The objective of this compassionate use study is to provide access and evaluate the outcome of Remdesivir and COVID-19 convalescent plasma use in patients with COVID-19. This protocol provides a coordinated approach for distribution and guidance for safe and effective administration of Remdesivir and convalescent plasma with antibodies against SARS CoV-2 for treatment of patients with COVID-19 infection who are most likely to benefit from this investigational treatment and monitor them for the following specific objectives and outcomes: SPECIFIC OBJECTIVES 1. Provide access to convalescent plasma for hospitalized patients with severe COVID-19 infection (compassionate use, expanded access program) 2. Monitor safety of the therapy with convalescent plasma containing antibodies against SAR CoV-2 and Remdesivir for hospitalized patients with severe COVID-19 infection 3. Evaluate outcomes in patients who received convalescent COVID-19 plasma therapy alone, Remdesivir alone, and both agents. Study Design: This study will be a prospective, observational clinical study with an intention-to-treat, cross-over design. Comparison groups will be patients who received convalescent plasma vs. those who received Remdesivir. In addition, cross-over to convalescent plasma arm will be allowed for patients who continued to get worse even after receiving Remdesivir for more than 48 hours.
ENROLLMENT Patients will be recruited from all COVID-19 treating hospitals of Nepal which are participating in this clinical study. All hospitalized patients with moderate to severe COVID-19 infection will be screened for Remdesivir Treatment and those with severe to life threatening COVID-19 infection will be screened for Convalescent plasma therapy. Donors Convalescent plasma donors will be recruited from the record of the hospitals from where they were discharged. The COVID hospitals will be asked to collect names of recovered patients who have voluntarily shown interest to donate plasma. When possible donated plasma will be stored in respective hospitals or blood bank.
Study Type
OBSERVATIONAL
Enrollment
200
The objective of this protocol is to provide a coordinated approach for distribution and guidance for safe and effective administration of convalescent serum with antibodies against SAR CoV-2 for treatment of patients with COVID-19 infection who are most likely to benefit from this investigational treatment and monitor them.
Narayani Hospital
Birgunj, Nepal
RECRUITINGSeti Provincial Hospital
Dhangadi, Nepal
RECRUITINGBP Koirala Institute of Health Sciences (BPKIHS)
Dharān, Nepal
RECRUITINGSukraraj Tropical Disease Hospital
Kathmandu, Nepal
RECRUITINGTU Teaching Hospital
Kathmandu, Nepal
RECRUITINGBheri Provincial Hospital
Nepalgunj, Nepal
RECRUITINGAvailability of convalescent plasma
* percentage of donors who donated plasma versus those who were eligible for donation * percentage of patient who received plasma vs. requests received
Time frame: 12 Weeks
Amount of Plasma
\- amount of plasma administered per patient
Time frame: 12 Weeks
Demographics of recipients
\- type of patients receiving plasma therapy : Age in Years, Sex: M/F,
Time frame: 12 Weeks
Co-morbidity of recipient
\- recipient comorbidities: Smoking, Diabetes, Heart disease, Chronic lung disease, chronic liver disease, cancer, organ transplant, HIV infection, TB. HIV, HBV, HCV, Syphillis
Time frame: 12 Weeks
Donor status
* donor health status: HIV, HBV, HCV, Syphillis * Donor status: duration after recovery from COVID-19, plasma antibody titer against SARS CoV-2
Time frame: 12 Weeks
Adverse events of convalescent COVID-19 plasma and Remdesivir Therapy
* any expected and unexpected adverse events during or after treatment (upto 7 days) * any other complications related or unrelated to plasma transfusion and Remdesivir during hospital stay
Time frame: 12 Weeks
Hospital and ICU length of stay
\- number of days of hospital stay and ICU stay
Time frame: 12 Weeks
Disposition of patients including survival
\- condition at discharge: complete recovery, partial recovery with complications, death
Time frame: 12 Weeks
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