AzTrials
AzTrials

COVID-19NCT04386694

Photobiomodulation Therapy Combined With Static Magnetic Field in Patients With COVID-19

A study testing Active PBMT/sMF in people with COVID-19 and Respiratory Failure, run by University of Nove de Julho at 1 site in Brazil.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

Coronavirus disease 2019 (COVID-19) is a disease caused by a novel coronavirus called SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). The most characteristic symptom of patients with COVID-19 is respiratory distress, leading to inability to sustain spontaneous breathing. Read more about this study

Who is it for?
Ages 15 years and older
Conditions the study is for
COVID-19, Respiratory Failure
What is being tested?
Active PBMT/sMF
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
30 participants
Where
1 siteBrazil
Study dates
18 May 2020to 17 Sep 2020
Phase
Interventional
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 15 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Patients admitted to the adult Intensive Care Unit with Covid-19 infection;
  • Need for orotracheal intubation;
  • Invasive mechanical ventilation due to respiratory failure.

Who cannot join

  • Suspected patients who had a negative result of the diagnostic examination for COVID-19 infection;
  • Patients positioned in pronation for more than 24 hours;
  • Cancer patients;
  • Pregnancy.

Trial locations and contacts

1 site in 1 country.

Brazil1 site
  • Hospital Tacchini

    Bento Gonçalves, Rio Grande do Sul, 95700-068

Other trials in Brazil

About this study

Official title: Is Photobiomodulation Therapy (PBMT) Combined With Static Magnetic Field (sMF) Able to Decrease the Intensive Care Unit (ICU) Length of Stay for Patients With COVID-19?

Coronavirus disease 2019 (COVID-19) is a disease caused by a novel coronavirus called SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). The most characteristic symptom of patients with COVID-19 is respiratory distress, leading to inability to sustain spontaneous breathing. In addition, patients with COVID-19 have dyspnea and respiratory muscle fatigue. Therefore, it is necessary to use strategies that minimize the impact of COVID-19 on the respiratory muscles, accelerating the ventilatory weaning process and optimizing the functional capacity of the involved muscles.

Over the past years, evidence has shown the effectivity of photobiomodulation therapy (PBMT) combined with static magnetic field (sMF) (PBMT/sMF) in delaying muscle fatigue, decrease in markers of inflammatory damage and oxidative stress of skeletal muscle. These effects result in an improvement in the functional capacity of the irradiated muscles by PBMT/sMF. However, do date, there is a lack of evidence regarding the effects of PBMT/sMF on the respiratory muscles.

Read more

Therefore, the irradiation of PBMT/sMF may result in improvement in the functional capacity of respiratory muscles in patients with COVID-19, accelerating the ventilatory weaning process of the patients intubated due to respiratory failure. In addition, the irradiation of PBMT/sMF may induce the increase of anti-inflammatory mediators' activity in patients with COVID-19.

Thus, the aim of this project is to investigate the effects of PBMT/sMF on respiratory muscles of patients admitted to the Intensive Care Unit (ICU) with COVID-19 using invasive mechanical ventilation.

Read the detailed description

To achieve the proposed objectives it will be performed a randomized, triple-blind, placebo-controlled trial, with patients admitted to the adult ICU with COVID-19 using invasive mechanical ventilation due to respiratory failure. The patients will be randomly allocated to two treatment groups: 1. Active PBMT/sMF (MR5™ ACTIV PRO LaserShower) or Placebo PBMT/sMF (MR5™ ACTIV PRO LaserShower). The patients will be treated by a blinded therapist, and the patients will be blinded to the treatment received.

Since there are no studies in this field, initially it will be randomized 30 patients (15 patients per group) to determine the final sample size for this study.

The patients randomly allocated to the two groups will be subjected to treatment once a day, during the ICU stay, until discharge or death.

All data will be collected by a blinded assessor. The investigators will analyze:

  1. Number of days hospitalized in the ICU until discharge or death.
  2. Survival rate: rate of how many people survived and were discharged and how many died.
  3. Muscular function of the diaphragm: the first assessment will be performed within 24 hours after the patient's intubation, the second 10 days after the first, and the third at the pre-discharge from the ICU.
  4. Blood tests: baseline (admission to the ICU), 10 days after the admission, and endpoint (discharge or death).
  5. Mechanical ventilation control parameters: baseline (admission to the ICU), 10 days after the admission, and endpoint (discharge or death).
  6. Arterial Blood Gas Analysis: baseline (admission to the ICU), 10 days after the admission, and endpoint (discharge or death).

