The primary aim of this study is to determine whether Camostat mesylate reduces SARS-COV-2 associated coagulopathy. Additional aims are to determine the effect of Camostat mesylate on SARS-COV-2 associated myocardial injury, to assess duration of hypoxia or intubation, to evaluate the length of intensive care unit and hospital stay, and assess mortality rates.
The trial is in-patient only. Participants are identified by the hospital physicians and house staff, and contacted by research study personnel. Potential participants fulfilling inclusion criteria and not fulfilling exclusion criteria who agree to participate and sign the informed consent undergo the enrollment process. Ono Pharmaceutical, Japan, will provide Camostat mesylate tablets. The Yale New Haven Hospital research pharmacy will receive and store the drug within 15-25C range according to protocol storage requirements. Microcrystalline Cellulose NF (PH-102) for placebo formulation will be acquired from Fagron. Empty gelatin capsules Size 0, for over-encapsulation will be acquired from Fagron. Before Ono Pharmaceutical can send the drug, an IND will be obtained from the FDA. Principal Investigator and the Yale New Haven Hospital research pharmacy will keep accountability records for all investigational products acquired, dispensed, used and disposed. Drugs are administered by nurses. There will be no restriction on taking other medications, activities or food intake. There are two arms to the study: (a) pharmacy-formulated placebo 3 times a day (b) 200 mg Camostat mesylate to be taken three times daily. Each arm will have 100 subjects. All patients will receive treatment until discharged. Participants will be randomized equally to Camostat mesylate or identical appearing placebo using a permuted-block design with variable block size. The actual treatment assignment will be concealed from the investigators and the participants. The randomization scheme will be generated by the statistical group. Participants have the option of refusing study drug. If the participant decides to stop the drug or blood drawing he or she would be dropped from the trial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Participants will be given Camostat mesylate three times daily.
Participants will be given Microcrystalline Cellulose (placebo) three times daily.
Percent change in plasma D-Dimer
The sum percent change in D-Dimer over 7 days will be compared to day 1
Time frame: 7 days
Overall Safety and adverse event
The first assessment on mortality and complications will be carried out 3 months after the start of the study.
Time frame: 3 months
Change in plasma Fibrinogen levels
Percent change in fibrinogen over 7 days compared to day 1
Time frame: 7 days
Change in plasma troponin
Percent change in troponin over 7 days compared to day 1
Time frame: 7 days
New onset cardiomyopathy
New onset cardiomyopathy defined by a reduction of EF by greater than 10% or less than 45% will be measured
Time frame: 7 days
Duration of intubation
Days with hypoxia (Room Air O2 Sat\<93%) or days intubated
Time frame: 7 days
Length of stay in the intensive care unit
The number of days in the intensive care unit
Time frame: 28 days
Time to discharge from hospital
The number of days since admission to discharge
Time frame: 30 days
Occurrence of major adverse cardiovascular events
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The ocurrence of major adverse cardiovascular events (MACE): MI, stroke, CHF, PCI, death from cardiovascular disease will be studied.
Time frame: 7 days