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Covid19Phase 3PLACOVIDNCT04547660

Convalescent Plasma for Severe COVID-19 Patients

A Phase 3 study testing Convalescent Plasma in people with Covid19, run by Hospital de Clinicas de Porto Alegre 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
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Trial summary

Plasma, the supernatant part of blood, contains a variety of different proteins, including immunoglobulins. These proteins, also called antibodies, are directed to previous foreign infecting organisms, such as virus, bacteria or parasites. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Covid19
What is being tested?
Convalescent Plasma
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
160 participants
Where
1 siteBrazil
Study dates
16 Jul 2020to 7 Jan 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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age equal to or greater than 18 yers;
  • Diagnosis of SARS-CoV-2 infection through nasal cavity or oropharynx swab RT-PCR;
  • Severe COVID-19 defined by the presence of at least 1 of the following:
  • Respiratory rate> 30 breaths per minute in room air; B. Oxygen saturation (O2) ≤93% in room air; C. PaO2 / FiO2 ratio ≤300; D. Need for supplemental O2 to maintain O2 saturation> 95%; E. Need for therapy with supplemental O2 by high flow catheter or non-invasive ventilation or invasive mechanical ventilation;
  • Onset of symptoms in a period not exceeding 14 days.

Who cannot join

  • Impossibility for any reason to perform the first plasma infusion within 14 days of the onset of symptoms;
  • Use of immunosuppressants for other underlying diseases, except corticosteroids for the SARS-CoV-2, in the last 30 days before enrollment;
  • Pregnancy;
  • History of serious adverse reactions such as transfusion anaphylaxis;
  • Participation in another interventional clinical trial;
  • Disagreement of attending physician;
  • Disagreement of the patient or legal representative to participate in the study.

Trial locations and contacts

1 site in 1 country.

Brazil1 site
  • Hospital de Clínicas de Porto Alegre

    Porto Alegre, Rio Grande do Sul, 90035-903

Other trials in Brazil

About this study

Official title: Convalescent Plasma for Severe COVID-19 Patients: a Randomized, Open-label, Phase 3 Trial

Plasma, the supernatant part of blood, contains a variety of different proteins, including immunoglobulins. These proteins, also called antibodies, are directed to previous foreign infecting organisms, such as virus, bacteria or parasites. Patients recovering from SARS-Cov-2 infection may develop protective antibodies which can prevent reinfection with the same agent or similar organisms with shared molecular structures. Those antibodies may be transferred to other patients through collection of such convalescent plasma from recovered donors and its transfusion to ill patients. In this research, the primary hypothesis is that those antibodies can exert passive immunization and help ameliorate symptoms from COVID-19 (Coronavirus Disease 2019), resulting in higher clinical improvement rates at day 28, especially when administered early in the infection course.

Read the detailed description

This is a randomized, open-label, phase 3 clinical trial on the use of convalescent plasma for severe COVID-19 patients. In this research, we are going to assess efficacy and safety of convalescent plasma in the treatment of severely compromised COVID-19 patients. Convalescent plasma will be collected from recovered COVID-19 patients, who will be recruited as plasma donors and will be submitted to apheresis (with minimum interval of 14 days) to obtain two aliquots of 300 ml of convalescent plasma, which will be frozen at -80 and stored at -20 to -30 degrees Celsius. Enrolled patients will be randomized based on a concealed sequential allocation list by an independent researcher which will not be aware of patients characteristics, and stratified by COVID-19 severity (severe or life-threatening). There will be two arms of study, intervention or control group, and patients will be followed up for the next 28 days for clinical and laboratory outcomes such as improvement of disease status (measured by a 6-point ordinal severity scale); mechanical ventilation, intensive care unit (ICU) and total hospital stay period; cytokine levels (IL-6 and TNF-alfa) and several inflammatory, cellular injury and coagulation parameters. Intervention was conceived as two infusions of 300 ml of convalescent plasma, 2 days apart. Control group will receive full supportive treatment but will not be allowed to receive other investigational drugs. Sample size was calculated to a total of 160 patients, with a 1:1 randomization proportion between groups. This amount would be capable to detect an 18% or higher difference in the proportion of clinical improvement at 28 days of enrollment between intervention and control groups, with an alfa error of 0.05 and a statistical power of 0.8.

