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Efficacy of Human Coronavirus-immune Convalescent Plasma for the Treatment of COVID-19 Disease in Hospitalized Children

Phase 2
Withdrawn
Conditions
Hospitalized Children
Covid-19 Infection
Interventions
Biological: Convalescent plasma (CP)
Registration Number
NCT04377568
Lead Sponsor
The Hospital for Sick Children
Brief Summary

This is a multicentered, open-label, randomized controlled Phase 2 trial to evaluate the safety and efficacy of providing human coronavirus-immune convalescent plasma as treatment for COVID-19 disease in hospitalized children in the context of the COVID-19 pandemic.

Detailed Description

SARS-CoV-2 viral infection resulting in COVID-19 disease has recently been designated by the World Health Organization as a global pandemic. Outbreak forecasting and mathematical models suggest that the number of COVID-19 cases will continue to rise over the coming weeks and months. There is an urgent public health need for rapid development of novel interventions. This protocol aims to use passive antibody therapy via convalescent plasma from SARS-CoV-2-infected patients who have developed antibody immunity, COVID-19 convalescent plasma (C19-CP), as treatment for hospitalized children with COVID-19 disease at pediatric academic hospitals across Canada. The unknown role for convalescent plasma in treating COVID-19 necessitates further study.

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria
  1. Age 0 to <19 years old
  2. Hospitalized with symptoms compatible with COVID-19 illness
  3. Laboratory-confirmed SARS-CoV-2 infection as determined by PCR, or other commercial or public health assay in any specimen prior to randomization.
  4. ABO compatible convalescent plasma available
Exclusion Criteria
  1. Onset of symptoms began >12 days before screening
  2. History of adverse reactions to blood products or other contraindication to transfusion
  3. Refusal of plasma for religious or other reasons
  4. Acute heart failure with fluid overload
  5. Any condition or diagnosis, that could in the opinion of the Site Principal Investigator interfere with the participant's ability to comply with study instructions, or put the participant at risk
  6. Anticipated discharge within 24 hours

Note: The intent of this exclusion criteria is to only include participants with acute COVID-19 infections. This protocol is not intended to include participants with post-infectious complications. In cases where the distinction is not clear, participant eligibility will be discussed with the study steering committee prior to enrollment.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Convalescent Plasma + Standard of Care (C19-CP + SoC)Convalescent plasma (CP)Participants will receive COVID-19 convalescent plasma (C19-CP) plus standard of care while being hospitalized for COVID-19.
Primary Outcome Measures
NameTimeMethod
Clinical recoveryat day 30

defined in the last 24 hours as normal respiratory and heart rate (or return to baseline, absence of fever, absence of low blood pressure, oxygen saturation greater than 94% or room air (or return to baseline), no need for intravenous fluids (or return to baseline)

Secondary Outcome Measures
NameTimeMethod
Respiratory status-2time from admission to intubation

time to intubation

Combined mortality/intubationat 30 day

Proportion of patients experiencing death in hospital (Yes/No) 30 days

Respiratory status-1at 30 days

Proportion of patients experiencing Intubation (Yes/No)

Respiratory status-3from admission to day 30 of hospitalization

Mean number of ventilator-free days in 30 days

respiratory status -4from admission to day 30 of hospitalization

Mean number of ventilator days in 30 days

respiratory status -5from admission to day 30 of hospitalization

The number of oxygen free days in the first 30 days or the incidence and duration of new oxygen use during the trial, defined as oxygen use that was not present at time of randomization but occurs subsequently

respiratory status-6at 30 days

The proportion of patients needing ECMO in 30 days

Mortality 1aat 30 days

Time to in-hospital death censored

Mortality 1bat 90 days

Time to in-hospital death censored

Mortality 2aat 30 days

Proportion of patients with Survival status

Mortality 2bat 90 days

Proportion of patients with Survival status

Care and Critical Careat 30 days

Length of hospitalization and stay in the ICU

organ systems: renalup to 365 days

The proportion of patients needing renal replacement therapy

organ systems: cardiacup to 365 days

The proportion of patients developing myocarditis

Transfusion-associated adverse events (AE)up to 365 days

The proportion of patients developing adverse events to the treatment arm, C19-CP as assessed by Proposed Standard definitions for surveillance of non-infectious adverse transfusion reactions.

Safety of the interventionup to 365 days

cumulative incidence of severe and life-threatening AEs and severe AEs

organ systems: multi-system inflammatory diseaseup to 365 days

The proportion of patients developing multi-system inflammatory disease

Trial Locations

Locations (13)

IWK Health Centre

🇨🇦

Halifax, Nova Scotia, Canada

Alberta Children's Hospital

🇨🇦

Calgary, Alberta, Canada

Stollery Children's Hospital

🇨🇦

Edmonton, Alberta, Canada

BC Children's Hospital

🇨🇦

Vancouver, British Columbia, Canada

The Hospital for Sick Children

🇨🇦

Toronto, Ontario, Canada

CHU Sainte-Justine

🇨🇦

Montréal, Quebec, Canada

McGill Univ Health Ctr - Montreal Children's Hospital

🇨🇦

Montréal, Quebec, Canada

Winnipeg Children's Hospital

🇨🇦

Winnipeg, Manitoba, Canada

Kingston Health Sciences Centre

🇨🇦

Kingston, Ontario, Canada

McMaster Children's Hospital

🇨🇦

Hamilton, Ontario, Canada

Children's Hospital of Eastern Ontario

🇨🇦

Ottawa, Ontario, Canada

Jim Pattison Children's Hospital

🇨🇦

Saskatoon, Saskatchewan, Canada

Children's Hospital

🇨🇦

London, Ontario, Canada

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