Convalescent Plasma to Stem Coronavirus (CSSC-001)

Sponsor
Johns Hopkins University (Other)
Overall Status
Completed
CT.gov ID
NCT04323800
Collaborator
(none)
180
25
2
12.4
7.2
0.6

Study Details

Study Description

Brief Summary

Evaluate the efficacy of treatment with high-titer Anti- SARS-CoV-2 plasma versus control (SARS-CoV-2 non-immune plasma) in subjects exposed to Coronavirus disease (COVID-19) at day 28.

Condition or Disease Intervention/Treatment Phase
  • Biological: Anti- SARS-CoV-2 Plasma
  • Biological: SARS-CoV-2 non-immune Plasma
Phase 2

Detailed Description

This randomized, controlled, double-blinded phase 2 trial will assess the efficacy and safety of Anti- SARS-CoV-2 convalescent plasma as prophylaxis following exposure to COVID-19 (as defined in the inclusion criteria). Adults 18 years of age and older with high risk exposure as defined by CDC may participate. A total of 500 eligible subjects will be randomized in a 1:1 ratio to receive either high titer anti-SARS-CoV-2 plasma or control (SARS-CoV-2 non-immune plasma).

Study Design

Study Type:
Interventional
Actual Enrollment :
180 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Intervention Model Description:
1:1 ratio1:1 ratio
Masking:
Triple (Participant, Care Provider, Investigator)
Primary Purpose:
Treatment
Official Title:
Convalescent Plasma to Stem Coronavirus: A Randomized, Blinded Phase 2 Study Comparing the Efficacy and Safety Human Coronavirus Immune Plasma (HCIP) vs. Control (SARS-CoV-2 Non-immune Plasma) Among Adults Exposed to COVID-19
Actual Study Start Date :
Jun 10, 2020
Actual Primary Completion Date :
Apr 22, 2021
Actual Study Completion Date :
Jun 22, 2021

Arms and Interventions

Arm Intervention/Treatment
Experimental: High titer anti-SARS-CoV-2 plasma

Participants with High titer anti-SARS-CoV-2 plasma.

Biological: Anti- SARS-CoV-2 Plasma
SARS-CoV-2 convalescent plasma (1 unit; ~200-250 mL collected by pheresis from a volunteer who recovered from COVID-19 disease and has SARS-CoV-2 antibody titers ≥ 1:320

Active Comparator: SARS-CoV-2 non-immune plasma

Participants with SARS-CoV-2 non-immune plasma.

Biological: SARS-CoV-2 non-immune Plasma
Normal human plasma collected prior to December 2019

Outcome Measures

Primary Outcome Measures

  1. Efficacy of Treatment at Day 28 as Assessed by Number of Participants Who Develop SARS-Cov-2 Infection [Day 28]

    Comparison of proportions of cumulative incidence of development of SARS-Cov-2 infection (symptoms compatible with infection and/or + molecular testing) regardless of disease severity, following high-titer Anti- SARS-CoV-2 plasma versus control (SARS-CoV-2 non-immune plasma) in subjects exposed to COVID-19.

  2. Safety of Treatment With High-titer Anti- SARS-CoV-2 Plasma Versus Control as Assessed by Number of Participants With "Serious Adverse Events" [Up to Day 28]

    Number of participants with serious adverse events categorized as either severe infusion reactions or Acute Respiratory Distress Syndrome during the study period.

  3. Safety of Treatment With High-titer Anti- SARS-CoV-2 Plasma Versus Control as Assessed by Cumulative Incidence of Grade 3 and 4 Adverse Events [Up to Day 28]

    Cumulative incidence of grade 3 and 4 adverse events during the study period evaluated as events per 100 person-years will be used to assess safety of the intervention.

Secondary Outcome Measures

  1. Number of Participants With Severe Disease [Up to 28 days]

    Number of participants with severe disease between the anti-SARS-CoV-2 convalescent plasma and control groups. Severity of disease will be measured using the number of participants with any of the disease severity categories below: Death Requiring mechanical ventilation and/or in ICU non-ICU hospitalization, requiring supplemental oxygen non-ICU hospitalization, not requiring supplemental oxygen

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
Yes

Inclusion Criteria

  1. Subjects must be 18 years of age or older

  2. Close contact exposure (as defined by CDC guidelines) to person with COVID-19 within 96 hours of randomization (and 120 hours of receipt of plasma)

Exclusion Criteria

  1. Receipt of any blood product in past 120 days.

  2. Medical, psychiatric,cognitive illness or recreational drug/alcohol use that in the opinion of the principal investigator, would affect subject safety and/or compliance.

