Clinical trial NCT04594460: Hydrogen-oxygen Gas Mixture Inhalation in Patients With Convalescent Coronavirus Disease 2019 (COVID-19)
Official title: A Clinical Trial to Evaluate the Efficacy and Safety of Hydrogen-oxygen Mixed Gas Inhalation in Convalescent Severe/Critically Ill Patients With Novel Coronavirus Pneumonia (COVID-19)
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Covid19
Hydrogen-oxygen Gas
AMS-H-03
Keywords: Covid19
Hydrogen-oxygen Gas
AMS-H-03
Lead sponsor: Guangzhou Institute of Respiratory Disease
Sponsor class: OTHER
First posted: 2020-10-20
Enrollment: 198
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Subjects in the experimental arm and the control arm will receive hydrogen-oxygen mixed gas inhalation (Hydrogen-Oxygen Generator with Nebulizer, AMS-H-03, output: 3 L/min (hydrogen concentration: 66.7%, oxygen concentration: 33.3%)) and oxygen inhalation (OLO-1 Medical Molecular Sieve Oxygen Generator, output: 3 L/min (oxygen concentration: 33.3%), Shanghai Ouliang Medical Devices Co., Ltd.), respectively; the targeted treatment duration will be 8 hours per day, for 12 weeks.
Primary purpose: TREATMENT

Brief summary: This study is a multicenter, randomized, open, parallel-controlled study. Qualified subjects will randomly be assigned to the experimental arm or the control arm according to the ratio of 1:1, with age (\> 60 years or ≤ 60 years), smoking status (yes/no) and forced expiratory volume in one second/prediction (FEV1 %pred \> 60% or ≤ 60%) as the random stratification factors.

Detailed description: Subjects in the experimental arm and the control arm will receive hydrogen-oxygen mixed gas inhalation (Hydrogen-Oxygen Generator with Nebulizer, AMS-H-03, output: 3 L/min (hydrogen concentration: 66.7%, oxygen concentration: 33.3%)) and oxygen inhalation (OLO-1 Medical Molecular Sieve Oxygen Generator, output: 3 L/min (oxygen concentration: 33.3%), Shanghai Ouliang Medical Devices Co., Ltd.), respectively; the treatment duration will not be less than 8 hours per day, for 12 weeks.

Subjects in the experimental arm and the control arm will also receive other medications (excluding antiviral drugs) by the investigator as clinically indicated. Six visits are required for each subject in this study, including Visit 1 (D-7\~-1), Visit 2 (D1), Visit 3 (D14±3d), Visit 4 (D28±3d), Visit 5 (D56±7d), Visit 6 (D84±7d).

Eligibility criteria: Inclusion Criteria:

* 1） Male or female, aged between 18 and 75 (including boundary values) at screening.

  2) Severe or critically ill patients who have been diagnosed with a novel coronavirus during hospitalization (COVID-19).

  3) After treatment, the patients have met the discharge criteria of "COVID-19 Diagnosis and Treatment Guideline", and the time from hospital discharge is at least 1 month at the time of enrollment. The clinical symptoms of the subjects did not worsen significantly as compared with that at the time of discharge, and the COVID-19 nucleic acid test results are negative for at least 2 consecutive times (one of which could be the nucleic acid test before discharge).

  4) Forced vital capacity/per predicted (FVC% pred) ≥ 50%. 5) 50% ≤ FEV1 %pred ≤80%。 6) Subject (or legally authorized representative) provides written informed consent prior to initiation of any study procedures. Understands and agrees to comply with planned study procedures.

  7) Agrees not to participate in other drug/device studies until the study is completed.

Exclusion Criteria:

* 1) With one of the following respiratory diseases:

  1. Subjects with asthma history, or cannot rule out asthma based on the diagnosis of investigator;
  2. Subjects with chronic obstructive pulmonary disease (COPD);
  3. Subjects with following respiratory diseases such as active tuberculosis, lung cancer, sarcoidosis, pulmonary hypertension, pneumothorax, uncontrolled pleural effusion through intervention, pulmonary embolism, etc.;
  4. Lung volume reduction: subjects have had lung volume reduction surgery, pulmonary lobectomy, or bronchoscopic lung volume reduction surgery.

     2) Subjects with pulmonary heart disease. 3) Patients who are scheduled for elective surgery during the study period, such as thoracic and abdominal major surgery.

     4) Subjects, judged by investigators, with previous or current diseases, which may affect the participation in this study or the outcome of this study: such as cancer, diseases of heart, liver, kidney, hematopoietic system and other vital organs or systems, etc.

     5) Patients who have undergone surgery within 1 month prior to screening and have not fully recovered.

     6) Occurrence of congestive heart failure, uncontrolled or unstable angina or myocardial infarction, cerebrovascular accident, or history of pulmonary embolism within 6 months prior to screening.

     7) Patients with active tuberculosis infection within 12 months prior to screening.

     8) Pregnancy or lactating women, or women of childbearing potential not agree to either abstinence or use at least one primary form of contraception from the time of screening till the study is completed.

     9) Subjects with mental disorders or other conditions that are unable to cooperate effectively with the conduct of the clinical trial.

     10) Subjects intolerance to inhalation therapy. 11) Others whom the investigator or sub-investigator judged inappropriate for participation in the study.

