The purpose of this study was to evaluate the efficacy of cord-derived mesenchymal stem cell transplantation in the treatment of coadministration with other conventional therapies. It aims to reduce mortality and improve the immune system of patients.
Design
This study was a parallel randomized controlled clinical trial study design. The sample size of the study is 10 corona virus patients that will be assigned to intervention and control groups using simple randomization method.
Settings and conduct
This study will be performed to reduce the mortality of patients with COVID-19 and normalize blood tests and chest CT scan at Rasoul Akram Hospital of Iran University of Medical Sciences. Approved and admitted patients in infectious and intensive care units will be followed up for up to 28 days for the intended outcome after receiving the intervention.
Participants/Inclusion and exclusion criteria
Patients with acute form of COVID-19 infection who are confirmed by RT-PCR and HRCT will be included. Any confirmed pregnancy, viral disease, acquired or inherited immune deficiency, and mental illness will be excluded.
Intervention groups
Patients in the intervention group will be injected with an initial dose of 0.5–1 milion / kg of MSC. This process will be performed on the first, third and sixth days. This intervention will be supplemented with other treatments. The control group will receive placebo (normal saline) instead of the intervention.
Main outcome variables
Death, Pneumonia severity index, Oxygen index, C reactive protein, Procalcitonin, Lymphocyte count, CD3 +, CD4 + and CD8 + T cells count, Improved pneumonia using CT scan.
General information
Reason for update
Acronym
IRCT registration information
IRCT registration number:IRCT20140528017891N8
Registration date:2020-03-28, 1399/01/09
Registration timing:registered_while_recruiting
Last update:2020-03-28, 1399/01/09
Update count:0
Registration date
2020-03-28, 1399/01/09
Registrant information
Name
Nader Tavakoli
Name of organization / entity
Iran University Of Medical Science
Country
Iran (Islamic Republic of)
Phone
+98 21 8891 5410
Email address
tavakoli.n@iums.ac.ir
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2020-03-24, 1399/01/05
Expected recruitment end date
2020-04-13, 1399/01/25
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Evaluation of the efficacy and safety of cord-derived mesenchymal stem cell transplantation in the treatment of COVID-19
Public title
The effect of stem cell transplantation in the treatment of COVID-19
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Patients in acute phase
Laboratory confirmation of SARS-COV-2 infection
Pneumonia confirmed by chest x-ray or tomography
Respiratory rate> 30 times / minute
Oxygen Saturation less than 93%
Arterial oxygen partial pressure (Pao2) /oxygen inhalation(Fio2) less than 300 mmHg
No history of tumor or malignant disease
Exclusion criteria:
Pregnant patient with a positive pregnancy test or during lactation or who is planning to become pregnant during the study
The definitive history of acquired or inherited immune deficiency diseases
The definitive psychotic illness A history of serious mental illness or a history of suicide
The use of NG tube
Creatinine greater than 1.7 or hepatic enzymes three times normal or white blood cell count lower than 3000 and hemoglobin less than 10
Co-infection of human immunodeficiency viruses, Hepatitis B, Hepatitis C and Human T-lymphotropic virus
Age
From 18 years old to 95 years old
Gender
Both
Phase
3
Groups that have been masked
Participant
Outcome assessor
Sample size
Target sample size:
10
Randomization (investigator's opinion)
Randomized
Randomization description
We will use a randomization method to minimize the researchers' opinion to select participation in study groups to control bias. After selection, participants will be assigned to the groups using a simple randomization method for received intervention and placebo in each participant. The randomization process will be performed using Random Allocation software, and since this study consists of two groups, the allocation outputs of the participants will be identified by A and B so the assign of each patient in each group is unpredictable to other members of the research team. We will notify the team manager after selecting each patient and they will send out each patient's intervention type based on the software output, without the known of other team members. But only the clinical care will be aware of any patient's intervention in cases where the patient's condition is inappropriate.
Blinding (investigator's opinion)
Double blinded
Blinding description
After selecting each patient to the study, the patients will be selected based on the randomization output was taken from the randomization software and matching it with the patient number of the intervention in such a way that both the patients and outcome assessor will not determine the type of intervention the patients receive. Blinding in this study was double blind. To maintain the blindness of the injection shape, color of the placebo will be similar to the main intervention so that patients and physicians evaluating the final outcome will be blind of the participant's interventions to minimize the bias in outcome measurement..
