- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04344288
Corticosteroids During Covid-19 Viral Pneumonia Related to SARS-Cov-2 Infection (CORTI-Covid)
Infection with the SARS-Cov-2 virus, responsible of severe acute respiratory distress syndrome (SARS), is an emerging infectious disease called Covid-19 and declared as pandemic by the World Health Organization on March 11, 2020. This pandemic is responsible of significant mortality. In France, several thousand patients are hospitalized in intensive care units, and their number continues to increase. Mortality during Covid-19 is mainly linked to acute respiratory distress syndrome, which frequency is estimated in France to occur in 6% of infected patients. Comorbidities such as cardiovascular conditions, obesity and diabetes increase susceptibility to severe forms of Covid-19 and associated mortality. Therapeutic management has three components: symptomatic management, including supplementary oxygen therapy and in case of respiratory distress mechanical ventilation; the antiviral approach; and immunomodulation, aiming at reducing inflammation associated with viral infection, which is considered to take part in severe presentations of the disease.
During Covid-19 viral pneumonia related to SARS-COv-2, there is a significant release of pro-inflammatory cytokines in the acute phase of viral infection, which could participate in viral pneumonia lesions. In children with less mature immune system than adults, SARS-Cov-2 infection is less severe. The current prevailing assumption is that severe forms of Covid-19 may not only be related to high viral replication, but also to an excessive inflammatory response favoring acute lung injury and stimulating infection.
The investigators hypothesize that early control of the excessive inflammatory response may help reducing the risk of acute respiratory distress syndrome.
The investigators will evaluate the benefit, safety and tolerability of corticosteroid therapy to reduce the rate of subjects hospitalized for Covid-19 viral pneumonia who experience clinical worsening with a need of high-flow supplemental oxygen supplementation or transfer in intensive care units for respiratory support.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Bron, France
- Hôpital Pneumologique et Cardiovasculaire Louis Pradel
-
Lyon, France
- Hôpital Edouard Herriot
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Lyon, France
- Groupement Hospitalier Nord
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Lyon, France
- Hôpital St Joseph Saint Luc
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Marseille, France
- Hôpital St Joseph
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Pierre-Bénite, France
- Centre Hospitalier Lyon Sud
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Saint-Étienne, France
- CHU St Etienne
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Sainte-Foy-lès-Lyon, France
- Clinique Charcot
-
Vienne, France
- CHG Vienne
-
Villeurbanne, France
- Medipole
-
Vénissieux, France
- Clinique des Portes du Sud
-
Épagny, France
- CH Annecy-Genevois
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age ≥ 18 years old,
- Hospitalization for COVID-19 infection confirmed by RT-PCR or other virological method,
- Peripheral saturation by pulse oximeter SpO2 ≤ 94% in ambient air measured twice at 5-15 min intervals, or PaO2 / FiO2 <300 mmHg,
- Abnormalities on the chest x-ray or CT scan suggestive of viral pneumonia,
- Signed informed consent by the patient.
Exclusion Criteria:
- Covid-19 infection with first symptoms lasting for more than 9 days according to the patient's interview; D1 of symptoms is defined by the first day with fever, cough, shortness of breath, and / or chills related to Covid-19 infection;
- Patients with primary or secondary immune deficiency, including: HIV, chronic hematological disease, solid organ transplant, ongoing immunosuppressive therapy,
- Long-term corticosteroid therapy defined by a prescription of more than 10 mg/d (prednisone equivalent),
- Suspected or confirmed infection with bacteria, fungal agents or viruses (in addition to Covid-19),
- Known contraindication to systemic corticosteroids,
- Systolic blood pressure <80 mmHg,
- SpO2 <90% under 5 L / min of oxygen using medium concentration mask, or higher oxygen requirements,
- Patient on long-term oxygen therapy,
- Ongoing mechanical ventilation,
- Ongoing septic shock ongoing,
- Ongoing multi-organ failure ongoing,
- Participating in other COVID-19 therapeutic clinical trial
- Pregnant or breast-feeding woman (oral diagnosis),
- No affiliation or beneficiary of health insurance,
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: Control group
|
The control group will receive standard of care according to the international recommendations and practices of the investigational site.
No corticosteroid therapy can be prescribed in this group.
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Experimental: Prednisone group
Prednisone during 10 days after randomization
|
The experimental group will receive oral prednisone during 10 days (0.75 mg/kg/day during 5 days then 20 mg/day during 5 more days)
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of patients with a theoretical respiratory indication for transfer to intensive care unit evaluated by a SpO2 <90% stabilized at rest and under not more than 5 L / min of supplemental oxygen using medium concentration mask.
Time Frame: 7 days
|
SpO2 <90% stabilized at rest and under not more than 5 L / min of supplemental oxygen using medium concentration mask.
measured twice at 5-15 min intervalsThe average value of the two measurements will be calculated.
|
7 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
disease severity assessed on a 7-level ordinal scale
Time Frame: 7 days
|
level1: not hospitalized no limited activities, level 7: death
|
7 days
|
number of patients with a supplemental oxygen use
Time Frame: 7 days
|
7 days
|
|
radiological signs on chest imaging
Time Frame: 7 days
|
Reduction of radiological signs on chest imaging
|
7 days
|
number of patients transferred to intensive care unit
Time Frame: 21 days
|
21 days
|
|
number of patients requiring invasive ventilation
Time Frame: 21 days
|
21 days
|
|
Duration of oxygen therapy
Time Frame: 21 days
|
duration on days
|
21 days
|
number of adverse events induced by corticosteroid treatment
Time Frame: 21 days
|
21 days
|
|
number of patients with infections other than SARS-CoV-2
Time Frame: 21 days
|
21 days
|
|
number of deaths
Time Frame: 21 days
|
21 days
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jean-François MORNEX, Hospices Civils de Lyon
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Coronavirus Infections
- Coronaviridae Infections
- Nidovirales Infections
- RNA Virus Infections
- Virus Diseases
- Infections
- Respiratory Tract Infections
- Respiratory Tract Diseases
- Lung Diseases
- COVID-19
- Pneumonia
- Pneumonia, Viral
- Physiological Effects of Drugs
- Anti-Inflammatory Agents
- Antineoplastic Agents
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antineoplastic Agents, Hormonal
- Prednisone
Other Study ID Numbers
- 69HCL20_0321
- 2020-001553-48 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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