  3. Symptoms consistent with COVID-19 infection (fevers, acute onset cough, shortness of breath) at time of screening.

  4. Laboratory evidence of COVID-19 infection at time of screening.

  5. History or known laboratory evidence of previous COVID-19 infection.

  6. History of prior reactions to transfusion blood products.

  7. Inability to complete therapy with the study product within 24 hours after randomization.

Contacts and Locations

Locations

Site City State Country Postal Code
1 University of Alabama at Birmingham Birmingham Alabama United States 35294
2 Center for American Indian Health - Whiteriver Office Whiteriver Arizona United States 85941
3 University of California, San Diego La Jolla California United States 92093
4 University of California, Los Angeles Los Angeles California United States 90095
5 University of California, Irvine Health Orange California United States 92868
6 Western Connecticut Health Network, Danbury Hospital Danbury Connecticut United States 06810
7 Western Connecticut Health Netowrk, Norwalk Hospital Norwalk Connecticut United States 06856
8 MedStar Georgetown University Hospital Washington District of Columbia United States 20007
9 University of Miami Coral Gables Florida United States 33124
10 University of Miami Clinical Translational Research Site Miami Florida United States 33136
11 NorthShore University HealthSystem Evanston Illinois United States 60201
12 Anne Arundel Medical Center Annapolis Maryland United States 21401
13 The Johns Hopkins University Baltimore Maryland United States 21205
14 University of Massachusetts Worcester Worcester Massachusetts United States 01655
15 Wayne State University Detroit Michigan United States 48202
16 University of New Mexico Health Sciences Center Albuquerque New Mexico United States 87131
17 Center for American Indian Health - Gallup Office Gallup New Mexico United States 87301
18 Center for American Indian Health - Shiprock Office Shiprock New Mexico United States 87420
19 Vassar Brothers Medical Center Poughkeepsie New York United States 12601
20 University of Rochester Rochester New York United States 14642
21 University of Cincinnati Medical Center Cincinnati Ohio United States 45219
22 Lifespan/BrownUniversity (Rhode Island Hospital) Providence Rhode Island United States 02903
23 Baylor College of Medicine Houston Texas United States 77030
24 University of Texas Health Science Center at Houston Houston Texas United States 77030
25 The University of Utah Salt Lake City Utah United States 84132

Sponsors and Collaborators

  • Johns Hopkins University

Investigators

  • Principal Investigator: Shmuel Shoham, MD, Johns Hopkins University

Study Documents (Full-Text)

More Information

Publications

None provided.
Responsible Party:
Johns Hopkins University
ClinicalTrials.gov Identifier:
NCT04323800
Other Study ID Numbers:
  • IRB00245634
First Posted:
Mar 27, 2020
Last Update Posted:
Apr 26, 2022
Last Verified:
Apr 1, 2022
Individual Participant Data (IPD) Sharing Statement:
No
Plan to Share IPD:
No
Studies a U.S. FDA-regulated Drug Product:
Yes
Studies a U.S. FDA-regulated Device Product:
No
Product Manufactured in and Exported from the U.S.:
No
Keywords provided by Johns Hopkins University
Additional relevant MeSH terms:

Study Results

Participant Flow

Recruitment Details
Pre-assignment Detail
Arm/Group Title High Titer Anti-SARS-CoV-2 Plasma SARS-CoV-2 Non-immune Plasma
Arm/Group Description Participants with High titer anti-SARS-CoV-2 plasma. Anti- SARS-CoV-2 Plasma: SARS-CoV-2 convalescent plasma (1 unit; ~200-250 mL collected by pheresis from a volunteer who recovered from COVID-19 disease and has SARS-CoV-2 antibody titers ≥ 1:320 Participants with SARS-CoV-2 non-immune plasma. SARS-CoV-2 non-immune Plasma: Normal human plasma collected prior to December 2019
Period Title: Overall Study
STARTED 87 93
COMPLETED 81 87
NOT COMPLETED 6 6

