Clinical trial NCT04869579: Selenium as a Potential Treatment for Moderately-ill, Severely-ill, and Critically-ill COVID-19 Patients.
Official title: Selenium as a Potential Treatment for Moderately-ill, Severely-ill, and Critically-ill COVID-19 Patients
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE2
Conditions: Covid19
Keywords: COVID-19 Pneumonia
Cytokine Storm
ARDS
Moderate COVID-19 Infections
Severe COVID-19 Infections
Critical COVID-19 Infections
Selenium
Lead sponsor: CHRISTUS Health
Sponsor class: OTHER
Collaborators: name: Pharco Pharmaceuticals
First posted: 2021-05-03
Enrollment: 100
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: This is a randomized double-blinded, placebo-controlled Phase 2 clinical trial to assess the efficacy of Selenium in the treatment of moderately-ill, severely-ill, and critically ill COVID-19 patients. The patients will be randomized in a 1:1 ratio to receive standard of care plus a loading dose of Selenium followed by continuous infusion for a total of 14 days, or standard of care plus a Saline-based placebo.
Primary purpose: TREATMENT

Brief summary: Given its anti-viral, anti-oxidative, immune-enhancing, cytokine-modulating, and anticoagulant properties, the investigators hypothesize that Selenium infusion at supranutritional doses for moderately-ill, severely-ill, and critically-ill COVID-19 patients will prevent further clinical deterioration thus decreasing overall mortality and improving survival. To test this hypothesis, a prospective, single-center, phase II trial is proposed to assess the efficacy of Selenium in hospitalized adult patients with moderate, severe, and critical COVID-19 infections.

Detailed description: COVID-19 is a respiratory illness that is caused by the novel SARS-CoV-2. Illness severity can widely range from mild, moderate, severe featuring pneumonia, to critical. Despite ongoing extensive research to find a cure for COVID-19, there had been no proven, efficacious, and widely-available treatment for the disease. With the death toll rising in various parts of the US and the world, it is imperative that investigators work on determining new therapeutic modalities. This study relates to inpatient and critical care for COVID-19 patients.

The role of Selenium (Se) as a trace element involved in many biological processes and reactions is well established in various organisms. Particularly, Selenium is known to have anti-viral, anti-oxidative, cytokine-modulating, immune-enhancing, and anticoagulant properties that might be beneficial in COVID-19 infections given the pathophysiological processes involved in the disease. Multiple preclinical and clinical studies have shed the light on the various effects exerted by Selenium in multiple inflammatory conditions including acute lung injury and acute respiratory distress syndrome, as well as viral infections including HIV and Influenza. The study team aims to explore the possible role of Selenium in mitigating the inflammatory processes involved in COVID-19 infections and hence its effect on disease progression and mortality.

Patients with COVID-19 who exhibit the signs and symptoms of moderate or severe infection or are critically ill will receive Selenium infusion for 14 days. The working hypothesis of this trial is that selenium treatment would decrease the death rates and increase the rate of hospital discharges among hospitalized patients.

Eligibility criteria: Inclusion Criteria:

1. Willing and able to provide written informed consent, or with a legal representative who can provide informed consent, or enrolled under International Conference on Harmonization (ICH) E6(R2) 4.8.15 emergency use provisions as deemed necessary by the investigator (age ≥18) prior to performing study procedure.
2. Aged ≥ 18 years.
3. Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV)-2 infection confirmed by polymerase chain reaction (PCR) test ≤ 4 days before randomization.
4. Currently hospitalized.
5. Peripheral capillary oxygen saturation (SpO2) ≤ 94% or requiring supplemental oxygen on screening.

Exclusion Criteria:

1. Participation in any other clinical trial of an experimental treatment for COVID-19.
2. Evidence of multiorgan failure.
3. Mechanically ventilated for \> 5 days.
4. Alanine Aminotransferase (ALT) or aspartate aminotransferase (AST) \> 5 X upper limit of normal (ULN).
5. Creatinine clearance \< 50 mL/min.

Primary outcomes:
measure: Mean change in the ordinal scale
timeFrame: Day 1 through Day 29
measure: Rate of hospital discharges or deaths
timeFrame: Study duration
Secondary outcomes:
measure: Clinical status using ordinal scale
timeFrame: Day 1 through Day 29
measure: Mean change in the ordinal scale
timeFrame: Day 1 though Day 29
measure: Time to an improvement of one category using an ordinal scale
timeFrame: Day 1 though Day 29
measure: Change in National Early Warning Score (NEWS) from baseline
timeFrame: Day 1 through Day 29
measure: Cumulative incidence of serious adverse events (SAEs)
timeFrame: Day 1 through Day 29
measure: Duration of hospitalization
timeFrame: Day 1 though Day 29
measure: Incidence of new oxygen use
timeFrame: Day 1 though Day 29
measure: Duration of new oxygen use
timeFrame: Day 1 though Day 29
measure: Incidence of new non-invasive ventilation or high flow oxygen use
timeFrame: Day 1 though Day 29
measure: Duration of new non-invasive ventilation or high flow oxygen use
timeFrame: Day 1 though Day 29
measure: Incidence of new ventilator use
timeFrame: Day 1 though Day 29
measure: Duration of new ventilator use
timeFrame: Day 1 though Day 29
measure: Discontinuation or temporary suspension of investigational therapeutics
timeFrame: Day 1 through Day 14
measure: Change from baseline in alanine transaminase (ALT)
timeFrame: Day 1 through Day 29
measure: Change from baseline in aspartate transaminase (AST)
timeFrame: Day 1 through Day 29
measure: Change from baseline in creatinine (Cr)
timeFrame: Day 1 through Day 29
measure: Change from baseline in glucose
timeFrame: Day 1 through Day 29
measure: Change from baseline in hemoglobin
timeFrame: Day 1 through Day 29
measure: Change from baseline in platelets
timeFrame: Day 1 through Day 29
measure: Change from baseline in prothrombin time
timeFrame: Day 1 through Day 29
measure: Change from baseline in total bilirubin
timeFrame: Day 1 through Day 29
measure: Change from baseline in white blood cell count (WBC) with differential
timeFrame: Day 1 through Day 29
measure: Change from baseline in interleukin-1 (IL-1)
timeFrame: Day 1 through Day 29
measure: Change from baseline in interleukin-6 (IL-6)
timeFrame: Day 1 through Day 29
measure: Change from baseline in tumor necrosis factor alpha (TNF-α)
timeFrame: Day 1 through Day 29
Other outcomes:
Locations:
city: Longview
country: United States
facility: CHRISTUS Good Shepherd Medical Center
state: Texas
Study officials:
affiliation: CHRISTUS Health
name: Mohamed S Ghoweba, MD
role: PRINCIPAL_INVESTIGATOR
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