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COVID-19Phase 3PLASCOSSANCT04372979

Efficacy of Convalescent Plasma Therapy in the Early Care of COVID-19 Patients.

A Phase 3 study testing Transfusion of SARS-CoV-2 Convalescent Plasma. and Transfusion of standard Plasma. in people with COVID-19, run by Direction Centrale du Service de Santé des Armées at 4 sites in France.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

COVID-19 (Corona Virus Disease 2019) hospitalized patients evolution is marked by the risk of worsening of the respiratory system during the second week of the disease. To date, treatments are currently being evaluated and none of them have shown to be effective in the care of these patients. Read more about this study

Who is it for?
Ages 18 to 90 years
Conditions the study is for
COVID-19
What is being tested?
Transfusion of SARS-CoV-2 Convalescent Plasma. and Transfusion of standard Plasma.
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
18 participants
Where
4 sitesFrance
Study dates
14 Sep 2020to 1 Jun 2021
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 90 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age 18-90 years ;
  • COVID-19 confirmed case ;
  • Cases showing respiratory symptoms, checking at least one of the following criteria:
  • Cough, dyspnea, respiratory rate > 24 breaths/min
  • Oxygen saturation < 95% at rest in ambient air
  • PaO2 < 70mmHg
Show all 22Show fewer
  • Scanographic pulmonary compatible with COVID in the absence of any other etiology
  • Risk of deterioration, checking at least one of the following comorbidity criteria :
  • Chronic respiratory pathology
  • Diabetes
  • Cancer pathology
  • Cardiovascular disease
  • Chronic kidney failure
  • Congenital or acquired immunodeficiency
  • Cirrhosis at stage B
  • Major sickle cell syndrome
  • BMI > 30 kg/m2
  • OR one of the biological criteria :
  • D-dimer 1 µg/mL,
  • Lymphocytes < 0.8 G/L,
  • Ferritin > 300 µg/L,
  • Troponin I > 11 pg/mL or Troponin T > 24.8 pg/mL

Who cannot join

  • Patients admitted in intensive care within the first 6 hours of hospital care,
  • Patients after 10 days from the start of symptoms
  • Age < 18 years and > 90 years
  • Long-term oxygen-dependent patients (at home),
  • Decompensated chronic cardiac, respiratory, urological pathology
  • Patient refusing administration of blood products,
Show all 14Show fewer
  • Allergic reaction to plasma products,
  • IgA deficiency,
  • Contraindication to transfusion
  • Ig transfusion within 30 days,
  • Patient currently participating to another clinical trial,
  • Pregnant women,
  • No affiliated to the social security,
  • Person deprived of liberty by a legal or administrative decision, person under guardianship

Trial locations and contacts

4 sites in 1 country.

France4 sites
  • HIA Percy

    Clamart, 92140

  • HIA Laveran

    Marseille, 13013

  • HIA Bégin

    Saint-Mandé, 94160

  • HIA Sainte Anne

    Toulon, 83000

Other trials in France

About this study

Official title: Evaluation Of Efficacy Of COVID-19 Convalescent Plasma Versus Standard Plasma In The Early Care Of COVID-19 Patients Hospitalized Outside Intensive Care Units.

COVID-19 (Corona Virus Disease 2019) hospitalized patients evolution is marked by the risk of worsening of the respiratory system during the second week of the disease. To date, treatments are currently being evaluated and none of them have shown to be effective in the care of these patients. The use of convalescent plasma is a passive immunotherapy. It has often been used in respiratory virus epidemic situations (during the 1918 or 2009 influenza pandemic, or during SARS-CoV-1 or MERS-CoV pandemic). Effects reported in literature are in favour of a beneficial impact of transfusion of these plasma without serious adverse effects reported.

PlasCoSSA is a randomized, controlled, triple-blinded, parallel clinical trial. This study tests the efficacy of convalescent plasma transfusion therapy in the early care of COVID-19 hospitalized patients outside intensive care units.

Read the detailed description

During SARS-CoV-2 infection, two clinical-biological phases can be observed: an initial viral phase followed by an immunological phase whose onset has been associated with more severe prognosis. Hospitalized patients with comorbidities or clinical risk factors have a higher risk of respiratory functions deterioration and significant risk to need intensive care.

Early transfusion of convalescent plasma (2 units of 200-230 mL of apheresis plasma inactivated by amotosalen) would prevent this secondary worsening and reduce the risk to be transferred to intensive care, length of stay and mortality. Considering clinical and biological manifestations of the disease, including coagulation disorders, endothelial alterations, immunological disorders, it seems interesting to compare this convalescent plasma with a SARS-CoV-2 lacking antibodies plasma.