Baseline Characteristics

Arm/Group Title High Titer Anti-SARS-CoV-2 Plasma SARS-CoV-2 Non-immune Plasma Total
Arm/Group Description Participants with High titer anti-SARS-CoV-2 plasma. Anti- SARS-CoV-2 Plasma: SARS-CoV-2 convalescent plasma (1 unit; ~200-250 mL collected by pheresis from a volunteer who recovered from COVID-19 disease and has SARS-CoV-2 antibody titers ≥ 1:320 Participants with SARS-CoV-2 non-immune plasma. SARS-CoV-2 non-immune Plasma: Normal human plasma collected prior to December 2019 Total of all reporting groups
Overall Participants 87 93 180
Age (years) [Median (Full Range) ]
Median (Full Range) [years]
48
46
48
Age, Customized (Count of Participants)
18 - 34 years
18
20.7%
26
28%
44
24.4%
35 - 44 years
19
21.8%
18
19.4%
37
20.6%
45 - 54 years
22
25.3%
19
20.4%
41
22.8%
55 - 64 years
14
16.1%
16
17.2%
30
16.7%
>/=65 years
14
16.1%
14
15.1%
28
15.6%
Sex: Female, Male (Count of Participants)
Female
41
47.1%
40
43%
81
45%
Male
46
52.9%
53
57%
99
55%
Ethnicity (NIH/OMB) (Count of Participants)
Hispanic or Latino
15
17.2%
16
17.2%
31
17.2%
Not Hispanic or Latino
72
82.8%
77
82.8%
149
82.8%
Unknown or Not Reported
0
0%
0
0%
0
0%
Race (NIH/OMB) (Count of Participants)
American Indian or Alaska Native
0
0%
0
0%
0
0%
Asian
2
2.3%
7
7.5%
9
5%
Native Hawaiian or Other Pacific Islander
1
1.1%
0
0%
1
0.6%
Black or African American
4
4.6%
6
6.5%
10
5.6%
White
80
92%
78
83.9%
158
87.8%
More than one race
0
0%
2
2.2%
2
1.1%
Unknown or Not Reported
0
0%
0
0%
0
0%
BMI (Count of Participants)
<18
2
2.3%
0
0%
2
1.1%
18-24.9
23
26.4%
34
36.6%
57
31.7%
25-29.9
30
34.5%
14
15.1%
44
24.4%
30-34.9
10
11.5%
16
17.2%
26
14.4%
35-39.9
6
6.9%
11
11.8%
17
9.4%
>/=40
3
3.4%
5
5.4%
8
4.4%
Missing
13
14.9%
13
14%
26
14.4%
Number of people in household (Count of Participants)
1
18
20.7%
26
28%
44
24.4%
2
19
21.8%
21
22.6%
40
22.2%
3
17
19.5%
15
16.1%
32
17.8%
4
17
19.5%
10
10.8%
27
15%
>/=5
12
13.8%
17
18.3%
29
16.1%
Missing
4
4.6%
4
4.3%
8
4.4%
Number of household COVID-19 positives (Count of Participants)
1
54
62.1%
54
58.1%
108
60%
2
8
9.2%
5
5.4%
13
7.2%
3
1
1.1%
3
3.2%
4
2.2%
>/=4
0
0%
1
1.1%
1
0.6%
Missing
24
27.6%
30
32.3%
54
30%
Median time from last exposure to transfusion (hours) [Median (Inter-Quartile Range) ]
Median (Inter-Quartile Range) [hours]
2
3
3
Days from last exposure to transfusion (Count of Participants)
0
7
8%
7
7.5%
14
7.8%
1
24
27.6%
16
17.2%
40
22.2%
2
12
13.8%
14
15.1%
26
14.4%
3
11
12.6%
17
18.3%
28
15.6%
4
12
13.8%
16
17.2%
28
15.6%
>/=5
7
8%
9
9.7%
16
8.9%
Missing
9
10.3%
9
9.7%
18
10%
Not transfused
5
5.7%
5
5.4%
10
5.6%
Cancer Status (Count of Participants)
Active cancer
1
1.1%
1
1.1%
2
1.1%
Active cancer on chemotherapy
0
0%
1
1.1%
1
0.6%
Cancer in remission
6
6.9%
5
5.4%
11
6.1%
Leukemia/Lymphoma
2
2.3%
6
6.5%
8
4.4%
No cancer
78
89.7%
80
86%
158
87.8%
Cardiac condition (Count of Participants)
Arrhythmia
2
2.3%
1
1.1%
3
1.7%
Atrial fibrillation, on anticoagulant
1
1.1%
0
0%
1
0.6%
Cardiomyopathy
1
1.1%
0
0%
1
0.6%
Coronary artery disease
1
1.1%
3
3.2%
4
2.2%
Myocardial infarction
0
0%
2
2.2%
2
1.1%
No cardiac condition
82
94.3%
87
93.5%
169
93.9%
Immunologic condition (Count of Participants)
Allergic rhinitis
12
13.8%
10
10.8%
22
12.2%
Inflammatory bowel disease
0
0%
3
3.2%
3
1.7%
HIV, on antiretroviral treatment
4
4.6%
6
6.5%
10
5.6%
Psoriasis
2
2.3%
0
0%
2
1.1%
Immunosuppression or on other immune modulator
1
1.1%
0
0%
1
0.6%
No immunologic condition
68
78.2%
74
79.6%
142
78.9%
Metabolic condition (Count of Participants)
Diabetes Mellitus
6
6.9%
5
5.4%
11
6.1%
Vitamin D deficiency
1
1.1%
1
1.1%
2
1.1%
No metabolic condition
80
92%
87
93.5%
167
92.8%
Respiratory condition (Count of Participants)
Asthma
4
4.6%
5
5.4%
9
5%
Chronic Bronchitis
0
0%
2
2.2%
2
1.1%
Chronic sinusitis
0
0%
1
1.1%
1
0.6%
Cough
1
1.1%
1
1.1%
2
1.1%
Pulmonary fibrosis
0
0%
1
1.1%
1
0.6%
Pulmonary hypertension
1
1.1%
1
1.1%
2
1.1%
No respiratory condition
81
93.1%
82
88.2%
163
90.6%
Tobacco use status (Count of Participants)
Current tobacco user
2
2.3%
1
1.1%
3
1.7%
Past tobacco user
1
1.1%
4
4.3%
5
2.8%
No tobacco use
84
96.6%
88
94.6%
172
95.6%

