Clinical research focused to evaluate the effect as coadyuvant of a combination of L. plantarum and P. acidilactici in adults positive for SARS-CoV-2 with mild clinical COVID-19 symptoms. Main objective is to evaluate how this combination of probiotics reduce the risk to progress to moderate or severe COVID and associated advantages such as reduce the risk of death. Adittionnally this RCT is launching to explore the benefits of this combination of strains to modulate fecal microbiome and explore how this correlate with clinical improvement.
Randomized controlled trial (RCT) to evaluate safety and efficacy of Lactobacillus plantarum CECT 30292, Lactobacillus plantarum CECT 7484, Lactobacillus plantarum CECT 7485 y P. acidilactici CECT 7483, one dose a day to reduce the risk of subjects with mild COVID-19 to evolute to moderate or severe disease. As secondary aims this trial is intented to evaluate the effect of this strains combinations to reduce the frequency and severity of gastrointestinal COVID-19 symptoms and lung abnormalities, to reduce the viral load, modulate the levels of IgG/IgM, and positively modify the fecal microbiota. 300 adults, 18 to 60 years, RTq-PCR positive for SARS-CoV-2, with mild COVID-19, and SpO2 \> 90%, living in Mexico city (2,200m over the sea level) will be randomized, after sign of informed consent to receive a combintation of Lactobacillus plantarum CECT 30292, Lactobacillus plantarum CECT 7484, Lactobacillus plantarum CECT 7485 y P. acidilactici CECT 7483 one a day orally or placebo for 30 days. Clinical severity, lung abnormalities (x-rays), viral load, IgG/IgM levels, and fecal microbiome will be evaluated at COVID-19 research center before randomization. Participants will be invited to remain at home and clinical evolution, temperature, SpO2 will be recorder and reported remotely during the 30 days intervention. On days 15 and 30, participants will be invited to return to COVID-19 research center to take samples to evaluate evolution of viral load, IgG/IgM and fecal microbiome. During the 30-days intervention period outcomes such as clinical progression, need of hospitalization, admission to Intensive Care Unit and death will be evaluated
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Combination of Lactobacillus plantarum CECT30292, Lactobacillus plantarum CECT 7484, Lactobacillus plantarum CECT 7485, and Pediococcus acidilactici CECT 7483
Combination of maltodextrin (E1400, qs) in a vegetable hydroxymethylpropyl-cellulose capsule (HPMC) of size 0
Hospital General Dr. Manuel Gea Gonzalez
Mexico City, Mexico
Severity progression of COVID-19
Frequency of randomized subjects who progress from mild to moderate or severe COVID-19, or remission, as evaluated by WHO Clinical Progression Scale
Time frame: 30 days
Stay at ICU
Length of stay at Intensive Care Unit (ICU)
Time frame: 30 days
Mortality ratio
Mortality ratio for all causes related to COVID-19
Time frame: 30 days
Viral load
Description of SARS-Cov-2 viral load evaluated by RT-PCR at screening and on days 15 and 30
Time frame: 30 days
Lung abnormalities
Frequency of lung abnormalities clasified by severity and measured by x-ray and artificial intelligence
Time frame: 30 days
Levels of immunoglobulins
Levels of Immunoglobulin G and Immunoglobulin M evaluated on day 15 and 30
Time frame: 30 days
Gastrointestinal manifestations, where 0 means good health status and 5 worse status
Frequency and severity of gastrointestinal manifestation evaluated by Gastrointestinal Symptom Rating Scale (GSRS)
Time frame: 30 days
Fecal microbiome
Changes on fecal microbiome evaluated by 16S analysis on day 1st and 30th
Time frame: 30 days
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Masking
QUADRUPLE
Enrollment
300
Adverse events
Frequency of adverse events reported on dairy report form after randomization and until day 30
Time frame: 30 days
Change on Serum Biomarkers
Change on high sensitivity C-reactive protein (hsCRP) and D-Dimer
Time frame: Days 1st, 15th and 30th after randomization
Duration of Individual Symptoms
Days of fever, cough, myalgia, dyspnea and headache
Time frame: 30 days