COVID-19 Clinical Trials and Expanded Access

Myocardial infarction (MI), as one of the many complications of COVID-19, is one of thecontributing patients of patients' death. This study attempts on developing anintervention of MI by regenerating damaged cardiomyocytes due to insufficiency of oxygenin cardiac muscles, triggered by an occlusion of coronary artery (MI). Heart patchdeveloped from amnion bilayer seeded with amnion epithelial stem cells and patient'sautologous cardiomyocytes is used as a therapy. Patients who undergo bypass (CABG)surgery are given heart patch, and then patients condition are observed by ECG, Echo,blood test, and radiology (technetium-99m)

The purpose of this study is to examine how patients with multiple myeloma (MM) have beenimpacted by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.The study will use a questionnaire to further understand how patients are being affectedand gather information in order to track the long-term effects of the coronavirus.The scope of the questionnaire will include, COVID-19 diagnosis and treatment, changes inmyeloma treatment and care, clinical trial familiarity, health and fitness, and qualityof life.This questionnaire is a follow-on to the "MM and COVID-19" questionnaire.

Sex and gender matter to health equity, especially in a pandemic. Sex (a biologicalattribute) and gender (a social construct) may influence an individual's susceptibility,vulnerability and exposure to infectious disease. In previous coronavirus epidemics (SARSand MERS), male sex was associated with worse outcomes. Both immune and the hemostaticresponse display ample sexual dimorphism.The primary aim of the study is to determine whether sex differences in biomarkers ofplatelet and immune function, gut microbiome, clinical characteristics, therapy, clinicalcost sensitive outcomes (i.e. in-hospital transition of care, case severity, andmortality due to COVID-19) exist in patients affected by COVID-19.

At least 1 in 6 COVID-19 patients admitted to hospital to receive extra oxygen will dieof complications. In patients with COVID-19, invasive treatment such as mechanicalventilation (e.g. breathing with a machine) is associated with a 50% increased risk ofdeath. Invasive treatments use a lot of healthcare resources in intensive care units andmay lead to further deaths if patients do not have access to care.The investigators aim to improve outcomes for COVID-19 patients by implementinghyperbaric oxygen therapy (HBOT). HBOT allows patients to breathe 100% oxygen in aspecial chamber at a pressure higher than sea level. It is approved by Health Canada for14 conditions. HBOT is safe when administered by experienced teams.There are two main causes of death in severe COVID-19 respiratory infections: (i) adecreased diffusion of oxygen from the lungs to the blood and (ii) an increasedinflammatory response (also called a "cytokine storm"). HBOT leads to increased oxygenlevel in blood, has strong anti-inflammatory effects, and may destroy the virusresponsible for COVID-19 disease. The initial experience with HBOT and COVID-19 fromChina, France and the United States is promising in that it prevents further worsening ofthe condition and need for intensive care.The investigators propose to test the effectiveness of HBOT for COVID-19 patients who areadmitted to hospital to receive extra oxygen. Using the most rigorous and innovativeresearch methods, this Canadian-led international study will operate at 5 centers across3 countries (Canada: Ottawa, Toronto, Edmonton; Switzerland: Geneva; UK: Rugby/London).The investigators anticipate that when treated by HBOT, COVID-19 patients needing extraoxygen to breathe will see significant health improvements as well as a decrease incomplications, inflammation in the blood, need for invasive care, death, and cost ofcare.

Preliminary reports have been received from several sources that the periodic inhaling ofthe nebulized mist from water that has a heightened level of kinetic activity has quickly(less than 2 days) lessened the severity of symptoms in Covid-19 infected patients. On atleast several occasions, a repeat PCR test performed several after inhaling a particularwater-based product was negative. There are no perceived adverse effects from inhalingthe water mist by using a nebulizer or humidifier. It is important, however, to validatethese preliminary findings and to include the inhaling of the mist from water, which doesnot have an elevated level of kinetic activity. This will be by performed in apatient-blinded manner by sequentially inhaling the two types of water over consecutive2-day periods with Covid-19 testing at the end of each of the two day periods.Participants will be randomized as to whether they are to inhale the mist from the testor the control water.