Outcome Measures

1. Primary Outcome
Title Efficacy of Treatment at Day 28 as Assessed by Number of Participants Who Develop SARS-Cov-2 Infection
Description Comparison of proportions of cumulative incidence of development of SARS-Cov-2 infection (symptoms compatible with infection and/or + molecular testing) regardless of disease severity, following high-titer Anti- SARS-CoV-2 plasma versus control (SARS-CoV-2 non-immune plasma) in subjects exposed to COVID-19.
Time Frame Day 28

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title High Titer Anti-SARS-CoV-2 Plasma SARS-CoV-2 Non-immune Plasma
Arm/Group Description Participants with High titer anti-SARS-CoV-2 plasma. Anti- SARS-CoV-2 Plasma: SARS-CoV-2 convalescent plasma (1 unit; ~200-250 mL collected by pheresis from a volunteer who recovered from COVID-19 disease and has SARS-CoV-2 antibody titers ≥ 1:320 Participants with SARS-CoV-2 non-immune plasma. SARS-CoV-2 non-immune Plasma: Normal human plasma collected prior to December 2019
Measure Participants 81 87
Count of Participants [Participants]
12
13.8%
13
14%
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection High Titer Anti-SARS-CoV-2 Plasma, SARS-CoV-2 Non-immune Plasma
Comments
Type of Statistical Test Superiority
Comments
Statistical Test of Hypothesis p-Value 0.42
Comments One-sided p-value
Method Restricted Mean Survival Test statistic
Comments
Method of Estimation Estimation Parameter Risk Difference (RD)
Estimated Value 0.01
Confidence Interval (1-Sided) 95%
to
Parameter Dispersion Type:
Value:
Estimation Comments
2. Primary Outcome
Title Safety of Treatment With High-titer Anti- SARS-CoV-2 Plasma Versus Control as Assessed by Number of Participants With "Serious Adverse Events"
Description Number of participants with serious adverse events categorized as either severe infusion reactions or Acute Respiratory Distress Syndrome during the study period.
Time Frame Up to Day 28

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title High Titer Anti-SARS-CoV-2 Plasma SARS-CoV-2 Non-immune Plasma
Arm/Group Description Participants with High titer anti-SARS-CoV-2 plasma. Anti- SARS-CoV-2 Plasma: SARS-CoV-2 convalescent plasma (1 unit; ~200-250 mL collected by pheresis from a volunteer who recovered from COVID-19 disease and has SARS-CoV-2 antibody titers ≥ 1:320 Participants with SARS-CoV-2 non-immune plasma. SARS-CoV-2 non-immune Plasma: Normal human plasma collected prior to December 2019
Measure Participants 81 87
Count of Participants [Participants]
0
0%
1
1.1%
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection High Titer Anti-SARS-CoV-2 Plasma, SARS-CoV-2 Non-immune Plasma
Comments
Type of Statistical Test Superiority
Comments
Statistical Test of Hypothesis p-Value 0.67
Comments
Method Chi-squared
Comments
Method of Estimation Estimation Parameter Risk Difference (RD)
Estimated Value -5
Confidence Interval (2-Sided) 95%
-31 to 19
Parameter Dispersion Type:
Value:
Estimation Comments
3. Primary Outcome
Title Safety of Treatment With High-titer Anti- SARS-CoV-2 Plasma Versus Control as Assessed by Cumulative Incidence of Grade 3 and 4 Adverse Events
Description Cumulative incidence of grade 3 and 4 adverse events during the study period evaluated as events per 100 person-years will be used to assess safety of the intervention.
Time Frame Up to Day 28

