Phase IIa Randomized Placebo Controlled Clinical Study of Codivir in Hospitalized Patients with Moderate COVID-19

Overview

This is a double-blind, multicentre, multinational study to evaluate the safety and collect preliminary efficacy data of Codivir drug product in 130 hospitalized adults with moderate COVID-19 symptoms. COVID-19 symptoms (fever, cough, myalgia and changes in smell or taste) onset must be within 7 days prior enrolment. Treatment will begin in the hospital, participants will be discharged according to medical decision and continue the treatment until to Day 7 at home and followed up to day 28.

Detailed description

eligible hospitalized participants will be recruited to the study and will receive standard of care treatments as well as Codivir or placebo, which will be administered at a dose of 20 mg SC, twice a day, for 7 days. If up to medical decision of the medical staff in the site, the patient should be released before Day 7, site study team will contact the medical monitor of the study to get the instructions. Participants will be followed up to the 28th day via phone contact. The phone visit will be performed to monitor the clinical symptoms, collect adverse events and concomitant medication and provide the patient with additional instructions, if relevant.

If they have progressed well, they will continue the treatment up to Day 7 at home, receiving a nurse's home visit twice a day to administer Codivir and collect vital signs. Participants will be followed up to Day 28 by telemedicine. A doctor will call them periodically to monitor the clinical evolution, collect adverse events, concomitant medication and instruct the participants. In case of unfavorable evolution, the participants will remain hospitalized receiving the appropriate care. The investigator will decide whether or not the investigational medication will continue, considering the participant's health and well-being.

Interventions

• Drug Covidir injections
  administration of the investigational product CODIVIR/Placebo at a dose of 20 mg twice a day subcutaneously at visits Day0-Day6 (7 days total)
• Diagnostic test Quantitative PCR SARS-CoV-2
  detection of viral RNA in nasopharyngeal and oropharyngeal samples by the Real Time Protein Chain Reaction technique.
• Diagnostic test IgM and IgG dosage
  lood collection for dosage of Anti SARS-CoV-2 antibodies.
• Diagnostic test Screening Blood tests
  omplete blood count, urea, creatinine, uric acid, sodium, potassium, chloride, calcium, glucose, glycated hemoglobin, alkaline phosphatase (FA), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubins and fractions ( BTF), total proteins and fractions (PTF), lipid profile (total cholesterol, fractions and triglycerides); coagulogram (TP, aPTT); D-dimer; C-reactive protein; HIV, HBV, HCV serology; Ferritin; troponin, fibrinogen,Coagulogram (TP, aPTT); D-dimer, Pregnancy
• Diagnostic test Electrocardiogram
  valuation by the principal investigator or assistant physician with a complete physical examination
• Other NEWS-2 score
  assessment of the participant by the NEWS-2 score.
• Other WHO score
  assessment of the participant by the score of the World Health Organization.
• Other Physical examination
  evaluation by the principal investigator or assistant physician
• Other COVID-19-Related Symptoms assessment
  will be completed by the study staff member based on patient status and answers.

Primary outcome measures

• Change in World Health Organization Ordinal Scale for clinical improvement [Time frame: up to 28 days]

Secondary outcome measures (4)

• Change in COVID-19-Related Symptoms score (measured on days 7, 14, 21, 28) in the treatment group in comparison with Placebo). [Time frame: up to 28 days]
• adverse events [Time frame: up to 28 days]
• RT-PCR viral load [Time frame: up to 28 days]
• IgM & IgG anti-SARS-CoV-2 [Time frame: up to 28 days]

Eligibility criteria

Inclusion criteria

• Age between 18 and 75 years
• Male or female
• SARS-CoV-2 infection indicated by confirmed RT-PCR test
• Moderate hospitalized COVID-19 (at least two out of three criterias below):

• Evidence of lower respiratory disease during clinical assessment (cough, fever, difficulty breathing) or imaging (X-rays)
• Oxygen saturation (SpO2) in room air < 93%
• <30 breaths per minute
• No signs of hemodynamic decompensation
• Absence of pregnancy in women of childbearing age
• Ability to understand and comply with the requirements of the protocol
• Consent to participate
• Consent to use at least one highly effective contraception methods (condoms, IUD, oral contraceptives) since the ICF signature and at least 30 days after the study.

Exclusion criteria

• Patients receiving oxygen supplementation except of nasal prongs, nasal intermittent positive pressure ventilation (NIPPV) or high flow nasal cannula (HFNC) that are allowed to be enrolled to the study).
• Positive RT-PCR test more than 72 hours prior to enrolment.
• Onset of symptoms more than 7 days prior to enrolment.
• Participant using drugs that are under clinical investigation in last 30 days.
• Body mass index less than 19.9 or greater than 35.
• Comorbidities such as: other serious infections, active malignancies, autoimmune diseases, liver, kidney or heart failure; another systemic disease and / or laboratory abnormality, which, in the investigator's opinion, prevent the patient from participating in the study.
• Concomitant HIV, HBV or HCV infection.
• Pregnancy or lactation.
• Vaccination for any other infection in the 4 weeks prior to enrolment.
• Any condition that increases the risk of participating in the study, in the opinion of the investigator.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Single group

Masking

Quadruple blind

Primary purpose

Treatment

Study locations

Brazil · 5 centers

• Hospital de Amor — Paulo Prata
• Infection Control — Prado
• Instituto Lobus — Casa de Pedra
• A2Z Clinical — Vila Martina
• Casa de Saude — Centro

Identifiers

NCT: NCT05218356 · CP-21-01

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