Clinical Protocol for Convalescent Plasma and Remdesivir Therapy in Nepal

NCT ID: NCT04570982

Last Updated: 2020-09-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

200 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-07-30

Study Completion Date

2020-12-30

Brief Summary

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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.

Detailed Description

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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.

Conditions

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COVID-19

Keywords

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Convalescent Plasma Remdesivir

Study Design

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Observational Model Type

CASE_CROSSOVER

Study Time Perspective

PROSPECTIVE

Study Groups

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Convalescent Plasma with SOC

All patients will receive CPT and SOC

Convalescent Plasma

Intervention Type BIOLOGICAL

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.

Interventions

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Convalescent Plasma

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.

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

All patients:

1. Minimum 18 years of age
2. Laboratory-confirmed diagnosis of COVID-19 infection with PCR test positive for SARS-CoV-2
3. Hospitalized patients admitted to an acute care facility for the treatment of COVID-19
4. Signed informed consent provided by the patient or patient's healthcare proxy

For Remdesivir:
5. Moderate to severe COVID-19 infection who require to be on oxygen supplementation

For convalescent plasma therapy:

A patient has to meet one of the following criteria to be eligible for receiving convalescent plasma therapy:
6. Severe or life-threatening COVID-19 infection, or judged by the treating provider to be at high risk of progression to severe or life-threatening disease
7. Patients who progress to severe or life threatening infection despite being on remdesivir for 48 hours or longer.

Exclusion Criteria

1. Under 18 years of age
2. Not confirmed with PCR test for COVID-19 infection
3. Cases not meeting criteria for severe or life-threatening COVID-19 infection
4. Any patient with contraindications for receiving plasma transfusion will not receive plasma
5. Any patient with contraindications for receiving Remdesivir will not receive Remdesivir
6. Patient's declination to enroll in the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ministry of Health and Population, Nepal

OTHER_GOV

Sponsor Role collaborator

Dr. Pradip Gyanwali,MD

OTHER_GOV

Sponsor Role lead

Responsible Party

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Dr. Pradip Gyanwali,MD

Chief-Executive

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Pradip Gyanwali, MD

Role: STUDY_CHAIR

Nepal Health Research Council

Meghnath Dhimal, PhD

Role: STUDY_DIRECTOR

Nepal Health Research Council

Janak Koirala, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Nepal Health Research Council

Locations

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Narayani Hospital

Birgunj, , Nepal

Site Status RECRUITING

Seti Provincial Hospital

Dhangadi, , Nepal

Site Status RECRUITING

BP Koirala Institute of Health Sciences (BPKIHS)

Dharān, , Nepal

Site Status RECRUITING

Sukraraj Tropical Disease Hospital

Kathmandu, , Nepal

Site Status RECRUITING

TU Teaching Hospital

Kathmandu, , Nepal

Site Status RECRUITING

Bheri Provincial Hospital

Nepalgunj, , Nepal

Site Status RECRUITING

Countries

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Nepal

Central Contacts

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Janak Koirala, MD, MPH

Role: CONTACT

Phone: +977 9818762117

Email: [email protected]

Saroj Bhattarai, MSc.

Role: CONTACT

Phone: +977 9840388970

Email: [email protected]

Facility Contacts

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Uday N Singh, MD.

Role: primary

Sher B Kamar, MD.

Role: primary

Krishna Pokhrel, MD.

Role: primary

Anup Bastola, MD.

Role: primary

Santa K Das, MD.

Role: primary

Rajan Pandey, MD.

Role: primary

References

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Koirala J, Gyanwali P, Gerzoff RB, Bhattarai S, Nepal B, Manandhar R, Jha R, Sharma S, Sharma YR, Bastola A, Murphy H, Acharya S, Adhikari P, Rajkarnikari M, Vaidya KM, Panthi CL, Bista B, Giri G, Aryal S, Pant S, Pokharel A, Karki S, Basnet S, Koirala B, Dhimal M; Nepal COVID-19 Clinical Study Collaborators. Experience of Treating COVID-19 With Remdesivir and Convalescent Plasma in a Resource-Limited Setting: A Prospective, Observational Study. Open Forum Infect Dis. 2021 Aug 21;8(8):ofab391. doi: 10.1093/ofid/ofab391. eCollection 2021 Aug.

Reference Type DERIVED
PMID: 34430672 (View on PubMed)

Other Identifiers

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NHRC2020-001

Identifier Type: -

Identifier Source: org_study_id