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Corona Virus InfectionPhase 2NCT04437823

Efficacy of Intravenous Infusions of Stem Cells in the Treatment of COVID-19 Patients

A Phase 2 study testing Intravenous Infusions of Stem Cells in people with Corona Virus Infection, run by Jinnah Hospital at 1 site in Pakistan.

Completed

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

Official record
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Trial summary

Stem cell therapy has emerged as a revolutionary treatment for diseases that were considered untreatable only a few years ago. Umbilical cord-derived mesenchymal stem cells (UCMSCs) have been shown to repair damaged liver, kidney, heart, pancreas, skin, cartilage, and cornea in animal models and several human trials. Read more about this study

Who is it for?
Ages 30 to 70 years
Conditions the study is for
Corona Virus Infection
What is being tested?
Intravenous Infusions of Stem Cells
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
5 participants
Where
1 sitePakistan
Study dates
1 Jun 2020to 30 Nov 2021
Phase
Phase 2
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 30 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Provide written informed consent
  • Male or female subjects age >18 years at the time of signing the Informed Consent Form
  • Must have a clinical diagnosis of COVID-19, with at least one of clinical symptoms (e.g., fever ≥38°C, fatigue, cough) and a positive result by the reverse-transcription polymerase chain reaction (RT-PCR) testing or equivalent
  • Individuals with moderate to severe COVID-19 symptoms
  • Adequate venous access
  • For female patients only, willingness to use recommended birth control until 6 months post-treatment
  • Must agree to comply with all study requirements and be willing to complete all study visits
  • Need in-patient admission

Who cannot join

  • A female who is pregnant, nursing, or of child-bearing potential while not practicing effective contraceptive methods. Female subjects must undergo a blood pregnancy test at screening and prior to infusion.
  • Inability to perform any of the assessments required for endpoint analysis
  • Have known allergies to penicillin or streptomycin
  • Have a clinical history of malignancy within 3 years (i.e., subjects with prior malignancy must be disease-free for 3 years), except curatively-treated basal cell carcinoma, squamous cell carcinoma, melanoma in situ or cervical carcinoma, if recurrence occurs; - History of drug abuse (illegal "street" drugs except for marijuana, or prescription medications not being used appropriately for a pre-existing medical condition) or alcohol abuse (≥ 5 drinks/day for ˃ 3 months), or documented medical, occupational, or legal problems arising from the use of alcohol or drugs within the past 24 months
  • Be serum positive for HIV, hepatitis BsAg or Viremic hepatitis C.

Trial locations and contacts

1 site in 1 country.

Pakistan1 site
  • Jinnah Hospital

    Lahore, Punjab Province, 54550

Other trials in Pakistan

About this study

Stem cell therapy has emerged as a revolutionary treatment for diseases that were considered untreatable only a few years ago. Umbilical cord-derived mesenchymal stem cells (UCMSCs) have been shown to repair damaged liver, kidney, heart, pancreas, skin, cartilage, and cornea in animal models and several human trials. In addition to cellular replacement through regeneration, UCMSCs mediate through paracrine signaling pathways resulting in immune modulation. Clinical manifestations of coronavirus disease 2019 (COVID-19), are believed to arise from septic shock and cytokine storm that cause acute respiratory dysfunction and acute cardiac injury. There is presently no cure for the COVID-19 viral disease; however, multi-treatment strategies are being examined. During the past two months, four reports were published that suggest, mesenchymal stem cells (MSCs), owing to their powerful immunomodulatory ability, may prevent the cytokine storm and thus reduce the COVID-19 related morbidity. All studies reported that COVID-19 patients responded favorably to MSCs therapy. These reports, taken together with the previous successes of stem cell therapy in animal models, the investigators, a seven-institution consortium, propose to explore the efficacy of UCMSC treatment in COVID-19 patients at Jinnah hospital, Lahore. The investigators propose to administer UCMSCs in patients with acute pulmonary inflammation due to COVID-19 infection with moderate to severe symptoms. In the first cohort of 15 patients, UCMSCs will be administered with three intravenous infusions of 500,000 UCMSCs per Kg body weight each on days 1, 3, and 5. The second group of five patients serving as control will only receive standard treatment. During the 30-day post-infusion period, a battery of tests will be performed to evaluate the safety and efficacy of the UCMSCs treatment. In parallel, the investigators propose a comparative study to determine COVID-19 viral count by quantitative real-time PCR and through viral coat protein ELISA, developed in the investigator advisor lab (Dr. Tauseef Butt, Progenra Inc. Philadelphia, USA) with the ultimate objective to locally developing a rapid diagnostic assay.