Conditions
COVID-19
Being tested
Transfusion of SARS-CoV-2 Convalescent Plasma., Transfusion of standard Plasma.
Keywords
SARS-CoV-2, COVID 19, Convalescent plasma
Medical subject headings
COVID-19

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Transfusion of SARS-CoV-2 Convalescent Plasma.Drug

    2 Convalescent Plasma units of 200-230mL each, inactivated by amotosalen.

  • Transfusion of standard Plasma.Drug

    2 Standard Plasma units of 200-230mL each, inactivated by amotosalen.

Study groups in NCT04372979
Study groupRoleWhat they receive
SARS-CoV-2 patients treated with convalescent plasmaExperimentalSubjects will receive an intravenous injection of SARS-CoV-2 Convalescent Plasma.
Receives: Drug: Transfusion of SARS-CoV-2 Convalescent Plasma.
SARS-CoV-2 patients treated with standard plasmaActive comparatorSubjects will receive an intravenous injection of standard Plasma.
Receives: Drug: Transfusion of standard Plasma.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Survival time without needs of a ventilator.

    Survival time without needs of ventilator, i.e. the time until oxygen supply (patient previously in ambient air), or an increase by more than 6L/min of O2 for more than 24 hours, or the use of non-invasive ventilation, or intubation, or death.

    Measured: Day 30

Secondary outcomes (12)
  1. Morbidity

    The percentage of patients i) not hospitalized, without limitation of activities, ii) Not hospitalized, with activity limitation, iii) Hospitalized without oxygen therapy, iv) Hospitalized with oxygen therapy, v) Hospitalized with intensive oxygen therapy or non- invasive ventilation (NIV), vi) Hospitalized and intubated or on extracorporeal membrane oxygenation (ECMO), vii) Dead.

    Measured: Day 15

  2. Morbidity

    Difference of the SOFA (Sequential Organ Failure Assessment) mean score per patient between the two groups.

    Measured: Day 30

  3. Mortality

    Measured: Day 30

  4. Length of stay

    Measured: Day 30

  5. Effect on viral pharyngeal specimen clearance

    Quantitative SARS-CoV2 PCR carried out on pharyngeal specimen.

    Measured: At inclusion and Day 7

  6. Effect on viral blood specimen clearance

    Quantitative SARS-CoV2 PCR carried out on blood specimen.

    Measured: At inclusion and Day 7

  7. Effect on hemostasis disorders

    Effects on biological hemostasis parameters disorders.

    Measured: At inclusion, Day 1 and every 48 hours

  8. Kinetics of appearance of neutralizing antibodies

    Anti-SARS-Cov2 immunoglobulin G/A level and anti-SARS-Cov2 neutralizing antibody levels.

    Measured: At inclusion, Day 7

  9. Transfusion endotheliopathy effect

    Evolution of biological endotheliopathy parameters

    Measured: At inclusion, Day 1, Day 7

  10. Transfusion biological Inflammation effect

    Evaluation of biological dosages on inflammation effects

    Measured: At inclusion, Day 1, Day 7

  11. Transfusion hemovigilance

    Number of transfusion adverse events

    Measured: 30 days

  12. Decrease in the consumption of antibiotics

    Measured: 30 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 May 2020
  2. Study start14 Sep 2020
  3. Primary completion1 Jun 2021
  4. Study completion1 Jun 2021

Why it stopped: Reluctance of patients and physicians in this transfusion study setting. Blood products have expired. New variants have appeared since the plasma collection period. Some recent publications question the effectiveness of transfusion.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
18 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04372979
Sponsor's protocol ID
2020-A01166-33
Acronym
PLASCOSSA
Status last verified
Apr 2022
First submitted
24 Apr 2020
Last updated
14 Apr 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506. doi: 10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24.

    PubMed 31986264
  • Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-1069. doi: 10.1001/jama.2020.1585.

    PubMed 32031570
  • Ahn DG, Shin HJ, Kim MH, Lee S, Kim HS, Myoung J, Kim BT, Kim SJ. Current Status of Epidemiology, Diagnosis, Therapeutics, and Vaccines for Novel Coronavirus Disease 2019 (COVID-19). J Microbiol Biotechnol. 2020 Mar 28;30(3):313-324. doi: 10.4014/jmb.2003.03011.

    PubMed 32238757
  • Shen C, Wang Z, Zhao F, Yang Y, Li J, Yuan J, Wang F, Li D, Yang M, Xing L, Wei J, Xiao H, Yang Y, Qu J, Qing L, Chen L, Xu Z, Peng L, Li Y, Zheng H, Chen F, Huang K, Jiang Y, Liu D, Zhang Z, Liu Y, Liu L. Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma. JAMA. 2020 Apr 28;323(16):1582-1589. doi: 10.1001/jama.2020.4783.

    PubMed 32219428
  • Zhang B, Liu S, Tan T, Huang W, Dong Y, Chen L, Chen Q, Zhang L, Zhong Q, Zhang X, Zou Y, Zhang S. Treatment With Convalescent Plasma for Critically Ill Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Infection. Chest. 2020 Jul;158(1):e9-e13. doi: 10.1016/j.chest.2020.03.039. Epub 2020 Mar 31.

