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Effectiveness and Safety of Convalescent Plasma Therapy on COVID-19 Patients With Acute Respiratory Distress Syndrome

Phase 2
Conditions
COVID
Acute Respiratory Distress Syndrome
Interventions
Biological: Convalescent plasma
Drug: Standard of care
Registration Number
NCT04380935
Lead Sponsor
Indonesia University
Brief Summary

Corona virus disease 2019 (COVID-19) has been declared as a Pandemic by the World Health Organization (WHO). According to WHO report on March 31st 2020, globally COVID-19 have infected over 750,000 people and caused over 36,000 deaths with case fatality rate of 4.85%. In Indonesia, COVID-19 have infected 1,414 people and caused 122 deaths with case fatality rate of 8.63%. In severe cases, COVID-19 causes complications, such as acute respiratory distress syndrome (ARDS), sepsis, septic shock, and multi-organ dysfunction syndrome (MODS), where age and comorbid illnesses as a major factor to these complications. Up to this point there are several promising therapies for COVID-19 but is not yet recommended and in need of further research. The use of convalescent plasma has been approved by the US Food and Drug Administration (FDA) through the scheme of emergency investigational new drug (eIND). This method has been used as the treatment in several outbreak or plague cases over the years, such as the flu epidemic in 1918, polio, measles, mumps, SARS (severe acute respiratory syndrome), EVD (Ebola virus disease) and MERS (middle-eastern respiratory syndrome) and this treatment shows better outcome. Several case report on the use of convalescent plasma for COVID-19 patients with ARDS and mechanical ventilation has been reported and shows promising outcome. Nevertheless, larger and multicenter research need to be done to assess and evaluate the effectiveness and safety of convalescent plasma therapy on for COVID-19 patients with ARDS.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
60
Inclusion Criteria
  • Patients aged more than equal to 18 years.
  • COVID-19 confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR)
  • Having severe pneumonia.
  • PAO2 / FIO2 <300.
Exclusion Criteria
  • Contraindication to blood transfusions (fluid overload, history of anaphylaxis of blood products)
  • Multiple and severe organ failure, hemodynamically unstable
  • Other uncontrolled infections
  • Disseminated intravascular coagulation (DIC) which requires a replacement factor/FFP
  • Hemodialysis patients or CRRT (continuous renal replacement therapy)
  • Active intracranial bleeding
  • Significant myocardial ischemia
  • Receiving tocilizumab treatment

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
convalescent plasma and standard of careConvalescent plasma-
convalescent plasma and standard of careStandard of care-
standard of careStandard of care-
Primary Outcome Measures
NameTimeMethod
All-cause mortalityup to 28 days

Proportion of all-cause mortality

Secondary Outcome Measures
NameTimeMethod
Length of stay in intensive care unitup to 28 days

Mean length of stay in intensive care unit

Duration of mechanical ventilationup to 28 days

Mean duration of mechanical ventilation

Body temperature (degree in Celsius)Day 1, 3, 5, and 7 after administration of therapy

Mean change from baseline using time series analysis

The Sequential Organ Failure Assessment (SOFA) ScoreDay 1, 3, 5, and 7 after administration of therapy

Mean change from baseline using time series analysis

PAO2/FIO2 ratioDay 1, 3, 5, and 7 after administration of therapy

Mean change from baseline using time series analysis

C-Reactive Protein (CRP) in mg/LDay 1, 3, 5, and 7 after administration of therapy

Mean change from baseline using time series analysis

D-Dimer in ng/mLDay 1, 3, 5, and 7 after administration of therapy

Mean change from baseline using time series analysis

Procalcitonin in ng/mLDay 1, 3, 5, and 7 after administration of therapy

Mean change from baseline using time series analysis

Interleukin 6 (IL-6) in pg/mLDay 1, 3, 5, and 7 after administration of therapy

Mean change from baseline using time series analysis

Allergic/ anaphylaxis transfusion reaction24 hours post-transfusion

Number of participants with allergic/ anaphylaxis transfusion reaction

Hemolytic transfusion reaction24 hours post-transfusion

Number of participants with Hemolytic transfusion reaction

Transfusion Related Acute Lung Injury24 hours post-transfusion

Number of participants with Transfusion Related Acute Lung Injury

Transfusion associated Circulatory Overload24 hours post-transfusion

Number of participants with Transfusion associated Circulatory Overload

Trial Locations

Locations (3)

Dr. Cipto Mangunkusumo General Hospital

🇮🇩

Jakarta, DKI Jakarta, Indonesia

St. Carolus Hospital

🇮🇩

Jakarta, DKI Jakarta, Indonesia

Ciputra Hospital CitraRaya

🇮🇩

Jakarta, DKI Jakarta, Indonesia

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