COVID-19's mechanism to enter the cell is initiated by its interaction with its cellular receptor, the angiotensin-converting enzyme. As a result of this union, a clathrin-mediated endocytosis process begins. This route is one of the therapeutic targets for which available drugs are being investigated in order to treat COVID-19 infection. This is one of the mechanisms blocked by drugs like ruxolitinib and chloroquine. Various drugs approved for clinical use that block the clathrin-mediated endocytosis pathway have been explored. It has been found that the best in vitro and in vivo results were obtained with statins, which also allowed generating a greater potent adaptive immune response. Therefore, statins and specifically simvastatin make it possible to block the entry process used by COVID-19, block inflammation by various mechanisms and increase the adaptive immune response. All of these processes are desirable in patients infected with COVID-19. Statins have been proposed to have beneficial effects in patients infected with MERS-COV, another coronavirus similar to COVID-19, but there have been no randomized studies supporting the use of statins in patients with COVID-19 infection. In this project we propose the combined use of one of these drugs, ruxolitinib with simvastatin, looking for a synergistic effect in the inhibition of viral entry and in the anti-inflammatory effect.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
94
Ruxolitinib 5 mg orally every 12 hours for 7 days, which will be increased to 10 mg every 12 hours for a total of 14 days. Simvastatin 40 mg orally every 24 hours for 14 days
Patients will receive treatment according to usual clinical practice in the participant site.
Hospital Universitario Madrid Sanchinarro
Madrid, Spain
Percentage of patients who develop severe respiratory failure.
Patients achieving a grade 5 or higher of the WHO 7-point ordinal scale of severity categorization for COVID at day 7 from randomization.
Time frame: 7 days
Percentage of patients who develop severe respiratory failure.
Patients achieving a grade 5 or higher of the WHO 7-point ordinal scale of severity categorization for COVID at day 14 from randomization.
Time frame: 14 days
Length of ICU stay.
Time from ICU admision to ICU discharge.
Time frame: 28 days
Length of hospital stay
Time from hospital admision to hospital discharge.
Time frame: 28 days
Survival rate at 6 months
Percentage of patients alive at 6 months
Time frame: 6 months
Survival rate at 12 months
Percentage of patients alive at 12 months
Time frame: 12 months
Survival rate at 28 days
Percentage of patients who died from any cause 28 days after inclusion in the study
Time frame: 28 days
Percentage of patients with each AE by grade
Percentage of patients with each AE by grade in relation with total number of treated patients
Time frame: 28 days
Percentage of patients who discontinued due to AEs
Percentage of patients who discontinued due to AEs in relation with total number of treated patients
Time frame: 28 days
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