COVIDSynCovNCT04420676
Synbiotic Therapy of Gastrointestinal Symptoms During Covid-19 Infection
A study testing Omnibiotic AAD in people with COVID, run by Medical University of Graz at 1 site in Austria.
Trial summary
We hypothesize that the intake of Omni-Biotic® 10 AAD can reduce intestinal inflammation and improves dysbiosis in Covid-19 disease. We further hypothesize that Omni-Biotic® 10 AAD can reduce the duration of diarrhea, stool frequency, improve stool consistency, improve other gastrointestinal symptoms of Covid-19… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- COVID
- What is being tested?
- Omnibiotic AAD
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 30 participants
- Where
- 1 siteAustria
- Study dates
- 24 Sep 2020to 31 Dec 2024
- 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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- 18 years or older
- Covid-19 infection diagnosed by a positive SARS-Cov-2 PCR (Polymerase chain reaction) result from a nasopharyngeal swab
- Informed (tele)consent Exclusion criteria
- Pre-existing diarrhoea (including but not restricted to chronic inflammatory bowel disease, chronic diarrhea of other causes, acute diarrheal illness -4 to -1 week before inclusion)
- Antibiotic therapy -4 to -1 week before inclusion
- Probiotic treatment -4 to -1 week before inclusion
- Technical difficulties to perform telemedicine study visits
Who cannot join
None listed.
Trial locations and contacts
1 site in 1 country.
Austria1 site
Department of Internal Medicine, Medical University of Graz
Graz, 8010
About this study
Official title: Synbiotic Therapy of Gastrointestinal Symptoms During Covid-19 Infection: A Randomized, Double-blind, Placebo Controlled, Telemedicine Study (SynCov Study)
We hypothesize that the intake of Omni-Biotic® 10 AAD can reduce intestinal inflammation and improves dysbiosis in Covid-19 disease. We further hypothesize that Omni-Biotic® 10 AAD can reduce the duration of diarrhea, stool frequency, improve stool consistency, improve other gastrointestinal symptoms of Covid-19, reduce disease duration and severity.
The investigators aim to perform a randomized, double blind, placebo-controlled study using telemedicine in patients with Covid-19 disease.
Read the detailed description
The outbreak of the novel coronavirus (SARS-CoV-2)-infected disease (COVID-19) began in Wuhan, Hubei province in December 2019, spread throughout China in early 2020 and developed as a pandemic thereafter. Although the virus mainly causes respiratory symptoms, GI (gastrointestinal) presentations have been reported in and outside of China. Patients may present with anorexia, nausea, vomiting, diarrhea and abdominal discomfort. Also, faecal-oral transmission of the virus is currently discussed. Preliminary, unpublished data from China suggest that patients with GI symptoms may suffer more frequently from severe courses of the disease. Clinical studies show an incidence rate of diarrhea ranging from 2% to 50% of cases. It may precede or trail respiratory symptoms. A pooled analysis revealed an overall percentage of diarrhea onset of 10.4%. SARS-CoV-2 uses the angiotensin-converting enzyme 2 (ACE2) for cellular entry. ACE2 is expressed in the small intestinal epithelia as well as in the upper esophagus, liver, and colon. SARS-CoV-2 binding affinity to ACE2 is significantly higher (10-20 times) compared with SARS-CoV. Diarrhea is associated with prolonged symptoms and viral carriage.
Clinical information on the characteristics of Covid-19 diarrhea is scarce. The duration of diarrhea is around 4 days with 3-4 loose stools per day. Faecal calprotectin is elevated in stool of patients with Covid-19 diarrhea, indicating a relation between gastrointestinal symptoms and this well-established inflammation biomarker.
So far, no therapy is available for Covid-19 infection in general or for Covid-19 induced diarrhea. Rehydration and potassium monitoring should be performed as in all patients with diarrhea. It is important to underline that antivirals and antibiotics are often used for COVID-19 treatment or treatment of bacterial superinfections, involving a likely alteration of the gut microbiota and causing diarrhea. It is therefore plausible that the gut microbiota could be a new therapeutic target and that probiotics or synbiotics (combination of probiotics with prebiotics) could have a role in the management of these patients. The China's National Health Commission recommended the use of probiotics for the treatment of patients with severe COVID-19 in order to preserve intestinal balance and to prevent secondary bacterial infections without any available clinical studies to support this and probiotics apparently were used in Zhejiang during the Covid-19 pandemic. Although there is no specific data on the effects of probiotics on SARS-CoV2 infections, meta-analyses show that probiotics are effective in the treatment of upper respiratory tract infections and viral gastroenteritis of other origins. Furthermore, Enterococcus faecium has been shown to have antiviral effects in enteropathogenic coronavirus transmissible gastroenteritis virus infections in piglets. We therefore aim to assess the role of synbiotics in the therapy of Covid-19 infection with gastrointestinal symptoms.
