The purpose of this research study is to find out if CCP is safe and to determine the safest and most effective level of anti-viral antibody when given to people admitted to the hospital with confirmed COVID-19 infection. Participants enrolled on this study will be transfused with 2 units of CCP through an IV. These units will be given one at a time 4 to 24 hours apart. Participants will be randomized to receive either 2 units with standard antibody levels as recommended by the FDA or 2 units with an antibody level higher than that recommended by the FDA. This study is experimental and CCP is investigational and has not been approved by the FDA for the treatment of COVID-19. The CCP is collected per FDA guidelines from persons recovered from COVID-19 infection. The plasma contains antibodies and possibly other properties that inhibit the virus. The investigators do not know if the level of antibodies present in the CCP will make a difference in how the participant's body is able to fight the infection and hope to learn that in this study.
This randomized, double-blinded, phase 2 trial will assess the efficacy and safety of
anti-SARS-CoV-2 convalescent plasma in hospitalized patients with less than 8 days of
symptoms. Eligible participants will receive institutional-guided standard-of-care (SOC) and
ABO-compatible convalescent COVID-19 plasma (CCP). The CCP units will be tested for the
presence of anti-SARS-CoV-2 antibodies and pre-assigned as high-titer (CCP1) or
standard-titer (CCP2) in a 1:1 randomization. Participants and clinical investigators will be
blinded to the CCP titer group identities.
The investigators plan to enroll approximately 56 participants (28 in each group) at
UNC-Chapel Hill. Participants will be randomized within 48 hours of admission to a COVID
service and will receive convalescent plasma within 24 hours of randomization. At least two
units of CCP will be transfused 4-24 hours apart on study Day 0. If available, a third unit
may be administered. All participants will undergo a series of safety and efficacy
assessments pre-, during, and post-transfusion. Samples for research will be collected on Day
0 through Day 28, unless previously discharged. Additionally, after discharge, participants
can provide longitudinal samples collected at 1, 3, and 6-month timepoints after the
infusion.
Biological: High-titer Convalescent COVID-19 Plasma (CCP1)
At least two units of CCP transfused 4-24 hours apart on Study Day 0. A third unit may be administered, if available.
Biological: Standard-titer Convalescent COVID-19 plasma (CCP2)
At least two units of CCP transfused 4-24 hours apart on Study Day 0. A third unit may be administered, if available.
Inclusion Criteria:
1. Age at least 18 years
2. Ability and willingness of participant or Legally Authorized Representative (LAR) to
give written informed consent.
3. Laboratory confirmed diagnosis of infection with SARS-CoV-2 by PCR
4. Hospitalized for COVID-19 with one or more respiratory or gastrointestinal (GI)
symptoms:
- COVID-19 associated respiratory symptoms include but are not limited to: cough,
shortness of breath, difficulty breathing, or sore throat
- COVID-19 associated GI symptoms include but are not limited to: loss of taste,
loss of sense of smell, diarrhea, nausea, or vomiting,
Note: Respiratory and GI symptoms other than those listed above, must be noted as
acceptable and signed by study PI or designee.
Exclusion Criteria:
1. Receipt of pooled immunoglobulin in past 30 days
2. Current or prior enrollment in a SARS-CoV-2 antibody or T-cell therapeutic study.
Note: Patients enrolled on other randomized controlled trials of pharmaceutical and/or
non-pharmaceutical interventions for COVID and meeting eligibility criteria will not
be excluded, as determined by study PI (or designee) on a case-by-case basis and as
allowed by eligibility criteria of the other trials.
3. Contraindication to transfusion or history of prior reactions to transfusion blood
products. This may include religious or cultural objections to receiving blood
products and transfusions.
4. ABO-compatible titered plasma is not available
5. > 10 days from noted COVID-related subjective or objective fever at randomization.
Patients without subjective or objective fever, > 10 days from symptom onset as
determined by study PI.
University of North Carolina Health Care
Chapel Hill, North Carolina, United States