The purpose of the study is to determine if Liquid Alpha1-Proteinase Inhibitor (Human) (Liquid Alpha1-PI) plus SMT can reduce the proportion of participants dying or requiring intensive care unit (ICU) admission on or before Day 29 or who are dependent on high flow oxygen devices or invasive mechanical ventilation on Day 29 versus placebo plus SMT in hospitalized participants with COVID-19.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
57
Birmingham VA
Birmingham, Alabama, United States
St. Joseph's Hospital
Phoenix, Arizona, United States
Percentage of Participants Dying or Requiring Intensive Care Unit (ICU) Admission
Time frame: Up to Day 29
Percentage of Participants Who Are Dependent on High Flow Oxygen Devices or Invasive Mechanical Ventilation
Time frame: Day 29
Change From Baseline in National Early Warning Score (NEWS)
NEWS is clinical scoring developed to improve detection of deterioration in ill participant. It is based on 7 clinical parameters: Respiration rate, oxygen saturation, supplemental oxygen, systolic blood pressure (BP), pulse rate, level of consciousness, and temperature. A score of 0 and 2 was allocated to supplemental oxygen, 0 and 3 for level of consciousness and score of 0, 1, 2 and 3 for remaining parameters (i.e. respiration rate, oxygen saturation, systolic BP, pulse rate and temperature) where 0 = normal health condition to 3 = worst health condition; Higher scores indicated more severity. All scores were summed to get an aggregate score. Aggregate NEWS score ranged from 0 to 20, with higher scores indicating more severity/higher risk.
Time frame: Baseline, Days 15 and 29
Time to Clinical Response as Assessed by NEWS Score ≤ 2 Maintained for 24 Hours
Time to clinical response was reported at 50th percentile in days.
Time frame: Up to Day 29
Time to Hospital Discharge
Time to hospital discharge is defined as duration of hospitalization from Day 1 through Day 29.
Time frame: Up to Day 29
Duration of ICU Stay
Duration of ICU stay in days is analyzed for participants admitted to ICU post randomization.
Time frame: Up to Day 29
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University of Miami Hospital
Miami, Florida, United States
Sparrow Hospital
Lansing, Michigan, United States
Hannibal Clinic
Hannibal, Missouri, United States
Kansas City VA
Kansas City, Missouri, United States
CHI Health Center
Omaha, Nebraska, United States
Columbia University Medical Center
New York, New York, United States
Memphis VA
Memphis, Tennessee, United States
University of Utah
Salt Lake City, Utah, United States
...and 10 more locations
Duration of Any Oxygen Use
Time frame: Up to Day 30
Duration of Mechanical Ventilation
Duration of Mechanical Ventilation is analyzed for participants requiring mechanical ventilation post randomization.
Time frame: Up to Day 29
Mean Change From Baseline in Ordinal Scale
The ordinal scale is a 7-point scale ranging from 1 to 7 used to measure clinical status based on the following points: 1) Death; 2) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO) 3) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 4) Hospitalized, requiring supplemental oxygen; 5) Hospitalized, not requiring supplemental oxygen; 6) Not hospitalized, limitation on activities; 7) Not hospitalized, no limitations on activities. Higher score indicated no severe illness. Mean change in Ordinal scale was evaluated by fitting a linear mixed-effects model for repeated measures (MMRM).
Time frame: Baseline, Days 15 and 29
Absolute Change From Baseline in Ordinal Scale
The ordinal scale is a 7-point scale ranging from 1 to 7 used to measure clinical status based on the following points: 1) Death; 2) Hospitalized, on invasive mechanical ventilation or ECMO; 3) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 4) Hospitalized, requiring supplemental oxygen; 5) Hospitalized, not requiring supplemental oxygen; 6) Not hospitalized, limitation on activities; 7) Not hospitalized, no limitations on activities. Higher score indicated no severe illness.
Time frame: Baseline, Days 15 and 29
Percentage of Participants in Each Severity Category of the 7-point Ordinal Scale
The ordinal scale is a 7-point scale ranging from 1 to 7 used to measure clinical status based on the following points: 1) Death; 2) Hospitalized, on invasive mechanical ventilation or ECMO 3) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 4) Hospitalized, requiring supplemental oxygen; 5) Hospitalized, not requiring supplemental oxygen; 6) Not hospitalized, limitation on activities; 7) Not hospitalized, no limitations on activities. The percentages are rounded off to the single decimal point.
Time frame: Day 15 and Day 29
Time to Sustained Normalization of Temperature
Time to sustained normalization of temperature was reported at 50th percentile in days.
Time frame: Up to Day 29
Percentage of Participants Who Experienced Sustained Normalization of Fever
Normalization of fever is defined as temperature \< 36.6 °C armpit, \< 37.2 °C oral, or \< 37.8 °C rectal sustained for at least 24 hours.
Time frame: Up to Day 29
Number of Participants Who Develop Acute Respiratory Distress Syndrome (ARDS)
ARDS was defined based on Berlin criteria (chest imaging, origin of edema, oxygenation).
Time frame: Up to Day 29
Time to Clinical Progression
Time to clinical progression is defined as the time to death, mechanical ventilation, or ICU admission. Time to clinical progression was reported at 50th percentile in days.
Time frame: Up to Day 29