- Conditions
- COVID
- Being tested
- Omnibiotic AAD, Placebo
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Omnibiotic AADDietary supplement
Also called Ecologic AAD
Bacterial strains in Omni-Biotic® 10 AAD are Bifidobacterium bifidum W23, Bifidobacterium lactis W51, Enterococcus faecium W54, Lactobacillus acidophilus W37, Lactobacillus acidophilus W55, Lactobacillus paracasei W20, Lactobacillus plantarum W1, Lactobacillus plantarum W62, Lactobacillus rhamnosus W71 and Lactobacillus salivarius W24 which are embedded in a matrix containing maize starch, maltodextrin, inulin, potassium chloride, hydrolysed rice protein, magnesium sulphate, fructooligosaccharide (FOS), enzymes (amylases), vanilla flavour and manganese sulphate
PlaceboDietary supplement
matrix containing maize starch, maltodextrin, inulin, potassium chloride, hydrolysed rice protein, magnesium sulphate, fructooligosaccharide (FOS), enzymes (amylases), vanilla flavour and manganese sulphate.
| Study group | Role | What they receive |
|---|---|---|
| Probiotic | Active comparator | Group 1: receiving a probiotic mixture (Omni-Biotic® 10 AAD) twice a day Receives: Dietary Supplement: Omnibiotic AAD |
| Placebo | Placebo comparator | Group 2: receiving a similar looking and tasting placebo without bacteria twice a day Receives: Dietary Supplement: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Stool calprotectin
measured by ELISA
Measured: 30 days
Secondary outcomes (8)
Stool frequency
stool evacuations per days
Measured: 30 days
Stool consistency
Stool consistency according to Bristol stool scale for each evacuation, score 1-7, a higher score means a lower stool consistancy
Measured: 30 days
Gastrointestinal symptoms
presence of anorexia, nausea, vomiting, abdominal pain, bloating (yes/no)
Measured: 30 days
Duration of Covid-19 disease
days patients feel sick, are not able to work or are on sick leave
Measured: 30 days
Severity of Covid-19 disease
mild/moderate/severe
Measured: 30 days
Diarrhea
3 or more stool evacuations, consistency Bristol stool scale 5-7
Measured: 30 days
Stool Zonulin
measured by ELISA
Measured: 30 days
Microbiome composition
16S RNA sequencing
Measured: 30 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Jun 2020
- Study start24 Sep 2020
- Primary completion1 Dec 2021
- Study completion31 Dec 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for COVIDStudies of the same condition, open and under way.
- More trials run by Medical University of GrazThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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)
Sponsor and investigators
- Lead sponsor
- Medical University of Graz
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04420676
- Sponsor's protocol ID
- SynCov
- Acronym
- SynCov
- Status last verified
- Mar 2025
- First submitted
- 4 Jun 2020
- Last updated
- 4 Mar 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Upload of microbiome sequences and metadata to a repository
Study at a glance
From the registry record, last updated by the sponsor on 4 Mar 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Synbiotic Therapy of Gastrointestinal Symptoms During Covid-19 Infection: A Randomized, Double-blind, Placebo Controlled, Telemedicine Study (SynCov Study)
- ClinicalTrials.gov ID
- NCT04420676
- Acronym / sponsor ID
- SynCov / SynCov
- Conditions
- COVID
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 30 participants (actual)
- Lead sponsor
- Medical University of GrazUniversity, hospital or other
- Study start
- 24 Sep 2020 (actual)
- Primary completion
- 1 Dec 2021 (actual)
- Study completion
- 31 Dec 2024 (actual)
- First posted
- 9 Jun 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
We hypothesize that the intake of Omni-Biotic® 10 AAD can reduce intestinal inflammation and improves dysbiosis in Covid-19 disease. We further hypothesize that Omni-Biotic® 10 AAD can reduce the duration of diarrhea, stool frequency, improve stool consistency, improve other gastrointestinal symptoms of Covid-19, reduce disease duration and severity.
The investigators aim to perform a randomized, double blind, placebo-controlled study using telemedicine in patients with Covid-19 disease.
Detailed description
The outbreak of the novel coronavirus (SARS-CoV-2)-infected disease (COVID-19) began in Wuhan, Hubei province in December 2019, spread throughout China in early 2020 and developed as a pandemic thereafter. Although the virus mainly causes respiratory symptoms, GI (gastrointestinal) presentations have been reported in and outside of China. Patients may present with anorexia, nausea, vomiting, diarrhea and abdominal discomfort. Also, faecal-oral transmission of the virus is currently discussed. Preliminary, unpublished data from China suggest that patients with GI symptoms may suffer more frequently from severe courses of the disease. Clinical studies show an incidence rate of diarrhea ranging from 2% to 50% of cases. It may precede or trail respiratory symptoms. A pooled analysis revealed an overall percentage of diarrhea onset of 10.4%. SARS-CoV-2 uses the angiotensin-converting enzyme 2 (ACE2) for cellular entry. ACE2 is expressed in the small intestinal epithelia as well as in the upper esophagus, liver, and colon. SARS-CoV-2 binding affinity to ACE2 is significantly higher (10-20 times) compared with SARS-CoV. Diarrhea is associated with prolonged symptoms and viral carriage.