Read the detailed description

Isolation and characterization of human umbilical cord-derived mesenchymal stem cells (UCMSCs): Human umbilical cord tissues along with informed consent forms will be collected from hepatitis B, C, and COVID-19 virus-negative women with healthy pregnancies during the Cesarean Section surgery after completion of gestation period. The cord tissue will be transported in sterile 1x phosphate-buffered saline (PBS) containing 200 units/ml penicillin and 200 µg/ml streptomycin on ice. In the biosafety cabinet, the cord will be washed with 4-5 changes of sterile 1x PBS and placed in a Petri plate with 15 ml PBS. The cord will be gently scraped with a surgical blade to remove any dead cells. A 9 cm umbilical cord will be cut into three equal pieces and wash thoroughly to remove blood clots, umbilical cord arteries, and veins. Segments will be washed three times with PBS and minced. The minced pieces will be incubated in 17.5 ml of collagenase solution (201 U/ml collagenase type I in serum-free DMEM-HG) in a 50 ml conical tube for ~3.5 hours in an incubator at 5% CO2, 95% humidity at 37⁰C. After ~3.5 hours, the digested lysate will pass through a strainer and will be diluted three times with 1x PBS. Following centrifugation, the cells will be seeded into two 25 cm2 flasks and will be placed in an incubator at 5% CO2, 95% humidity at 37⁰C. The flasks will be fed with fresh media (DMEM-HG supplemented with 20% FBS and 1% antibiotic solution) every third day. At around day 18, cells will reach up to 85% confluency and will be transferred in two 75 cm2 flasks with media replaced at alternate days. UCMSCs at P3 will be characterized using different specific antibodies. Cells at P3 will be used for transplantation in patients. Fifteen (15) subjects will be treated with three intravenous infusions (IV) of 500,000 UCMSCs per Kg body weight delivered via peripheral intravenous infusion.

Being tested
Intravenous Infusions of Stem Cells
Keywords
COVID-19, Stem Cells treatment
Medical subject headings
Coronavirus Infections, COVID-19

What participants receive

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

  • Intravenous Infusions of Stem CellsBiological

    Cultured stem cells will be injected at days 1, 3 and 5 intravenously. While patients will be monitored and evaluated for various hematological and organ functions at baseline (day 0) and days 1, 3, 5, 7, 14, 21 and 30

Study groups in NCT04437823
Study groupRoleWhat they receive
Group 1 : TreatmentExperimentalFifteen (15) subjects will be treated with three intravenous infusion (IV) of 5 x 10^5 UCMSCs per Kg body weight delivered via peripheral intravenous infusion on days 1, 3 and 5 besides the standard care (SOC).
Receives: Biological: Intravenous Infusions of Stem Cells
Group 2: standard careNo interventionFive (5) subjects will be treated under Standard of Care (SOC) .

What is being measured

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

  1. Safety and efficacy assessment of infusion associated adverse events

    Number of participants with significant side effects in stem cell treated group

    Measured: Day 01 to Day 30

  2. Chest Radiograph or Chest CT Scan

    Assessment of Pneumonia improvement as a result of stem cell infusions

    Measured: Day 01 to Day 30

Secondary outcomes (4)
  1. COVID-19 Quantitative Real Time PCR

    Quantitative real-time PCR analysis for the evaluation of negative corona virus test results following stem cell treatment

    Measured: Day 01 to Day 30

  2. Sequential Organ Failure Assessment (SOFA) Score

    Evaluation of organ function (Each organ system is assigned a value for 0 (normal) to 4 (highest degree of dysfunction))

