COVID-19 (VA CURES-1)

  • STATUS
    Recruiting
  • End date
    Jul 18, 2022
  • participants needed
    702
  • sponsor
    VA Office of Research and Development
Updated on 30 November 2020

Summary

The purpose of this study is to determine if treatment with convalescent plasma improves the clinical outcomes of Veterans who are hospitalized and require supplemental oxygen due to COVID-19.

Description

As of August 25, 2020, SARS-Coronavirus 2 (SARS-CoV-2; COVID-19) infections are approaching 6 million persons and 180,000 deaths in the US. Of the 20% of patients admitted to hospital, up to half progress to ICU admission, respiratory failure or death. Prominent among these progressors are older men, particularly those with underlying comorbidities (e.g., hypertension, diabetes, lung, heart, kidney or liver disease, obesity and immunocompromised), all common among Veterans. There are no drugs or other therapeutics approved by the FDA to prevent or treat COVID-19 infection.

Convalescent plasma therapy is being used empirically, although only five of six small uncontrolled case series (total n=56) in SARS-CoV-23-8 and a recent study with non-randomized controls suggest improved selected clinical, virologic and laboratory outcomes; outcomes in another small randomized trial were equivocal. For other infections, such as influenza and Ebola virus, promising observational studies were not reliably confirmed by controlled trials. In multiple infections, use of convalescent plasma has been distinguished by its safety profile but not by the consistency of its benefit.

The current double-blind, placebo-controlled RCT is designed to determine definitively whether this intervention is effective in a population at high risk of complications and death from SARS-CoV-2 infection. The investigators compare the effect of convalescent plasma vs. saline placebo with a robust study design, adequate sample size and statistical and logistical rigor to assure that the interventions the investigators make to treat serious disease are well-validated to support its use or to move on to test other potentially safe and effective treatments.

This study is taking place at approximately 25 VA Medical Centers located across the US. A participant's involvement will last up to 33 days. The entire study, from the date the first person enters until the last participant is seen, is expected to last about 20 months.

Data collected for this study will be analyzed and stored at the Palo Alto Cooperative Studies Program Coordinating Center (CSPCC). After the study is completed, the de-identified, archived data will continue to be stored at the Palo Alto CSPCC, accessible for use by researchers including those outside of the study with an approved Data Use Agreement. The biospecimens collected in the study for current and future research will be kept at the VA Biorepository in Palo Alto, CA unless otherwise specified. The biospecimens will be accessible for future research with an approved Sample Use Agreement. The VA CIRB will oversee the biorepository for this study. All samples will be destroyed by standard practice within 20 years of study completion. Sample destruction will be validated according to the Standard Operating Procedures of the VA Biorepository.

Details
Treatment Convalescent plasma, Masked Saline Placebo
Clinical Study IdentifierNCT04539275
SponsorVA Office of Research and Development
Last Modified on30 November 2020

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Eligibility

Yes No Not Sure

Inclusion Criteria

Is your age greater than or equal to 18 yrs?
Gender: Male or Female
Do you have any of these conditions: *COVID-19 or Covid-19?
Veterans must meet ALL of the following criteria to be eligible to
participate
Admitted to a participating VA clinical site with symptoms suggestive of SARS-CoV-2 infection
Participant (or legally authorized representative) provides informed consent prior to initiation of any study procedures
Participant (or legally authorized representative) understands and agrees to comply with planned study procedures
Veteran 18 years of age at time of screening
Has laboratory-confirmed SARS-CoV-2 infection as determined by polymerase chain reaction (PCR) or antigen test, as documented by either of the following
(1)RT-PCR or antigen positive (nasopharyngeal, oropharyngeal, saliva, lower
respiratory) in sample collected 72 hours prior to screening; (2)RT-PCR or
antigen positive in sample collected > 72 hours but 168 hours (i.e. 7 days)
prior to screening, documented inability to obtain a repeat sample (e.g. due
to lack of testing supplies, limited testing capacity, results taking > 24
hours, etc.), AND progressive disease suggestive of ongoing SARS-CoV-2
infection
Requiring oxygen by nasal cannula or by face-mask as a new treatment (or if
previously on home oxygen, at a liter flow at least 2 Lpm greater than home
prescription), but not on humidified heated high-flow nasal cannula (HHHFNC)
at 15 Lpm
Can be randomized within 72 hours of hospital admission. 8.Agrees not to
participate in another therapeutic clinical trial for the treatment of
COVID-19 or SARS-CoV-2 through Day 29 without approval from the
investigator(s). Taking part in other research studies, including those
unrelated to SARS-CoV-2, without first discussing it with the investigators of
this study may invalidate the results of this study, as well as that of the
other study

Exclusion Criteria

An individual who meets any of the following criteria will be excluded from
participation in this study
Respiratory failure requiring mechanical ventilation, non-invasive ventilation including CPAP (for an indication other than previously diagnosed sleep apnea and maintained on outpatient settings), or extra-corporeal membrane oxygenation or anticipated to require any of those treatments or to die within 24 hours
Anticipated discharge from the hospital or transfer to another hospital that is not a study site within 72 hours
History of previous transfusion reaction
Previously documented serum IgA deficiency (<7 mg/dL)
Documented to have received convalescent plasma in the last 60 days
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