Clinical information on the characteristics of Covid-19 diarrhea is scarce. The duration of diarrhea is around 4 days with 3-4 loose stools per day. Faecal calprotectin is elevated in stool of patients with Covid-19 diarrhea, indicating a relation between gastrointestinal symptoms and this well-established inflammation biomarker.
So far, no therapy is available for Covid-19 infection in general or for Covid-19 induced diarrhea. Rehydration and potassium monitoring should be performed as in all patients with diarrhea. It is important to underline that antivirals and antibiotics are often used for COVID-19 treatment or treatment of bacterial superinfections, involving a likely alteration of the gut microbiota and causing diarrhea. It is therefore plausible that the gut microbiota could be a new therapeutic target and that probiotics or synbiotics (combination of probiotics with prebiotics) could have a role in the management of these patients. The China's National Health Commission recommended the use of probiotics for the treatment of patients with severe COVID-19 in order to preserve intestinal balance and to prevent secondary bacterial infections without any available clinical studies to support this and probiotics apparently were used in Zhejiang during the Covid-19 pandemic. Although there is no specific data on the effects of probiotics on SARS-CoV2 infections, meta-analyses show that probiotics are effective in the treatment of upper respiratory tract infections and viral gastroenteritis of other origins. Furthermore, Enterococcus faecium has been shown to have antiviral effects in enteropathogenic coronavirus transmissible gastroenteritis virus infections in piglets. We therefore aim to assess the role of synbiotics in the therapy of Covid-19 infection with gastrointestinal symptoms.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Probiotic | Active comparator | Dietary Supplement: Omnibiotic AADGroup 1: receiving a probiotic mixture (Omni-Biotic® 10 AAD) twice a day |
| Placebo | Placebo comparator | Dietary Supplement: PlaceboGroup 2: receiving a similar looking and tasting placebo without bacteria twice a day |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- 18 years or older
- Covid-19 infection diagnosed by a positive SARS-Cov-2 PCR (Polymerase chain reaction) result from a nasopharyngeal swab
- Informed (tele)consent Exclusion criteria
- Pre-existing diarrhoea (including but not restricted to chronic inflammatory bowel disease, chronic diarrhea of other causes, acute diarrheal illness -4 to -1 week before inclusion)
- Antibiotic therapy -4 to -1 week before inclusion
Key exclusion criteria (0 listed)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Omnibiotic AADAlso: Ecologic AADBacterial strains in Omni-Biotic® 10 AAD are Bifidobacterium bifidum W23, Bifidobacterium lactis W51, Enterococcus faecium W54, Lactobacillus acidophilus W37, Lactobacillus acidophilus W55, Lactobacillus paracasei W20, Lactobacillus plantarum W1, Lactobacillus plantarum W62, Lactobacillus rhamnosus W71 and Lactobacillus salivarius W24 which are embedded in a matrix containing maize starch, maltodextrin, inulin, potassium chloride, hydrolysed rice protein, magnesium sulphate, fructooligosaccharide (FOS), enzymes (amylases), vanilla flavour and manganese sulphate | Dietary supplement | Probiotic |
| Placebomatrix containing maize starch, maltodextrin, inulin, potassium chloride, hydrolysed rice protein, magnesium sulphate, fructooligosaccharide (FOS), enzymes (amylases), vanilla flavour and manganese sulphate. | Dietary supplement | Placebo |
Primary outcome
Stool calprotectin
Time frame: 30 days
measured by ELISA
8 secondary outcomes
Stool frequency
Time frame: 30 days
Stool consistency
Time frame: 30 days
Gastrointestinal symptoms
Time frame: 30 days
Duration of Covid-19 disease
Time frame: 30 days
Severity of Covid-19 disease
Time frame: 30 days
Diarrhea
Time frame: 30 days
Stool Zonulin
Time frame: 30 days
Microbiome composition
Time frame: 30 days
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Mar 2025.
- Individual participant dataSharing planned: Yes. Upload of microbiome sequences and metadata to a repository
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Omnibiotic AAD in people with COVID, run by Medical University of Graz at 1 site in Austria.
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 7 inclusion and 0 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 4 Mar 2025. 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 Austria. 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?
Stool calprotectin (time frame: 30 days). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 4 Mar 2025.