Cannabidiol in Patients With COVID-19 and Cardiovascular Disease or Risk Factors

Study to Evaluate the Efficacy and Safety of CardiolRx™ in Patients With COVID-19 and Cardiovascular Disease or Risk Factors A Double-blind, Placebo-controlled Trial

Non-critical patients, hospitalized within the previous 24 hours who tested positive for COVID-19 and have a prior history of cardiovascular disease (CVD) and/or significant risk factors for CVD will be treated for 28 days.

Study Overview

• Status: Terminated
• Conditions: Cardiovascular Diseases; COVID-19; Cardiovascular Risk Factor
• Intervention / Treatment: Drug: Cannabidiol, pharmaceutically produced with < 5 ppm THC; Drug: Placebo

Detailed Description

Multi-center, double-blind, randomized, placebo-controlled, parallel group design. 1:1 randomization.

Screening (Day 0-1): Patients hospitalized for COVID-19 within the past 24 hours will be screened. If patient consent can be obtained, baseline assessments will be carried out: Physical examination (including vital signs), ECG including QTc interval assessment, echocardiogram to measure left-ventricular ejection fraction (LVEF), chest X-ray, local laboratory (including CBC, AST/ALT, alkaline phosphatase, bilirubin, creatinine/eGFR, INR, pregnancy test (in women with child-bearing potential only), lymphocyte count and LDH. A C-SSRS will also be completed. Frozen plasma will be retained for central analysis of CardiolRx™ levels, hs-troponin, NT-proBNP, D-dimer as well as inflammatory markers (hs-CRP, ferritin, TNF-alpha, IL-1 beta, IL-6, IL-10).

If all eligibility criteria are met, the patient will be randomized to either CardiolRx™ or placebo.

Study treatment will be initiated immediately after all baseline assessments have been completed and the patient is randomized (Day1). Oral administration is as follows:

• Day 1 and Day 2: Initial dose: 2.5 mg/kg of body weight b.i.d. with food: CardiolRx™ or placebo
• Day 3 and Day 4: Increased to 5 mg/kg of body weight b.i.d. with food: CardiolRx™ or placebo
• Day 5 to Day 28: Increased to 7.5 mg/kg of body weight b.i.d. with food: CardiolRx™ or placebo For the first 7 days and on Day 10, an ECG will be recorded 4 hours post morning dose with QTc intervals measured. If the QTc interval is >500 msec or an increase of > 60 msec from baseline is observed, the study medication must be stopped immediately.

If the next higher dose is not tolerated for other reasons, the dose will be reduced to the previous tolerated dose. The highest tolerated dose will be administered until Day 28.

If the patient is discharged before Day 10, the assessments up to Day 10 will be carried out as home visits. After Day 10, all remaining scheduled assessments will be carried out during out-patient visits (or home visits, if out-patient visits are not feasible).

In addition to prolongation of the QTc intervals, careful observation is required to detect other Adverse Drug Reactions (ADRs) and Drug-Drug Interactions (DDIs). Because CardiolRx™, may inhibit the metabolism of other drugs, new symptoms may represent toxicity from a concomitant medication that had previously been well tolerated.

A nasopharyngeal swab will also be done every day until Day 7 and on Day 14 to test for presence of the SARS-CoV-2 virus.

After Day 7, assessments will be carried out on a weekly basis except for as noted above on Day 10.

Frozen plasma will be retained for central analysis of CardiolRx™ levels, hs-troponin, NT-proBNP, D-dimer, inflammatory markers (hs-CRP, ferritin, TNF-alpha, IL-1 beta, IL-6, IL-10) and additional parameters of interest every two days until Day 7 as well as on day 28.

The assessments on Day 28 include the following: Physical examination (including vital signs), ECG (recorded 4 hours post morning dose for measurement of QTc interval), echocardiogram to measure LVEF, chest X-ray, local laboratory assessments, including CBC, AST/ALT, alkaline phosphatase, bilirubin, creatinine/eGFR, INR, lymphocyte count and LDH. In addition, a C-SSRS will be completed and the patient will be asked to answer a PICQ.