Conditions
Covid19
Being tested
Convalescent Plasma, Best Supportive Care
Medical subject headings
COVID-19

What participants receive

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

  • Convalescent PlasmaBiological

    Fresh frozen plasma collected by apheresis from recovered COVID-19 patients added to best supportive care.

  • Best Supportive CareOther

    Also called Standard Treatment

    Any form of ventilatory support, extracorporeal membrane oxygenation, steroids, antibiotics and other supportive measures except for investigational interventions.

Study groups in NCT04547660
Study groupRoleWhat they receive
Convalescent PlasmaExperimentalTransfusion of 2 aliquots of 300 ml of frozen convalescent plasma, 2 days apart, thawed at 37 degrees Celsius before infusion. Best supportive care except for investigational interventions.
Receives: Biological: Convalescent Plasma; Other: Best Supportive Care
Best Supportive CareActive comparatorAny form of ventilatory support, extracorporeal membrane oxygenation, steroids, antibiotics and other supportive measures except for investigational interventions.
Receives: Other: Best Supportive Care

What is being measured

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

  1. Clinical improvement

    Improvement of 2 points from randomization in a 6-point ordinal severity scale (6 points, death; 5 points, hospitalization plus extracorporeal membrane oxygenation (ECMO) or invasive mechanical ventilation; 4 points, hospitalization plus noninvasive ventilation or high-flow supplemental oxygen; 3 points, hospitalization plus supplemental oxygen (not high-flow or noninvasive ventilation); 2 points, hospitalization with no supplemental oxygen; 1 point, hospital discharge)

    Measured: 28 days

Secondary outcomes (21)
  1. 6-point ordinal scale proportion at 14 days

    Proportions of individuals classified in each 6-point ordinal scale strata

    Measured: 14 days from randomization

  2. 6-point ordinal scale proportion at 28 days

    Proportions of individuals classified in each 6-point ordinal scale strata

    Measured: 28 days from randomization

  3. Overall mortality

    Death from any cause after randomization

    Measured: 14 days

  4. Overall mortality

    Death from any cause after randomization

    Measured: 28 days

  5. Days alive and free of respiratory support (DAFOR28)

    Days free of respiratory support during follow up

    Measured: 28 days

  6. Mechanical ventilation

    Duration of invasive ventilatory support (for those who received mechanical ventilation)

    Measured: 28 days

  7. PaO2/FiO2 ratio

    PaO2/FiO2 ratio at 7 days of follow up

    Measured: At the 7th day of randomization

  8. Hospital stay

    Time from randomization to hospital discharge (for 28-day survivors)

    Measured: 28 days

  9. Lactate Dehydrogenase

    LDH (U/L)

    Measured: Randomization day, Day 3, Day 7 and Day 14

  10. Troponin I

    Troponin I (pg/mL)

    Measured: Randomization day, Day 3, Day 7 and Day 14

  11. C Reactive Protein

    CRP (mg/L)

    Measured: Randomization day, Day 3, Day 7 and Day 14

  12. D-Dimers

    D-Dimers (mcg/mL)

    Measured: Randomization day, Day 3, Day 7 and Day 14

  13. Fibrinogen

    Fibrinogen (mg/dL)

    Measured: Randomization day, Day 3, Day 7 and Day 14

  14. Prothrombin Time (PT)

    PT (seconds)

    Measured: Randomization day, Day 3, Day 7 and Day 14

  15. Activated Partial Thromboplastin Time (APTT)

    APTT (seconds)

    Measured: Randomization day, Day 3, Day 7 and Day 14

  16. Tumor Necrosis Factor Alfa (TNF-Alfa)

    TNF-Alfa (pg/mL)

    Measured: Randomization day, Day 3, Day 7 and Day 14

  17. Interleukin-6 (IL-6)

    IL-6 (pg/mL)

