- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04390191
Early CPAP in COVID-19 Confirmed or Suspected Patients (PAP-COVID)
Early Continuous Positive Airway Pressure (CPAP) in COVID-19 Confirmed or Suspected Patients
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
New York
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New York, New York, United States, 10029
- Icahn School of Medicine at Mount Sinai
-
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion criteria:
- Adults > 18 years old
- Patients living alone or with more than one room at home
- COVID confirmed or suspected
- To be discharged home or already discharged
- One or more of these: fever (>38oC), sore throat, myalgia or flu-like illness
- One or more of the following: abnormal chest x-ray, new onset cough, mild hypoxemia (saturation between 92-96%), abnormal lung exam, chest tightness or shortness of breath
Exclusion criteria:
- Unable to self quarantine for 72 hours if in the CPAP arm
- Preexisting pulmonary diseases such as advanced COPD, advanced parenchymal lung disease, history of pneumothorax etc.
- Claustrophobic and unable to tolerate CPAP mask
- Evidence of hypercapnia
- Recent heart of lung surgery within 3 months
- Individuals without access to smart phones or wireless connection or internet access
- Prior history of aspiration
- Speech or swallowing impairment (risk of aspiration)
- History of stroke with significant neurologic deficit
- Advanced symptomatic heart failure
- Unable to provide informed consent
- household with young children and child care responsibilities
- household with high-risk individuals (defined as over 60 or with comorbidities (e.g. heart disease, diabetes, pulmonary))
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 |
---|---|
Experimental: Continuous Positive Airway Pressure (CPAP)
Patients will be given CPAP at fixed pressure of 8-10 cm water pressure for 72 hours continuously
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CPAP at fixed pressure (8-10cm H20) for 72 hours continuously (except for daily activities such as eating, personal activities and breaks for ambulation etc).
Other Names:
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No Intervention: Control
Patients in this arm will be not be given any intervention and will be monitored for 72 hours continuously, and then daily for a total of 14 days.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants Who Met the Efficacy Endpoint
Time Frame: 14 days
|
Number of participants who met the efficacy endpoint within 14 days. The efficacy endpoint is meeting any of the following: All-cause mortality within 14 days of randomization, hospital admission (including ED visit) within 14 days of randomization, oxygen saturation less than 90 during the 72-hour observation period from randomization, absolute reduction in oxygen saturation of more than 4% during the 72-hour observation period from randomization. If a participant meets any of the events noted in the composite endpoint, it is counted as a worse outcome. The composite endpoints were selected based on available covid-related information at the time of the study design. This study was conducted to determine measures that alleviated hospital burden, allowing patients to be managed at home. Oxygen-related endpoints measure improvement in a home setting and contribute to a higher number of events in the composite outcomes, to provide enough power to measure efficacy in a small trial. |
14 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants Admitted to the ICU
Time Frame: 14 days from randomization
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Number of Participant with an admission to the intensive care unit within 14 days from randomization
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14 days from randomization
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Time to Intubation and Mechanical Ventilation
Time Frame: 14 days from randomization
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The time from randomization to the patient needing to be intubated and needing mechanical ventilation within 14 days from randomization
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14 days from randomization
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Number of Deaths at 14 Day and 28 Day Mortality
Time Frame: 14-28 days from randomization
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Mortality Rate - the number of deaths within 14 and 28 days from randomization
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14-28 days from randomization
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Conversion of COVID Household Members in CPAP vs Control
Time Frame: 14 days from randomization
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The number of household members converting from being COVID negative to COVID positive in the CPAP arm vs the control arm within 14 days from randomization
|
14 days from randomization
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Change in Clinical COPD Questionnaire (CCQ)
Time Frame: baseline and 14 days from randomization
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Mean Change in CCQ - If there is any improvement in respiratory symptoms of cough or shortness of breath etc. assessed via a respiratory symptom questionnaire within 14 days from randomization. Patients were monitored for 72 hours continuously, and then daily for a total of 14 days. The time frame is a change between the baseline COPD score at the time of enrollment and the last COPD score recorded within the following 14 days. The CCQ is a 10-item instrument questionnaire, with each question scored on a scale of 0 to 6. Thus, the full scale is 0 to 60, with higher score indicating lower health status. A negative value indicates that their score improved. A decrease in CCQ indicates improvement, Last Observation Carried Forward (LOCF) applied. |
baseline and 14 days from randomization
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Number of Patients Electing to Continue CPAP for Greater Than 72 Hours
Time Frame: 7 days from randomization
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Number of the patients in the CPAP arm elect to continue using the CPAP after the initial 72 hour period.
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7 days from randomization
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Number of Participants With Improvement in Oxygen Saturation
Time Frame: 14 days from randomization
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The number of participants with improvement in oxygen saturation within 14 days of randomization.
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14 days from randomization
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Number of Participants With Hospital Admission or ED
Time Frame: 14 days from randomization
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Number of participants with hospital admission or ED within 14 days of randomization
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14 days from randomization
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Collaborators and Investigators
Investigators
- Principal Investigator: Neomi Shah, MD, MPH, MS, Icahn School of Medicine at Mount Sinai
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- GCO 20-0900
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
product manufactured in and exported from the U.S.
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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