Further follow-up visits are scheduled for Day 45 and Day 60 post randomization. These include a clinical assessment (including vital signs) as well as the completion of the PICQ (PICQ on Day 60 only). Any changes in concomitant medications and (S)AEs will also be recorded.

• Study Type: Interventional
• Enrollment (Actual): 90
• Phase: Phase 2; Phase 3

Contacts and Locations

Study Locations

• Brazil
  • Rio de Janeiro, Brazil, 24020
    • Complexo Hospitalar de Niteroi- Centro de Pesquisa Clinica
  • Paraná
    • Campo Largo, Paraná, Brazil, 83606
      • Science Valley Research Institute
    • Maringá, Paraná, Brazil, 87020-900
      • Universidade Estadual de Maringá
  • Rio Grande do Sul
    • Porto Alegre, Rio Grande do Sul, Brazil
      • Irmandade Santa Casa de Misericórdia
    • Porto Alegre, Rio Grande do Sul, Brazil, 90619-900
      • Hospital Sao Lucas PUCRS
  • Santa Maria
    • Conjunto ACM, Santa Maria, Brazil, 30380-472
      • Nucleo de Ensino e Pesquisa do Instituto Mario Penna
  • São Paulo
    • Barretos, São Paulo, Brazil, 14784-400
      • Fundação PIO XII - Hospital de Amor Barretos
    • Campinas, São Paulo, Brazil, 13060-080
      • IPECC-Instituto de Pesquisa Clínica de Campinas
    • Cerqueira César, São Paulo, Brazil, 05403-000
      • Instituto do Coração do HCFMUSP
    • Jabaquara, São Paulo, Brazil, 1409
      • SVRI- Irmandade de Santa Casa de Misercordia de Santos
    • Santo André, São Paulo, Brazil, 1409
      • Science Valley Research Institute
    • São José do Rio Preto, São Paulo, Brazil, 15090-000
      • Fundação Faculdade Regional de Medicine de Sao Jose do Rio Preto (SJRP)
• Mexico
  • Nuevo León
    • Monterrey, Nuevo León, Mexico, 64718
      • TecSalud
• United States
  • Arizona
    • Phoenix, Arizona, United States, 85008
      • Valleywise Health Medical Center
  • Florida
    • Cutler Bay, Florida, United States, 33189
      • JY Research Institute
    • Miami, Florida, United States, 33155
      • Westchester General Hospital
    • Tampa, Florida, United States, 33613
      • University of South Florida
  • Illinois
    • Springfield, Illinois, United States, 62769
      • Prairie Education And Research Cooperative
  • Texas
    • San Antonio, Texas, United States, 78229
      • University of Texas Health Science Center
    • Temple, Texas, United States, 76508
      • Baylor Scott & White Health - Temple

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Males and females 18 years of age or older 2. Hospitalized for COVID-19 with the most recent test positive*; not receiving or likely to receive invasive mechanical ventilation within the next 24 hours 3. Prior history of at least one of: i) CVD [cardiovascular (CV), cerebrovascular or peripheral vascular diagnoses], ii) Age > 64, iii) Diabetes (DM), iv) Hypertension (HTN), v) Abnormal serum lipids, vi) Obesity (BMI > or equal 30 or waist circumference >102 cm [40"] for men and >88 cm [35"] for women), vii) Current smoker

* Must be PCR test.