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title High Titer Anti-SARS-CoV-2 Plasma SARS-CoV-2 Non-immune Plasma
Arm/Group Description Participants with High titer anti-SARS-CoV-2 plasma. Anti- SARS-CoV-2 Plasma: SARS-CoV-2 convalescent plasma (1 unit; ~200-250 mL collected by pheresis from a volunteer who recovered from COVID-19 disease and has SARS-CoV-2 antibody titers ≥ 1:320 Participants with SARS-CoV-2 non-immune plasma. SARS-CoV-2 non-immune Plasma: Normal human plasma collected prior to December 2019
Measure Participants 81 87
Number (95% Confidence Interval) [Events per 100 person-years]
23
70
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection High Titer Anti-SARS-CoV-2 Plasma, SARS-CoV-2 Non-immune Plasma
Comments
Type of Statistical Test Superiority
Comments
Statistical Test of Hypothesis p-Value 0.06
Comments
Method Chi-squared
Comments
Method of Estimation Estimation Parameter Risk Difference (RD)
Estimated Value -47
Confidence Interval (2-Sided) 95%
-100 to 2
Parameter Dispersion Type:
Value:
Estimation Comments
4. Secondary Outcome
Title Number of Participants With Severe Disease
Description Number of participants with severe disease between the anti-SARS-CoV-2 convalescent plasma and control groups. Severity of disease will be measured using the number of participants with any of the disease severity categories below: Death Requiring mechanical ventilation and/or in ICU non-ICU hospitalization, requiring supplemental oxygen non-ICU hospitalization, not requiring supplemental oxygen
Time Frame Up to 28 days

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title High Titer Anti-SARS-CoV-2 Plasma SARS-CoV-2 Non-immune Plasma
Arm/Group Description Participants with High titer anti-SARS-CoV-2 plasma. Anti- SARS-CoV-2 Plasma: SARS-CoV-2 convalescent plasma (1 unit; ~200-250 mL collected by pheresis from a volunteer who recovered from COVID-19 disease and has SARS-CoV-2 antibody titers ≥ 1:320 Participants with SARS-CoV-2 non-immune plasma. SARS-CoV-2 non-immune Plasma: Normal human plasma collected prior to December 2019
Measure Participants 81 87
Count of Participants [Participants]
0
0%
2
2.2%

Adverse Events

Time Frame Within 28 days
Adverse Event Reporting Description Adverse events were evaluated among those transfused and not SARS Cov-2 positive at baseline. Adverse Events were monitored/assessed without regard to the specific Adverse Event Term.
Arm/Group Title High Titer Anti-SARS-CoV-2 Plasma SARS-CoV-2 Non-immune Plasma
Arm/Group Description Participants with High titer anti-SARS-CoV-2 plasma. Anti- SARS-CoV-2 Plasma: SARS-CoV-2 convalescent plasma (1 unit; ~200-250 mL collected by pheresis from a volunteer who recovered from COVID-19 disease and has SARS-CoV-2 antibody titers ≥ 1:320 Participants with SARS-CoV-2 non-immune plasma. SARS-CoV-2 non-immune Plasma: Normal human plasma collected prior to December 2019
All Cause Mortality
High Titer Anti-SARS-CoV-2 Plasma SARS-CoV-2 Non-immune Plasma
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 0/81 (0%) 0/87 (0%)
Serious Adverse Events
High Titer Anti-SARS-CoV-2 Plasma SARS-CoV-2 Non-immune Plasma
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 4/81 (4.9%) 14/87 (16.1%)
Blood and lymphatic system disorders
Severe transfusion reaction 0/81 (0%) 0 1/87 (1.1%) 1
General disorders
Grade 3 or 4 adverse events 4/81 (4.9%) 4 13/87 (14.9%) 13
Other (Not Including Serious) Adverse Events
High Titer Anti-SARS-CoV-2 Plasma SARS-CoV-2 Non-immune Plasma
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 24/81 (29.6%) 44/87 (50.6%)
General disorders
Non-serious adverse events 24/81 (29.6%) 24 44/87 (50.6%) 44

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

Results Point of Contact

Name/Title Shmuel Shoham
Organization The Johns Hopkins University School of Medicine
Phone 410-614-6431
Email sshoham1@jhmi.edu
Responsible Party:
Johns Hopkins University
ClinicalTrials.gov Identifier:
NCT04323800
Other Study ID Numbers:
  • IRB00245634
First Posted:
Mar 27, 2020
Last Update Posted:
Apr 26, 2022
Last Verified:
Apr 1, 2022