Placebo
Used
Assignment
Parallel
Other design features
Secondary Ids
empty
Ethics committees
1
Ethics committee
Name of ethics committee
Ethics committee of Iran University of Medical Sciences
Street address
Iran University of Medical Sciences, Hemmat Highway
City
Tehran
Province
Tehran
Postal code
1449614535
Approval date
2020-03-16, 1398/12/26
Ethics committee reference number
IR.IUMS.REC.1398.1400
Health conditions studied
1
Description of health condition studied
COVID-19
ICD-10 code
RA01.0
ICD-10 code description
Severe Acute Respiratory Syndrome coronavirus
Primary outcomes
1
Description
Death
Timepoint
Up to 28 days after starting the study
Method of measurement
Patient observation and evaluation of vital signs
Secondary outcomes
1
Description
Evaluation of Pneumonia Severity Index
Timepoint
Up to 28 days
Method of measurement
PSI
2
Description
Evaluation of oxygen supply index
Timepoint
Discharge from ICU
Method of measurement
Pulse Oximeter
3
Description
C- Reactive protein
Timepoint
28 days or until the marker is normalized
Method of measurement
Blood sample
4
Description
Procalcitonin
Timepoint
Until the marker is normalized
Method of measurement
Blood sample
5
Description
Lymphocyte count
Timepoint
Until the marker is normalized
Method of measurement
CBC
6
Description
Counting of CD3 +, CD4 + and CD8 + T cells
Timepoint
Before the first injection and after the third injection
Method of measurement
Flow cytometry
7
Description
+ CD4 + / CD8 ratio
Timepoint
Before the first injection and after the third injection
Method of measurement
Flow cytometry
8
Description
Improve pneumonia evaluated by CT scan
Timepoint
After the second and third infusions
Method of measurement
CT scan
Intervention groups
1
Description
Intervention group: In this group, mesenchymal stem cells will be injected at an initial dose of 0.5-1 milion/ kg. This process will be performed on the first, third and sixth days. This intervention will be done along with other treatments for this type of patients, varying in severity of COVID Infectious, and in accordance with national and international guidelines. Mesenchymal Stem Cell is GMP-approved by SinaCell
Category
Treatment - Drugs
2
Description
Control group:This group, like the intervention group, will receive all routine medication according to national and international guidelines, depending on the severity of COVID-19. But on the first, third and sixth day, placebo (normal saline) will be injected
Category
Placebo
Recruitment centers
1
Recruitment center
Name of recruitment center
Rasoul Akram hospital
Full name of responsible person
Nader Tavakoli
Street address
Rasoul Akram hospital, Niyayesh St, Sattarkhan St
City
Tehran
Province
Tehran
Postal code
1445613131
Phone
+98 21 6653 9260
Email
tavakoli.n@iums.ac.ir
Sponsors / Funding sources
1
Sponsor
Name of organization / entity
MOM research and innovation center
Full name of responsible person
Amirhossein Asgary
Street address
Kordestan highway - south shiraz st - 68th st - MOM research and innovation center
City
Tehran
Province
Tehran
Postal code
1436975173
Phone
+98 21 8805 9639
Fax
+98 21 8805 9639
Email
info@mom.ir
Web page address
Grant name
MOM research and innovation center
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
MOM research and innovation center
Proportion provided by this source
100
Public or private sector
Private
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Industry
Person responsible for general inquiries
Contact
Name of organization / entity
Iran University of Medical Sciences
Full name of responsible person
Nader Tavakoli
Position
Association
Latest degree
Specialist
Other areas of specialty/work
Emergency Medicine
Street address
Rasoul Akram Hospital, Niyayesh St, Sattarkhan St.
City
Tehran
Province
Tehran
Postal code
1445613131
Phone
+98 21 6653 9260
Email
tavakoli.n@iums.ac.ir
Person responsible for scientific inquiries
Contact
Name of organization / entity
Iran University of Medical Sciences
Full name of responsible person
Omid Moradimoghadam
Position
Assistant professor
Latest degree
Subspecialist
Other areas of specialty/work
Intensive care
Street address
Rasoul Akram Hospital, Niyayesh St, Sattarkhan St.
City
Tehran
Province
Tehran
Postal code
1445613131
Phone
+98 21 6653 9260
Email
moradimoghadam.o@iums.ac.ir
Person responsible for updating data
Contact
Name of organization / entity
Shahid Beheshti University of Medical Sciences
Full name of responsible person
Elham Jamshidi
Position
General Pharmacist
Latest degree
Medical doctor
Other areas of specialty/work
Medical Pharmacy
Street address
Unit 4, No 7, Hossein Khani Alley, Asef Ave., zaferaniyeh
City
Tehran
Province
Tehran
Postal code
1988865611
Phone
+98 912 140 1972
Email
hastijamshidii20@gmail.com
Sharing plan
Deidentified Individual Participant Data Set (IPD)
Undecided - It is not yet known if there will be a plan to make this available
Study Protocol
No - There is not a plan to make this available
Statistical Analysis Plan
Yes - There is a plan to make this available
Informed Consent Form
Undecided - It is not yet known if there will be a plan to make this available
Clinical Study Report
Yes - There is a plan to make this available
Analytic Code
Undecided - It is not yet known if there will be a plan to make this available
Data Dictionary
Undecided - It is not yet known if there will be a plan to make this available
Title and more details about the data/document
Findings of the study, demographic data of participants in the study, in addition to descriptive and analytical analysis of variables.
When the data will become available and for how long
Availability four months after the end of study
To whom data/document is available
Emergency medicine and infectious, pulmonology, intensive care, and other specialists
Under which criteria data/document could be used
In the case of comparison with other similar trials or treatmen
From where data/document is obtainable
Iran University of Medical Sciences
What processes are involved for a request to access data/document
By referring to the central library and clinical trial center in Iran University of Medical Sciences can access to the documents of participants, data and results