This is a phase 1 clinical trial to verify the safety and efficacy of DW-MSC in COVID-19 patients. A total of 9 subjects are randomly allocated. Subjects who meet the final inclusion and exclusion criteria are randomized to the test groups (low-dose group and high-dose group) or control group (placebo group) in a ratio of 1:1:1. Subjects assigned to the test groups were administered intravenously once with 5 x 10\^7cells of DW-MSC for the low-dose group or 1 x 10\^8cells for the high-dose group after registration. Subjects assigned to the control group were administered with placebo in the same manner as the test drug (DW-MSC). At this time, all of the existing standard co-treatment are allowed. DW-MSC is adjunct therapy to standard therapy. This clinical trial is a double-blind trial, in which a randomized method will be used. To maintain the double-blindness of the study, statistician who do not participate in this study independently generate randomization code. Subjects will be randomized to the test groups (low-dose group and high-dose group) or the control group (placebo group) in a 1:1:1 ratio. After the completion of the trial, the randomization code will be disclosed after unlocking the database and unblinding procedures. Follow Up period: observed for 28 days after a single administration
Patients with Covid-19 have a mortality rate of about 35 \~ 50% and currently, severe patients caused by the Coronavirus show respiratory distress. To date, the incidence rate has been more than 3 million each year; however, as the increase and globalization of the environmental pollution has been expanded, the number of patients is expected to increase due to acute diseases such as the Middle East Respiratory virus, SARS, and coronavirus. Since 2015, Daewoong Pharmaceutical intends to use stem cells for product research on rare and intractable diseases including respiratory distress. Stem cells are also called pluripotent cells or truncal cells that can convert to any organ. It is an embryonic stage undifferentiated cell that has stopped differentiating before forming a specific organ whose differentiation has not been determined and has the ability to differentiate into muscle, bone, and internal conformal body organs. There are three types of stem cells: embryonic stem cells, adult stem cells, and induced pluripotent stem cells. Daewoong Pharmaceutical intends to develop cell therapy products using mesenchymal stem cells (MSC).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
9
Assignment of Administration Group allogeneic mesenchymal stem cell: * Low-dose group (5 x 10\^7cells) * High-dose group (1 x 10\^8 cells)
Control group (placebo)
Site 550: University of Hassanudin/ Dr. Wahidin Sudirohusodo Hospital
Makassar, Indonesia
Incidence of TEAE* in Treatment group
Incidence of TEAE\* in Treatment group \* TEAE: Treatment-Emergent Adverse Event All adverse reactions will be organized according to System Organ Class (SOC) and Preferred Term (PT) using MedDRA (Medical Dictionary for Regulatory Activities), and the incidence of treatment-emergent adverse events will be summarized for the coded adverse reactions.
Time frame: 28 days
Survival rate
Survival rate is defined as the rate of subjects surviving until Day 14 and Day 28, and the number and rate of surviving subjects for each administration group is given.
Time frame: until Day 14 and Day 28
Duration of hospitalization
Duration of hospitalization is defined as the number of days in the hospital until Day 28, and descriptive statistics (number of subjects, mean, standard deviation, median, minimum, maximum) are given for each administration group.
Time frame: 28 days
Clinical improvement Ordinal scale
Clinical improvement measured by Ordinal scale change for clinical improvement from baseline to Day 14 and 28
Time frame: from baseline to Day 14 and Day 28
Clinical improvement National EWS
Clinical improvement measured by National EWS (National Early Warning Score) change from baseline to Day 7, 14, 28. EWS Points, Risk and Interpretation as follows: 0\~4: Low clinical risk; interpretation= Ward-based response 3\~4 : Low\~medium clinical risk; interpretation= Urgent ward-based response 5\~6: Medium clinical risk; interpretation= Key threshold for urgent response
Time frame: from baseline to Day 7, 14 and Day 28
Clinical improvement Oxygenation index
Clinical improvement measured by Oxygenation index (PaO2/FiO2) change from baseline (Day 1, 3, 7, 10, 14, 28)
Time frame: Day 1, 3, 7, 10, 14, 28
Clinical improvement Lung involvement change
Clinical improvement measured by Lung involvement change by Imaging from baseline (Day 7, 14, 28)
Time frame: Day 7, 14, 28
Clinical improvement Inflammation markers change
Inflammation markers change from baseline for WBC
Time frame: Day 7, 14, 28
Clinical improvement Inflammation markers change
Inflammation markers change from baseline for Lymphocytes
Time frame: Day 7, 14, 28
Clinical improvement Inflammation markers change
Inflammation markers change from baseline for ESR
Time frame: Day 7, 14, 28
Clinical improvement Inflammation markers change
Inflammation markers change from baseline for CRP
Time frame: Day 7, 14, 28
Clinical improvement Inflammation markers change
Inflammation markers change from baseline for Fibrinogen
Time frame: Day 7, 14, 28
Clinical improvement Inflammation markers change
Inflammation markers change from baseline for IL-6, TNF-α, IL-1β, IF-γ (Day 7, 14, 28)
Time frame: Day 7, 14, 28
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