    Measured: Randomization day, Day 3, Day 7 and Day 14

  18. RT-PCR

    Nasal and Oropharyngeal Swab RT-PCR

    Measured: At the 7th day of randomization (or at hospital discharge if earlier than 7 days)

  19. Sequential Organ Failure Assessment (SOFA) score

    SOFA score at 7 days of randomization (ranges from 0 to 24, prognosis worsens with higher score values)

    Measured: At the 7th day of randomization

  20. National Early Warning Score 2 (NEWS) 2

    Change in NEWS 2 from randomization at 7 days and 14 days (ranges from 0 to 20, prognosis worsens with higher score values)

    Measured: 7 and 14 days of randomization

  21. Safety and Adverse Events

    CTCAE grade 3-4 events during follow up

    Measured: 28 days

Timeline

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

  1. First posted14 Sep 2020
  2. Study start16 Jul 2020
  3. Primary completion7 Jan 2021
  4. Study completion7 Jan 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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Randomized, open-label, phase 3, comparing best supportive care (BSC, no investigational drugs allowed) and convalescent plasma, along BSC.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
160 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04547660
Sponsor's protocol ID
2020-0158
Acronym
PLACOVID
Status last verified
Feb 2021
First submitted
9 Sep 2020
Last updated
9 Feb 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Salazar E, Perez KK, Ashraf M, Chen J, Castillo B, Christensen PA, Eubank T, Bernard DW, Eagar TN, Long SW, Subedi S, Olsen RJ, Leveque C, Schwartz MR, Dey M, Chavez-East C, Rogers J, Shehabeldin A, Joseph D, Williams G, Thomas K, Masud F, Talley C, Dlouhy KG, Lopez BV, Hampton C, Lavinder J, Gollihar JD, Maranhao AC, Ippolito GC, Saavedra MO, Cantu CC, Yerramilli P, Pruitt L, Musser JM. Treatment of Coronavirus Disease 2019 (COVID-19) Patients with Convalescent Plasma. Am J Pathol. 2020 Aug;190(8):1680-1690. doi: 10.1016/j.ajpath.2020.05.014. Epub 2020 May 27.

    PubMed 32473109
  • Li L, Zhang W, Hu Y, Tong X, Zheng S, Yang J, Kong Y, Ren L, Wei Q, Mei H, Hu C, Tao C, Yang R, Wang J, Yu Y, Guo Y, Wu X, Xu Z, Zeng L, Xiong N, Chen L, Wang J, Man N, Liu Y, Xu H, Deng E, Zhang X, Li C, Wang C, Su S, Zhang L, Wang J, Wu Y, Liu Z. Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A Randomized Clinical Trial. JAMA. 2020 Aug 4;324(5):460-470. doi: 10.1001/jama.2020.10044.

    PubMed 32492084
  • 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
  • Joyner MJ, Bruno KA, Klassen SA, Kunze KL, Johnson PW, Lesser ER, Wiggins CC, Senefeld JW, Klompas AM, Hodge DO, Shepherd JRA, Rea RF, Whelan ER, Clayburn AJ, Spiegel MR, Baker SE, Larson KF, Ripoll JG, Andersen KJ, Buras MR, Vogt MNP, Herasevich V, Dennis JJ, Regimbal RJ, Bauer PR, Blair JE, van Buskirk CM, Winters JL, Stubbs JR, van Helmond N, Butterfield BP, Sexton MA, Diaz Soto JC, Paneth NS, Verdun NC, Marks P, Casadevall A, Fairweather D, Carter RE, Wright RS. Safety Update: COVID-19 Convalescent Plasma in 20,000 Hospitalized Patients. Mayo Clin Proc. 2020 Sep;95(9):1888-1897. doi: 10.1016/j.mayocp.2020.06.028. Epub 2020 Jul 19.

    PubMed 32861333

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Convalescent Plasma in people with Covid19, run by Hospital de Clinicas de Porto Alegre 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 5 inclusion and 7 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 9 Feb 2021. 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. 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 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?

Clinical improvement (time frame: 28 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 NCT04547660, which also lists 4 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 9 Feb 2021.

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