A prospective, randomized, placebo-controlled, double-blinded, phase III clinical trial of the therapeutic use of convalescent plasma in the treatment of patients with moderate to severe COVID-19
Full Title: A prospective, randomized, placebo-controlled, double-blinded, phase III clinical trial of the therapeutic use of convalescent plasma in the treatment of patients with moderate to severe COVID-19. Short Title: PROTECT-Patient study Aim: Assess the safety and efficacy of COVID-19 convalescent plasma (CCP) as a therapeutic treatment for hospitalised patients with moderate to severe COVID-19 Study Design: Randomised, double-blinded, placebo-controlled, phase III clinical trial Intervention: Randomised 1:1 to either CCP plus standard of care (SOC) or to SOC plus placebo (200 mL normal saline) Active Agent: A single unit of approximately 200-250 mL of CCP that contains anti-SARS-CoV-2 collected by plasmapheresis from a volunteer who recovered from COVID19 with SOC as determined by local practice and guidelines. Placebo: A single unit of 200 mL normal saline with SOC as determined by local practice and guidelines Sample Size: 600 Study Population: Consenting adult inpatients with moderate to severe COVID-19, not requiring invasive ventilation, who are admitted to a participating public or private sector hospital and who are not enrolled in another COVID-19 treatment trial. Settings: Participating public and private sector hospitals in South Africa
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
600
A single unit of approximately 200-250 mL of CCP that contains anti-SARS-CoV-2 collected by plasmapheresis from a volunteer who recovered from COVID19 with SOC as determined by local practice and guidelines.
A single unit of 200 mL normal saline with SOC as determined by local practice and guidelines
Universitas Hospital
Bloemfontein, Free State, South Africa
NOT_YET_RECRUITINGMitchells Plain Hospital
Cape Town, Western Cape, South Africa
RECRUITINGClinical Improvement
Proportion of participants with successful treatment outcome, defined as clinical improvement (≥ 2 points on WHO R\&D BOSCI 1) by Day 28 post-randomisation.
Time frame: Day 28
Adverse Events of special interest
1\. Proportion of participants with adverse events of special interest (Transfusion-Associated Circulatory Overload (TACO); Transfusion-Related Acute Lung Injury (TRALI); allergic transfusion reaction).
Time frame: Day 28
Serious Adverse Events
2\. Proportion of participants with serious adverse events.
Time frame: Day 28
Survival
3\. Proportion of participants surviving at Day 28 post-randomisation.
Time frame: Day 28
Invasive mechanical ventilation
4\. Proportion of participants requiring invasive mechanical ventilation.
Time frame: Day 28
Disease severity
5\. Proportion of participants with moderate and severe ARDS.
Time frame: Day 28
Time to outcomes of interest
6\. Time from randomization to death, clinical improvement, ICU admission, and invasive mechanical ventilation.
Time frame: Day28
Length of stay meausures
7\. Duration of hospitalisation, ICU stay, and mechanical ventilation in survivors.
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Time frame: Day28
SARS-CoV PCR
8\. Proportion negative SARS-CoV-2 PCR at Day 28; time to viral clearance (PCR-negativity); change in SARS-CoV-2 PCR Ct value.
Time frame: Day28
Inflammatory markers
9\. Proportion with and time to normalisation of inflammatory markers, including CRP, lymphocyte count, D-dimer, ferritin.
Time frame: Day28
Radiography
10\. Worsening of radiographic abnormalities.
Time frame: Day28
Fever & Hypoxia
11\. Proportion with and time to resolution of fever and hypoxia.
Time frame: Day28
patients with HIV infection and other comorbidities
12\. Proportion of patients with HIV infection and other comorbidities (obesity, diabetes, hypertension) with primary efficacy outcome.
Time frame: Day 28
Timing of IP & Efficacy Outcome
13\. Relationship between timing of transfusion from symptom onset and primary efficacy outcome.
Time frame: Day 28
Neutralising Ab
14\. Relationship between convalescent plasma neutralizing antibody titers and primary efficacy outcome
Time frame: Day28
SARS CoV Antibody titre
15\. Comparison of anti-SARS-CoV-2 titer dynamics between treatment arms
Time frame: Day28