Bucillamine in Treatment of Patients With COVID-19

Inclusion Criteria:

- Is within 72 hours from onset of symptoms consistent with COVID 19 at time of study
enrollment

- Has at least 2 of the following: fever (oral temperature ≥38°C), cough, shortness of
breath, chest x ray changes consistent with COVID-19 at time of screening

- Has peripheral capillary oxygen saturation (SpO2) ≥94 by pulse oximetry at time of
screening

- Has either a laboratory-confirmed SARS-CoV-2 infection as determined by FDA-approved
rapid diagnostic (e.g., PCR) assay

- Has a score of ≤ 2 on the 8-category NIAID ordinal scale at time of screening

- Agrees to the collection of blood and urine samples, nasopharyngeal (NP) swabs, and
non-invasive oxygen monitoring (via pulse oximeter) per protocol

- Patient (or their legally authorized representative) is willing and able to provide
written informed consent prior to performing study procedures

- Understands and agrees to comply with planned study procedures

- Women of childbearing potential must agree to either abstinence or use at least 1
primary form of contraception not including hormonal contraception from the time of
screening through Day 29 following randomization. All subjects of childbearing
potential, including males with partners of childbearing potential, must use highly
effective methods of birth control defined as those, alone or in combination, that
result in a low failure rate (i.e., less than 1 percent per year) when used
consistently and correctly. Abstinence is NOT an acceptable method of contraception
UNLESS it is the subject's normal practice.

Exclusion Criteria:

- Prior history of, or considered to be at risk for, agranulocytosis, nephropathy, liver
disease, or interstitial pneumonia

- Serious hepatic disorder (Child-Pugh scores B or C) or alanine transaminase (ALT) or
aspartate transaminase (AST) > 5 times the upper limit of normal (ULN) at screening

- Chronic kidney disease (CKD) National Kidney Foundation (NKF) stages 3B - 5 chronic
renal dysfunction (estimated glomerular filtration rate [eGFR] <45 mL/min/1.73m2
according to Cockcroft Gault formula)

- Proteinuria ≥ 1+ or ≥ 30 mg on dipstick urinalysis that is confirmed on repeat
assessment within 24 hours

- Serum BUN ≥ 2 × ULN or Cr ≥ 2 × ULN

- Leukopenia with absolute granulocyte count < 1500/µL

- History of positive Human Immunodeficiency virus (HIV) test or organ transplant

- Receipt of cancer chemotherapy or immunomodulatory drugs including (but not limited
to) biologics such as anti-CD20, anti-TNF, anti-IL6; alkylating agents (e.g.,
cyclophosphamide); antimetabolites (e.g., azathioprine); or chronic corticosteroid use
equivalent to prednisone >10 gm/day, during preceding 2 months

- Confirmed positive for influenza at screening

- Confirmed positive for respiratory syncytial virus (RSV) at screening

- Pregnant or breastfeeding

- Current use of, or known allergy to bucillamine or penicillamine (e.g., for Wilson's
disease, rheumatoid arthritis)

- Current participation in any other clinical trial of an experimental treatment

- Receipt of any experimental treatment for COVID-19 (herbal/homeopathic, off-label,
compassionate use, or trial related) within the 30 days prior to screening