The data regarding the blood tests and arterial blood gas analysis will be collected directly from electronic medical record of each patients, since it is a daily hospital routine to perform these blood tests. The data will be collected by two assessors blinded to the treatment applied. The mechanical ventilation control parameters will be collected directly in the mechanical ventilator.

Statistical analysis: All the data will be analyzed by a blinded researcher not involved in data collection. The findings will be tested for their normality using the Kolmogorov-Smirnov test. Parametric data will be expressed as mean and standard deviation and non-parametric data as median and respective upper and lower limits, data can be also expressed as frequency (%). Parametric data will be analysed by two-way repeated measures analysis of variance (time vs experimental group) with post hoc Bonferroni correction. Non-parametric data will be analysed using the Friedman test and, secondarily, the Wilcoxon signed-rank test. The association between categorical variables will be analyzed using the Chi-square test or Fisher's exact test. The significance level will be set at p<0.05.

Being tested
Active PBMT/sMF, Placebo PBMT/sMF
Keywords
Photobiomodulation Therapy, Static Magnetic Fields, Low-Level Laser Therapy, COVID-19, Invasive Mechanical Ventilation, Respiratory Muscles, Intensive Care United
Medical subject headings
COVID-19, Respiratory Insufficiency

What participants receive

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

  • Active PBMT/sMFDevice

    The PBMT/sMF will be irradiated in the lower thorax and neck areas, with the patients in supine position. PBMT/sMF application time will be 60 seconds per site. The dose used in the lower thorax will be 31.50 J per site, a total of 6 sites will be irradiated, totalizing a dose of 189J. In addition, the dose used in the neck area (bilaterally) will be 31.50J per site, a total of 1 site (bilaterally) will be irradiated, totalizing a dose of 31.50J (bilaterally). PBMT/sMF will be applied using the direct contact method with light pressure on the skin.

  • Placebo PBMT/sMFDevice

    The placebo PBMT/sMF will be irradiated in the lower thorax and neck areas, with the patients in supine position. PBMT/sMF application time will be 60 seconds per site. The dose used for applications during the treatment will be 0 Joules (J) per site. The sounds and signals emitted from the device as well as the information displayed on the screen will be identical, regardless of the type of treatment (active or placebo). PBMT/sMF will be applied using the direct contact method with light pressure on the skin.

Study groups in NCT04386694
Study groupRoleWhat they receive
PBMT/sMFExperimentalActive PBMT/sMF will be applied once a day, during the ICU stay, until discharge or death. The patients will receive standard physical therapy care associated with PBMT/sMF. PBMT/sMF will be applied using MR5™ ACTIV PRO LaserShower, manufactured by Multi Radiance Medical (Solon, OH, USA). This device has 4 diodes of 905 nm (1.25 mW each diode, 0.32 cm2 each), 8 diodes of 633 nm (25 mW each diode, 0.85 cm2 - each), and 8 diodes of 850 nm (40 mW each diode, 0.56 cm2 - each). The static magnetic field is 110 mT.
Receives: Device: Active PBMT/sMF
Placebo PBMT/sMFPlacebo comparatorPlacebo PBMT/sMF will be applied once a day, during the ICU stay, until discharge or death. The patients will receive standard physical therapy care associated with placebo PBMT/sMF. The placebo PBMT will be applied using MR5™ ACTIV PRO LaserShower Laser Therapy System, manufactured by Multi Radiance Medical (Solon, OH, USA). The ACTIV PRO emits 905nm, and 850nm via an electric diode energy source with outputs to 0%. The static magnetic field will be also turned off. The 660nm light via an electric diode energy source with outputs to >1% to appear like the active comparator.
Receives: Device: Placebo PBMT/sMF

What is being measured

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

  1. Time until discharge

    Number of days hospitalized in the ICU until discharge or death.

    Measured: From date of randomization until the date of discharge or date of death from any cause, whichever came first, assessed up to 20 days.

Secondary outcomes (15)
  1. Survival rate

    Rate of how many people survived and were discharged and how many died.

    Measured: From date of randomization until the date of discharge or date of death from any cause, whichever came first, assessed up to 20 days.

  2. Diaphragm muscle function

    Diaphragm thickness will be measured by ultrasound.