    Measured: Day 01 to Day 30

  3. Rate of mortality

    Number of all mortalities within 30 days post first infusion

    Measured: Day 01 to Day 30

  4. Clinical Respiratory Changes

    Examination of improvement in the physiology of lungs after treatment

    Measured: Day 01 to Day 30

Timeline

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

  1. First posted18 Jun 2020
  2. Study start1 Jun 2020
  3. Primary completion31 Oct 2021
  4. Study completion30 Nov 2021

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Group 1 (15 subjects) Fifteen (15) subjects will be treated with three intravenous infusion (IV) of 5 x 10\^5 (per Kg body weight) UCMSCs delivered via peripheral intravenous infusion on days 1, 3 and 5 besides the standard care (SOC). Group 2 (5 subjects) Five (5) subjects will be treated under SOC. From two subjects in group 1 will not be treated 24hrs apart. Patients will be randomized in a 1:3 ratio (SOC: UCMSC).
Masking
None (open label)
Enrolment
5 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04437823
Sponsor's protocol ID
JB&RSC-01
Status last verified
Oct 2023
First submitted
17 Jun 2020
Last updated
17 Oct 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The report will be published and available online.

Publications

  • Leng Z, Zhu R, Hou W, Feng Y, Yang Y, Han Q, Shan G, Meng F, Du D, Wang S, Fan J, Wang W, Deng L, Shi H, Li H, Hu Z, Zhang F, Gao J, Liu H, Li X, Zhao Y, Yin K, He X, Gao Z, Wang Y, Yang B, Jin R, Stambler I, Lim LW, Su H, Moskalev A, Cano A, Chakrabarti S, Min KJ, Ellison-Hughes G, Caruso C, Jin K, Zhao RC. Transplantation of ACE2- Mesenchymal Stem Cells Improves the Outcome of Patients with COVID-19 Pneumonia. Aging Dis. 2020 Mar 9;11(2):216-228. doi: 10.14336/AD.2020.0228. eCollection 2020 Apr.

    PubMed 32257537
  • Atluri S, Manchikanti L, Hirsch JA. Expanded Umbilical Cord Mesenchymal Stem Cells (UC-MSCs) as a Therapeutic Strategy in Managing Critically Ill COVID-19 Patients: The Case for Compassionate Use. Pain Physician. 2020 Mar;23(2):E71-E83.

    PubMed 32214286
  • Liu J, Cao R, Xu M, Wang X, Zhang H, Hu H, Li Y, Hu Z, Zhong W, Wang M. Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro. Cell Discov. 2020 Mar 18;6:16. doi: 10.1038/s41421-020-0156-0. eCollection 2020. No abstract available.

    PubMed 32194981
  • Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, Tan KS, Wang DY, Yan Y. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res. 2020 Mar 13;7(1):11. doi: 10.1186/s40779-020-00240-0.

    PubMed 32169119
  • Riazuddin S et al.,. Book chapter: Stem cells for the repair of damaged skin and cartilage, in Book: Stem Cells - From Drug to Drug Discovery. Ed. by Haider, Khawaja Husnain; ISBN# 978-3-11-049376-4; March 2017

  • Riazuddin S et al., Cell therapy for liver regeneration. In , (Eds.), Stem Cells - From Hype to Real Hope (pp. 130-145). Berlin, Boston: De Gruyter. https://doi.org/10.1515/9783110587043-007; Book DOI: https://doi.org/10.1515/9783110587043; Online ISBN: 9783110587043; © 2018 Walter de Gruyter GmbH, Berlin/Munich/Boston.

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Intravenous Infusions of Stem Cells in people with Corona Virus Infection, run by Jinnah Hospital at 1 site in Pakistan.

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 8 inclusion and 5 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 17 Oct 2023. 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 Pakistan. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 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?

Safety and efficacy assessment of infusion associated adverse events (time frame: Day 01 to Day 30). The study lists 2 primary outcomes in all. 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 NCT04437823, which also lists 6 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 17 Oct 2023.

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