    PubMed 32243945
  • Walls AC, Park YJ, Tortorici MA, Wall A, McGuire AT, Veesler D. Structure, Function, and Antigenicity of the SARS-CoV-2 Spike Glycoprotein. Cell. 2020 Apr 16;181(2):281-292.e6. doi: 10.1016/j.cell.2020.02.058. Epub 2020 Mar 9.

    PubMed 32155444
  • Zhang JS, Chen JT, Liu YX, Zhang ZS, Gao H, Liu Y, Wang X, Ning Y, Liu YF, Gao Q, Xu JG, Qin C, Dong XP, Yin WD. A serological survey on neutralizing antibody titer of SARS convalescent sera. J Med Virol. 2005 Oct;77(2):147-50. doi: 10.1002/jmv.20431.

    PubMed 16121363
  • Subbarao K, McAuliffe J, Vogel L, Fahle G, Fischer S, Tatti K, Packard M, Shieh WJ, Zaki S, Murphy B. Prior infection and passive transfer of neutralizing antibody prevent replication of severe acute respiratory syndrome coronavirus in the respiratory tract of mice. J Virol. 2004 Apr;78(7):3572-7. doi: 10.1128/jvi.78.7.3572-3577.2004.

    PubMed 15016880
  • Ko JH, Seok H, Cho SY, Ha YE, Baek JY, Kim SH, Kim YJ, Park JK, Chung CR, Kang ES, Cho D, Muller MA, Drosten C, Kang CI, Chung DR, Song JH, Peck KR. Challenges of convalescent plasma infusion therapy in Middle East respiratory coronavirus infection: a single centre experience. Antivir Ther. 2018;23(7):617-622. doi: 10.3851/IMP3243. Epub 2018 Jun 20.

    PubMed 29923831
  • Guo L, Ren L, Yang S, Xiao M, Chang D, Yang F, Dela Cruz CS, Wang Y, Wu C, Xiao Y, Zhang L, Han L, Dang S, Xu Y, Yang QW, Xu SY, Zhu HD, Xu YC, Jin Q, Sharma L, Wang L, Wang J. Profiling Early Humoral Response to Diagnose Novel Coronavirus Disease (COVID-19). Clin Infect Dis. 2020 Jul 28;71(15):778-785. doi: 10.1093/cid/ciaa310.

    PubMed 32198501
  • Thevarajan I, Nguyen THO, Koutsakos M, Druce J, Caly L, van de Sandt CE, Jia X, Nicholson S, Catton M, Cowie B, Tong SYC, Lewin SR, Kedzierska K. Breadth of concomitant immune responses prior to patient recovery: a case report of non-severe COVID-19. Nat Med. 2020 Apr;26(4):453-455. doi: 10.1038/s41591-020-0819-2. No abstract available.

    PubMed 32284614
  • Bouadma L, Lescure FX, Lucet JC, Yazdanpanah Y, Timsit JF. Severe SARS-CoV-2 infections: practical considerations and management strategy for intensivists. Intensive Care Med. 2020 Apr;46(4):579-582. doi: 10.1007/s00134-020-05967-x. Epub 2020 Feb 26. No abstract available.

    PubMed 32103284
  • To KK, Tsang OT, Leung WS, Tam AR, Wu TC, Lung DC, Yip CC, Cai JP, Chan JM, Chik TS, Lau DP, Choi CY, Chen LL, Chan WM, Chan KH, Ip JD, Ng AC, Poon RW, Luo CT, Cheng VC, Chan JF, Hung IF, Chen Z, Chen H, Yuen KY. Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study. Lancet Infect Dis. 2020 May;20(5):565-574. doi: 10.1016/S1473-3099(20)30196-1. Epub 2020 Mar 23.

    PubMed 32213337
  • Liu L, Wei Q, Lin Q, Fang J, Wang H, Kwok H, Tang H, Nishiura K, Peng J, Tan Z, Wu T, Cheung KW, Chan KH, Alvarez X, Qin C, Lackner A, Perlman S, Yuen KY, Chen Z. Anti-spike IgG causes severe acute lung injury by skewing macrophage responses during acute SARS-CoV infection. JCI Insight. 2019 Feb 21;4(4):e123158. doi: 10.1172/jci.insight.123158. eCollection 2019 Feb 21.

    PubMed 30830861
  • Tirado SM, Yoon KJ. Antibody-dependent enhancement of virus infection and disease. Viral Immunol. 2003;16(1):69-86. doi: 10.1089/088282403763635465.

    PubMed 12725690

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Transfusion of SARS-CoV-2 Convalescent Plasma. and Transfusion of standard Plasma. in people with COVID-19, run by Direction Centrale du Service de Santé des Armées at 4 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 22 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 14 Apr 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was stopped early (reason given: Reluctance of patients and physicians in this transfusion study setting. Blood products have expired. New variants have appeared since the plasma collection period. Some recent publications question the effectiveness of transfusion.). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Survival time without needs of a ventilator. (time frame: Day 30). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04372979, which also lists 47 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Apr 2022.

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PLASCOSSA Clinical Trial NCT04372979 | AzTrials