    Measured: 10 days after randomization and in the last test before discharge or death from any cause, whichever came first, assessed up to 20 days.

  3. Platelet count

    Platelet count will be measured by blood test.

    Measured: 10 days after randomization and in the last test before discharge or death from any cause, whichever came first, assessed up to 20 days.

  4. Leukogram

    Leukogram will be measured by blood test.

    Measured: 10 days after randomization and in the last test before discharge or death from any cause, whichever came first, assessed up to 20 days.

  5. Erythrogram

    Erythrogram will be measured by blood test.

    Measured: 10 days after randomization and in the last test before discharge or death from any cause, whichever came first, assessed up to 20 days.

  6. C-reactive protein

    C-reactive protein will be measured by blood test.

    Measured: 10 days after randomization and in the last test before discharge or death from any cause, whichever came first, assessed up to 20 days.

  7. D-dimer

    D-dimer will be measured by blood test.

    Measured: 10 days after randomization and in the last test before discharge or death from any cause, whichever came first, assessed up to 20 days.

  8. Immunoglobulin G

    Immunoglobulin G will be measured by blood test.

    Measured: 10 days after randomization and in the last test before discharge or death from any cause, whichever came first, assessed up to 20 days.

  9. Immunoglobulin M

    Immunoglobulin M will be measured by blood test.

    Measured: 10 days after randomization and in the last test before discharge or death from any cause, whichever came first, assessed up to 20 days.

  10. Levels of positive end-expiratory pressure (PEEP)

    The levels of PEEP will be measured using a mechanical ventilator.

    Measured: 10 days after randomization and in the last test before discharge or death from any cause, whichever came first, assessed up to 20 days.

  11. Fraction of inspired oxygen (FiO2)

    The levels of FiO2 will be measured using a mechanical ventilator.

    Measured: 10 days after randomization and in the last test before discharge or death from any cause, whichever came first, assessed up to 20 days.

  12. Arterial partial pressure of oxygen (PO2)

    PO2 will be measured by arterial blood gas analysis.

    Measured: 10 days after randomization and in the last test before discharge or death from any cause, whichever came first, assessed up to 20 days.

  13. Arterial partial pressure of oxygen (PO2)/Fraction of inspired oxygen (FiO2) ratio

    PO2/FiO2 ratio will be measured by arterial blood gas analysis.

    Measured: 10 days after randomization and in the last test before discharge or death from any cause, whichever came first, assessed up to 20 days.

  14. Levels of tumor necrosis factor-α (TNF-α)

    Levels of TNF-α will be measured by blood test.

    Measured: 10 days after randomization and in the last test before discharge or death from any cause, whichever came first, assessed up to 20 days.

  15. Levels of vitamin D

    Levels of vitamin D will be measured by blood test.

    Measured: 10 days after randomization and in the last test before discharge or death from any cause, whichever came first, assessed up to 20 days.

Timeline

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

  1. First posted13 May 2020
  2. Study start18 May 2020
  3. Primary completion17 Sep 2020
  4. Study completion17 Sep 2020

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 N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
30 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04386694
Sponsor's protocol ID
3.985.226
Status last verified
Oct 2020
First submitted
8 May 2020
Last updated
29 Oct 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes

Publications

  • De Marchi T, Francio F, Ferlito JV, Weigert R, de Oliveira C, Merlo AP, Pandini DL, Pasqual-Junior BA, Giovanella D, Tomazoni SS, Leal-Junior EC. Effects of Photobiomodulation Therapy Combined with Static Magnetic Field in Severe COVID-19 Patients Requiring Intubation: A Pragmatic Randomized Placebo-Controlled Trial. J Inflamm Res. 2021 Jul 24;14:3569-3585. doi: 10.2147/JIR.S318758. eCollection 2021.

    PubMed 34335043

Questions about this trial

What is this clinical trial studying?

A study testing Active PBMT/sMF in people with COVID-19 and Respiratory Failure, run by University of Nove de Julho at 1 site in Brazil.

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 3 inclusion and 4 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: finished, as of the sponsor's last update on 29 Oct 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Brazil. 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. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Time until discharge (time frame: From date of randomization until the date of discharge or date of death from any cause, whichever came first, assessed up to 20 days.). 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 NCT04386694, which also lists 1 linked publication.

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 29 Oct 2020.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in