Lymphopenia is common in patients with COVID-19 and is associated with worse clinical outcomes. NT-I7 is a long-acting human interleukin-7 (IL-7) that has been shown to increase absolute lymphocyte count (ALC) and CD4+ and CD8+ T cell counts with a well-tolerated safety profile in humans. In this study, patients who have tested positive for SARS-CoV-2 by PCR testing without severe disease and with ALC
Drug: NT-I7
Supplied by study
Drug: Placebo
Supplied by study
Procedure: Blood for research purposes
Prior to injection (Day 0), Day 7, and Day 14
Procedure: Blood for pharmacokinetic samples
-Phase I only: 1-2 hours prior to dosing, 6 hours after dosing, 24 hours after dosing, Day 7, Day 14, and Day 21
Procedure: Nasopharyngeal, oropharyngeal, or saliva swab
-Prior to study treatment, Day 4(optional), Day 7, and Day 14
Procedure: Blood for anti-drug antibody (ADA)
Baseline, Day 7, Day 14, Day 21, Day 60, and Day 90. Participants with ADA positivity on Day 90 will be monitored every 90 days until antibody level returns to baseline
Inclusion Criteria:
- Tested PCR positive for SARS-CoV-2by nasopharyngeal swab, oropharyngeal swab, or
saliva.
- Mild COVID-19, defined as WHO Ordinal Scale <4 .
- Respiratory rate < 20 bpm, HR < 90 bpm, and SpO2 > 93% on room air at sea level.
- Absolute lymphocyte count (ALC) < 1500 cells/mm3 at the time of screening.
- AST/ALT ≤ 3.0 x ULN, total bilirubin ≤ 1.5 x ULN (except if due to Gilbert's
syndrome).
-≥ 18 years of age.
- First day of treatment must be no more than 10 days from onset of COVID-19 symptoms.
- Must be willing to be closely monitored in the hospital or in an alternate setting
(e.g. clinical trial unit) for at least the first 7 days (±2 days allowed) following
NT-I7/placebo injection.
- Individuals of reproductive potential must agree to either abstinence or use of at
least one study-approved form of contraception when engaging in sexual activities that
can result in pregnancy from the time of screening through 60 days for female and 120
days for male after study agent administration. Acceptable forms of contraception for
this study are male or female condoms, diaphragms or cervical caps with a spermicide,
or non-hormonal intrauterine devices.
- Patients with factors or concomitant illness associated with higher risk of mortality
due to COVID-19 (such as older age, hypertension, diabetes, and/or COPD) are eligible.
- Able to understand and willing to sign an IRB approved written informed consent
document.
Exclusion Criteria:
- Receiving any other investigational agents which may affect patient's lymphocyte
counts. Note: There is no evidence that chloroquine or hydroxychloroquine could affect
lymphocyte counts. Thus, chloroquine or hydroxychloroquine use is not an exclusion
criteria for this study. Additionally, it is permissible for potential participants to
have received investigational or off-label agents for COVID-19 prior to or during
study participation.
- Pregnant or breastfeeding women are excluded from this study because NT-I7 has not
been evaluated regarding its potential for teratogenic or abortifacients effects.
There is a potential risk for adverse events in nursing infants secondary to treatment
of the mother with the study drug; therefore, breastfeeding should be discontinued if
the mother is treated with NT-I7.
- Transferred from ICU to the floor.
- Requiring dialysis.
- Shortness of breath or known hypoxia (defined as PaO2/FiO2 ≤ 300 mmHg), or signs of
serious lower airway disease.
- Evidence of ARDS, SIRS/shock, or cardiac failure.
- Elevated inflammatory markers such as CRP > 2 x ULN, LDH > 2 x ULN, D-dimer > 2 x ULN,
ferritin > ULN, or IL-6 > ULN (when available).
- Any established diagnosis of autoimmune disease requiring systemic treatment EXCEPT
for vitiligo or endocrine disease (such as diabetes, thyroid disease, and adrenal
disease) controlled by replacement therapy.
- Receipt of live attenuated vaccine within 30 days before the study treatment. Examples
of live vaccines include, but are not limited to, the following: measles, mumps,
rubella, chicken pox, yellow fever, rabies, Bacillus Calmette-Guérin (BCG), Zoster,
and typhoid vaccine. Seasonal influenza vaccines for injection are generally killed
virus vaccines and are allowed; however, intranasal influenza vaccines (e.g. FluMist)
are live attenuated vaccines and are not allowed.
Saint Louis University Hospital
Saint Louis, Missouri, 63110
Investigator: Mary McLennan, M.D.
Contact: 314-768-8028
Investigator: Alexandre Lacasse, M.D.
Contact: 314-768-8028
Investigator: Mary McLennan, M.D.
Investigator: Alexandre Lacasse, M.D.
Jian Campian, M.D., Ph.D., Principal Investigator
Washington University School of Medicine