Exclusion Criteria:

1. Patients who have received vasopressors, extracorporeal membrane oxygenation and mechanical ventilation within last 30 days
2. Background of cardiac transplant surgery
3. Implanted defibrillator (ICD) in the last three months
4. Implanted left-ventricular assist device (LVAD)
5. Acute coronary syndrome (ACS) within 30 days
6. Percutaneous coronary intervention (PCI) within 30 days
7. Receiving any immuno-suppressive agent other than dexamethasone
8. History of QTc interval prolongation
9. QTc interval > 500 msec
10. Treated with strong inducers of CYP3A4 or CYP2C19
11. Chronic renal failure, determined as eGFR < 30 ml/min
12. Elevated alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 5 times the upper limit of normal (ULN) or ALT or AST >3x ULN plus bilirubin >2x ULN
13. Bacterial sepsis, defined as documented bacteremia at the time of presentation or other active bacterial infection
14. Current participation in any research study involving investigational drugs or devices with the exception of dexamethasone, remdesivir, baricitinib plus remdesivir, convalescent plasma or monoclonal antibodies against the SARS-CoV-2 virus or any other therapy approved under emergency use in the region for treatment of COVID-19
15. Inability or unwillingness to give informed consent
16. Ongoing drug, alcohol or cannabis abuse
17. Women who are pregnant or breastfeeding
18. Any factor, which would make it unlikely that the patient can comply with the study procedures
19. Hemoglobin <8.5 gm/dL
20. Leukocyte count < 3000/ mm3
21. Platelets < 100,000 / mm3
22. Current diagnosis of cancer, with the exception of non-melanoma skin cancer
23. Showing suicidal tendency as per the Columbia-Suicide Severity Rating Scale (C-SSRS) administered at screening
24. Any cannabinoid intake in the past month
25. Body weight > 170 kg

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Placebo	Drug: Placebo; Placebo 2.5 mg/kg to 7.5 mg/kg of body weight b.i.d taken orally with food
Experimental: Cannabidiol, pharmaceutically produced with < 5 ppm THC; CardiolRx	Drug: Cannabidiol, pharmaceutically produced with < 5 ppm THC; CardiolRx 2.5 mg/kg to 7.5 mg/kg of body weight b.i.d taken orally with food; Other Names: CardiolRx

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Composite of All-cause Mortality, Requirement for ICU Admission and/or Ventillatory Support and Cardiovascular Complications	Proportions of patients in each group not having one of the outcome measures as described above (All-cause mortality, requirement for ICU admission and/or ventillatory support and cardiovascular complications)	28 days post randomization

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Ordinal Outcome Scale	Ordinal Outcome Scale: Not hospitalized and no limitations of activities.; Not hospitalized, with limitation of activities, home oxygen requirement, or both.; Hospitalized, not requiring supplemental oxygen and no longer requiring ongoing medical care.; Hospitalized, not requiring supplemental oxygen but requiring ongoing medical care.; Hospitalized, requiring any supplemental oxygen.; Hospitalized, requiring noninvasive ventilation or use of high-flow oxygen devices.; Hospitalized, receiving invasive mechanical ventilation or ECMO.; MI or stroke diagnosed since randomization.; Death.	28 days

Collaborators and Investigators

• Sponsor: Cardiol Therapeutics Inc.
• Investigators: Study Chair: Dennis McNamara, MD, University of Pittsburgh

Study record dates

Study Major Dates

• Study Start (Actual): April 30, 2021
• Primary Completion (Actual): November 30, 2022
• Study Completion (Actual): November 30, 2022

Study Registration Dates

• First Submitted: November 2, 2020
• First Submitted That Met QC Criteria: November 3, 2020
• First Posted (Actual): November 4, 2020

Study Record Updates

• Last Update Posted (Actual): April 21, 2026
• Last Update Submitted That Met QC Criteria: March 31, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Respiratory Tract Infections; Infections; RNA Virus Infections; Virus Diseases; Respiratory Tract Diseases; Lung Diseases; Pneumonia, Viral; Pneumonia; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; COVID-19; Cardiovascular Diseases; Organic Chemicals; Hydrocarbons; Terpenes; Cannabinoids; Cannabidiol
• Other Study ID Numbers: CARDIOL 100-03

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The data will become available once the study has been published
• IPD Sharing Time Frame: Data will become available in Q4 2022
• IPD Sharing Access Criteria: Access to the journal in which article has been published
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No