Primary outcomes:
measure: (VO2max)
timeFrame: The change from baseline in maximum oxygen consumption (VO2max) at maximum exercise load at Week 12 of treatment.
Secondary outcomes:
measure: (VO2max)
timeFrame: The change from baseline in maximum oxygen consumption (VO2max) at maximum exercise load at Week 4 of treatment.
measure: (VO2max)
timeFrame: The change from baseline in maximum oxygen consumption (VO2max) at maximum exercise load at Week 8 of treatment.
measure: (VE /VCO2)
timeFrame: Differences in the change from baseline in ventilatory equivalent for carbon dioxide (VE /VCO2) at maximum exercise load at Week 4 of treatment.
measure: (VE /VCO2)
timeFrame: Differences in the change from baseline in ventilatory equivalent for carbon dioxide (VE /VCO2) at maximum exercise load at Week 8 of treatment.
measure: (VE /VCO2)
timeFrame: Differences in the change from baseline in ventilatory equivalent for carbon dioxide (VE /VCO2) at maximum exercise load at Week 12 of treatment.
measure: (VE /VO2)
timeFrame: Differences in the change from baseline in ventilatory equivalent for oxygen (VE /VO2) at maximum exercise load at Week 4 of treatment.
measure: (VE /VO2)
timeFrame: Differences in the change from baseline in ventilatory equivalent for oxygen (VE /VO2) at maximum exercise load at Week 8 of treatment.
measure: (VE /VO2)
timeFrame: Differences in the change from baseline in ventilatory equivalent for oxygen (VE /VO2) at maximum exercise load at Week 12 of treatment.
measure: (VO2 /HR)
timeFrame: Differences in the change from baseline in oxygen pulse (VO2 /HR) at maximum exercise load at Week 4 of treatment.
measure: (VO2 /HR)
timeFrame: Differences in the change from baseline in oxygen pulse (VO2 /HR) at maximum exercise load at Week 8 of treatment.
measure: (VO2 /HR)
timeFrame: Differences in the change from baseline in oxygen pulse (VO2 /HR) at maximum exercise load at Week 12 of treatment.
measure: (P (A-a) O2)
timeFrame: The change from baseline in the alveolar-arterial oxygen tension gradient (P (A-a) O2) at maximum exercise load at Week 4 of treatment.
measure: (P (A-a) O2)
timeFrame: The change from baseline in the alveolar-arterial oxygen tension gradient (P (A-a) O2) at maximum exercise load at Week 8 of treatment.
measure: (P (A-a) O2)
timeFrame: The change from baseline in the alveolar-arterial oxygen tension gradient (P (A-a) O2) at maximum exercise load at Week 12 of treatment.
measure: (P (a-et) CO2)
timeFrame: The change from baseline in the arterial-to-end-tidal CO2 difference (P (a-et) CO2) at maximum exercise load at Week 4 of treatment.
measure: (P (a-et) CO2)
timeFrame: The change from baseline in the arterial-to-end-tidal CO2 difference (P (a-et) CO2) at maximum exercise load at Week 8 of treatment.
measure: (P (a-et) CO2)
timeFrame: The change from baseline in the arterial-to-end-tidal CO2 difference (P (a-et) CO2) at maximum exercise load at Week 12 of treatment.
measure: maximum exercise power
timeFrame: The change from baseline in maximum exercise power at Week 4 of treatment.
measure: maximum exercise power
timeFrame: The change from baseline in maximum exercise power at Week 8 of treatment.
measure: maximum exercise power
timeFrame: The change from baseline in maximum exercise power at Week 12 of treatment.
measure: RER
timeFrame: The change from baseline in respiratory quotient (RER) at maximum exercise load at Week 4 of treatment.
measure: RER
timeFrame: The change from baseline in respiratory quotient (RER) at maximum exercise load at Week 8 of treatment.
measure: RER
timeFrame: The change from baseline in respiratory quotient (RER) at maximum exercise load at Week 12 of treatment.
measure: The change from baseline in total exercise duration at maximum exercise load at Week 4 of treatment.
timeFrame: The change from baseline in total exercise duration at maximum exercise load at Week 4 of treatment.
measure: The change from baseline in total exercise duration at maximum exercise load at Week 8 of treatment.
timeFrame: The change from baseline in total exercise duration at maximum exercise load at Week 8 of treatment.
measure: The change from baseline in total exercise duration at maximum exercise load at Week 12 of treatment.
timeFrame: The change from baseline in total exercise duration at maximum exercise load at Week 12 of treatment.
measure: (SpO2)
timeFrame: The change from baseline in fingertip oxygen saturation (SpO2) at rest and without oxygen inhalation at Week 4 of treatment.
measure: (SpO2)
timeFrame: The change from baseline in fingertip oxygen saturation (SpO2) at rest and without oxygen inhalation at Week 8 of treatment.
measure: (SpO2)
timeFrame: The change from baseline in fingertip oxygen saturation (SpO2) at rest and without oxygen inhalation at Week 12 of treatment.
measure: (mMRC)
timeFrame: The change from baseline in the modified Medical Research Council (mMRC) Dyspnea Scale score at week 4 of treatment.
measure: (mMRC)
timeFrame: The change from baseline in the modified Medical Research Council (mMRC) Dyspnea Scale score at week 8 of treatment.
measure: (mMRC)
timeFrame: The change from baseline in the modified Medical Research Council (mMRC) Dyspnea Scale score at week 12 of treatment.
Other outcomes:
Locations:
city: Guangzhou
country: China
facility: Guangzhou Institute of Respiratory Disease
state: Guangdong
city: Guangzhou
country: China
facility: First Affiliated Hospital of Guangzhou Medical University
state: Guangdong
Study officials:
affiliation: Guangzhou Institute of Respiratory Disease
name: Wei-jie Guan, PhD
role: PRINCIPAL_INVESTIGATOR
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