A Respiratory infection with the SARS-CoV2 virus is associated with a major risk of viralpneumonia that can lead to respiratory distress requiring resuscitation. In the mostsevere forms, it may require mechanical ventilation or even lead to an acute respiratorydistress syndrome with a particularly poor prognosis. The SARS-CoV2 is a single-strandedRNA virus of positive polarity and belongs to the beta genus of Coronaviruses. SARS-CoV2is responsible for the third epidemic in less than twenty years secondary to aCoronavirus (SARS-CoV then MERS-CoV) and if the mortality associated with it is lowerthan that of previous strains, notably MERS-CoV, its spread is considerably big. As aresult, the number of patients developing respiratory distress requiring invasivemechanical ventilation is high, with prolonged ventilation duration in these situations

This research aims to investigate the incidence, clinical condition, mode of transmissionand laboratory data of women and their babies, who were exposed to COVID-19 infectionduring pregnancy. This project will consist of 4 subprojects, being that Subprojects 1and 2, will be of the observational, longitudinal type of prospective Cohort; Subproject3 will be of prevalence; Subproject 4 will be case-control. Subproject 1- This study aimsto assess periodontal condition and quality of life before and after delivery of womenwith excess weight gain or not, with exposure to coronavirus-sars-cov2. Subproject 2-Identify the proteins differentially expressed in saliva associated with COVID-19infection during the 3rd trimester of pregnancy in obese and eutrophic patients.Subproject 3- Assess the prevalence of congenital syndrome in babies associated with thepresumed maternal infection with SARS-CoV-2. Subproject 4- Case-control study in whichnewborns are submitted to clinical examination, being a group with congenitalmalformations and their respective controls and an interview with the mother was carriedout.

The main differences observed between SARSCoV-2 pneumonia and other epidemic viralpneumopathies (e.g., seasonal influenza) are the greater infectivity of SARSCoV-2, theclinical severity of the disease, particularly in young patients without co-morbidities,and the observation of radiological images related to significant parenchymal aggressionin a large number of patients.The lesions in the acute phase correspond essentially to bilateral ground glass opacitymore or less associated with condensations which would be markers of more severeinfections.The major scope of the lesions in the acute phase raises the question of whether or notthe scanning anomalies are completely resolved over time, and the possible impact on lungfunction. This risk of sequelae is very important to study given the large number ofpatients affected by SARSCoV-2, especially since these are often young patients whoappear to be "healthy".In the current context of the CoV-2 SARS pandemic, the improved quality and availabilityof diagnostic scanners provides a wealth of information on the semiology and progressionof lung disease with minimal exposure to ionizing radiation. A majority of hospitalizedpatients with SARSCoV-2 received a CT scan in the early phase of the disease. Indeed, theFrench Society of Radiology has recommended the performance of a CT scan withoutinjection in thin sections in case of suspicion or for confirmation of the diagnosis inpatients presenting initial or secondary clinical signs of severity and justifyinghospital management due to the initial lack of reagents for performing biological tests(RT-PCR) and the high sensitivity of the CT scan and its specificity in epidemic periods.The present study aims to study the kinetics of lung involvement in SARS CoV 2, to studythe predictive character of the chest CT scan performed at the patient's discharge on theexistence of radiological sequelae at 3 months but also at 1 year in order not tomisunderstand the constitution of late fibrosis after partial resolution of the CTimages. The investigatos will study the correlation between possible radiologicalabnormalities and the clinical presentation (patient symptoms and lung function). Therigorous follow-up of these patients will allow us to set up, if necessary, earlytreatment of the detected abnormalities (inhaled corticoids in case of bronchial orbronchiolar damage, study of the place of an anti-fibrosis treatment in case offibrosis,...).

There is a pandemic in the world by COVID-19. Currently, the pharmacological curative orprophylactic treatments for this infection are not known. Recent studies have suggestedthat Hydroxy-Chloroquine could be effective in vitro and in vivo against COVID-19. Themain objective of this study is to assess in patients with autoimmune disease treatedwith long course Hydroxy-Chloroquine initiated before the pandemic COVID-19 had anindependent protective effect on the risk or the severity of infection with COVID-19.

This phase I trial investigates breathing techniques and meditation for health careworkers during COVID-19 pandemic. Breathing techniques and medication may help managestress and improve lung health. The goal of this trial is to learn if breathingtechniques and meditation may help to reduce stress and improve lung health in healthcare workers during the COVID-19 pandemic.