SARS-CoV-2 CTLS for Mild to Moderate COVID-19 Disease

A Pilot Study of SARS-CoV-2 Specific Cytotoxic T Lymphocytes (SARS-CoV-2-CTLs) for Treatment of Mild to Moderate Coronavirus Disease 2019 (COVID-19)

The 2019 Severe Acute Respiratory Syndrome (SARS) is a global pandemic secondary to a novel coronavirus - SARS-CoV-2. The reported case-fatality ratio for SARS-CoV-2 in the United States is 1.8% with a current death toll of >300,000 and climbing.4 There is no accepted standard of care or FDA approved therapies for treatment of COVID-19. Virus specific cytotoxic T lymphocytes (CTLs) have become an important part of the treatment landscape for viral reactivation post hematopoietic and solid organ transplantation. Donor derived CTLs have been shown to be safe and effective against a variety of viruses including CMV, EBV, BK and adenovirus. We hypothesize that SARS-CoV-2 specific CTLs generated from a previously infected family donor will be safe and effective for treatment of COVID-19 in family members with mild to moderate disease.

Study Overview

• Status: Recruiting
• Conditions: Covid19
• Intervention / Treatment: Other: Standard of Care; Biological: SARS-CoV2-CTLS

• Study Type: Interventional
• Enrollment (Estimated): 50
• Phase: Phase 2; Phase 1

Contacts and Locations

• Study Contact: Name: Lauren Harrison, RN, MSN; Phone Number: 16172857844; Email: lauren_harrison@nymc.edu
• Study Contact Backup: Name: Mitchell S Cairo, MD; Phone Number: 9145942150; Email: mitchell_cairo@nymc.edu

Study Locations

• United States
  • New York
    • Valhalla, New York, United States, 10595
      • Recruiting
      • New York Medical College
      • Contact: Lauren Harrison, MSN, RN; Phone Number: 617-285-7844; Email: lauren_harrison@nymc.edu
      • Contact: Elizabeth Mintzer; Email: emintzer2@nymc.edu
  • Ohio
    • Columbus, Ohio, United States, 43205
      • Not yet recruiting
      • Nationwide Children's Hosptial
      • Contact: Dean Lee, MD, PhD; Phone Number: (614) 722-3550; Email: Dean.Lee@nationwidechildrens.org
  • Pennsylvania
    • Philadelphia, Pennsylvania, United States, 19104
      • Not yet recruiting
      • Children's Hospital of Pennsylvania
      • Contact: Nancy Bunin, MD; Phone Number: 215 590-2255; Email: buninn@email.chop.edu
  • Wisconsin
    • Milwaukee, Wisconsin, United States, 53226
      • Not yet recruiting
      • Medical College of Wisconsin/Children's Hospital of Wisconsin
      • Contact: Julie A Talano, MD; Phone Number: 414-955-4185; Email: jtalano@mcw.edu
      • Contact: Kathy Jodarski; Phone Number: 414-266-2681; Email: kjodarski@chw.org

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

INCLUSION CRITERIA

• Age ≥18 to 65 years. AND
• Proven infection with SARS-CoV-2, defined as detection of SARS-CoV-2 by RT-PCR from nasopharyngeal swab or lower respiratory tract specimen AND
• Hospitalized at the time of enrollment AND
• HLA Matched Family Related donor with recent SARS-CoV-2 infection is at least 10 days out from symptom onset. A negative result for COVID-19 by a diagnostic test is not necessary to qualify the donor AND
• In Stage I or II of disease (mild or moderate) at the time of enrollment (Table 1) AND

• ONE of the following high-risk conditions:

  • Chronic lung disease not requiring oxygen at home prior to admission (including but not limited to COPD, cystic fibrosis, asthma and sickle cell disease); Underlying heart disease (including hypertension); Patients with an acute myocardial infarction within the last 3 months will require cardiology clearance prior to enrollment; Diabetes mellitus (type I or II) ; Obesity (BMI ≥ 30); Immunosuppressed, based on investigator's assessment.

