 × upper limit of normal (ULN) or ALT or AST = 3 × ULN and total bilirubin = 2 × ULN
2. SBP > 160 mmHg or DBP > 100 mmHg at the time of screening and randomization
3. ANC < 1000/mL
4. Patient requires use of strong CYP3A modulators from Table above (Clarithromycin, Indinavir, Itraconazole, Ketoconazole, Nefazodone, Nelfinavir, Ritonavir, Saquinavir, Telithromycin, Troleandomycin, Carbamazepine, Efavirenz, Enzalutamide, Modafinil, Nevirapine, Oxcarbazepine, Phenobarbital, Phenytoin, Rifabutin, Rifampin, St. John’s Wort, or Troglitazone).
5. Patient unable to participate or declines participation in the fostamatinib arm.

Study & Design

Study Type: Interventional clinical trial of medicinal product

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method

Secondary Outcome Measures

Name	Time	Method

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