EXCLUSION CRITERIA:

• Stage III disease (severe) at the time of enrollment (see Table 1)
• Lack of an identified eligible HLA family related donor
• No high-risk comorbidities defined in the inclusion criteria (Section 5.1)
• Patient with acute GVHD > grade 2 or extensive chronic GVHD at the time of enrollment
• Patient treated with donor lymphocyte infusion (DLI) within 4 weeks prior to CTL Infusion
• Patients with chronic respiratory failure requiring ventilator support and/or oxygen at home prior to admission are excluded
• Patients with stage D heart failure and/or symptoms at rest are excluded
• Renal function: patients with eGFR or CrCl <30 mL/min/1.73 m2 will be excluded from study entry.
• Liver function: Total bilirubin > 2 mg/dl (unless Gilbert's syndrome) OR ALT/AST > 5 x ULN
• Patients currently listed for transplant or potentially eligible to receive organ transplants are excluded from this study
• Patient with poor performance status determined by Karnofsky (patients >16 years) or Lansky (patients ≤16 years) score ≤50%
• Female patient of childbearing age who is pregnant or breast-feeding or not willing to use an effective method of birth control during study treatment and for at least 6 weeks after the last dose of SARS-CoV-2 CTLS.
• Male subjects with female partners of childbearing age who are not willing to use an effective method of birth control during study treatment and for at least 6 weeks after the last dose of SARS-CoV-2 CTLS.

• Concurrent use of following medications is prohibited:

  • Steroids (>2 mg/kg/day prednisone equivalent); Immunotherapies within 4 weeks prior to CTL infusion including checkpoint blockade, ATG, Campath, CAR T cells, blinatumomab; Chemotherapy: Tyrosine kinase inhibitors and hydroxyurea must be stopped > 72 hours prior to SARS-COV-2-CTL cell infusion; High dose chemotherapy must be stopped > 2 weeks prior to SARS-CoV-2-CTLs. High dose chemotherapy is defined in this protocol as any cancer directed therapy causing myelosuppression; Pegylated-asparaginase must be stopped > 4 weeks prior to SARS-COV-2-CTL infusion; Intrathecal chemotherapy must be stopped > 1 week prior to SARS-COV-2-CTL infusion (e.g. intrathecal methotrexate); Anti T-cell Antibodies: Administration of any T cell lytic or toxic antibody (e.g. alemtuzumab) within 30 days prior to SARS-CoV-2-CTLs is prohibited.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: SARS-CoV-2 CTLS + Standard of Care; Patients will get family donor derived SARS-CoV-2 cytotoxic t-lymphocytes up to 5 times every 2 weeks along with Standard of care of COVID-19.	Other: Standard of Care; Patients will receive standard of care for COVID-19.; Biological: SARS-CoV2-CTLS; Patients may receive up to 5 CTL infusions to treat SARA-CoV-2 in combination with standard of care.
Active Comparator: Standard of Care Only; Patients will NOT received COVID CTLs but will get standard of care.	Other: Standard of Care; Patients will receive standard of care for COVID-19.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of adverse events	no adverse events will occur due to CTL infusion(s)	12 weeks

Collaborators and Investigators

• Sponsor: New York Medical College
• Collaborators: Children's Hospital of Philadelphia; Medical College of Wisconsin; Nationwide Children's Hospital
• Investigators: Study Chair: Mitchell S Cairo, MD, New York Medical College

Publications and helpful links

General Publications

• Chu Y, Milner J, Lamb M, Maryamchik E, Rigot O, Ayello J, Harrison L, Shaw R, Behbehani GK, Mardis ER, Miller K, Prakruthi Rao Venkata L, Chang H, Lee D, Rosenthal E, Kadauke S, Bunin N, Talano JA, Johnson B, Wang Y, Cairo MS. Manufacture and Characterization of Good Manufacturing Practice-Compliant SARS-COV-2 Cytotoxic T Lymphocytes. J Infect Dis. 2023 Mar 28;227(6):788-799. doi: 10.1093/infdis/jiac500.

Study record dates

Study Major Dates

• Study Start (Actual): September 20, 2021
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: May 19, 2021
• First Submitted That Met QC Criteria: May 19, 2021
• First Posted (Actual): May 21, 2021

Study Record Updates

• Last Update Posted (Actual): April 13, 2026
• Last Update Submitted That Met QC Criteria: April 10, 2026
• Last Verified: August 1, 2025

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; Health Services Administration; Health Care Quality, Access, and Evaluation; Quality of Health Care; Quality Indicators, Health Care; Standard of Care
• Other Study ID Numbers: NYMC 604

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

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