COVID-19 Clinical Trials and Expanded Access

Oslo University Hospital has initiated an observational study on hospitalised patientswith confirmed COVID-19, the infection caused by Severe Acute Respiratory SyndromeCoronavirus type 2 (SARS-CoV-2).

The study researchers think that a medication called N-acetylcysteine can help fight theCOVID-19 virus by boosting a type of cell in your immune system that attacks infections.By helping your immune system fight the virus, the researchers think that the infectionwill get better, which could allow the patient to be moved out of the critical care unitor go off a ventilator, or prevent them from moving into a critical care unit or going ona ventilator.The US Food and Drug Administration (FDA) has approved N-acetylcysteine to treat theliver side effects resulting from an overdose of the anti-inflammatory medicationTylenol® (acetaminophen). N-acetylcysteine is also used to loosen the thick mucus in thelungs of people with cystic fibrosis or chronic obstructive pulmonary disease (COPD).This study is the first to test N-acetylcysteine in people with severe COVID-19infections.

This trial is designed to evaluate the efficacy and safety of moxibustion plus cupping inthe convalescence of COVID-19.

The Harnessing Online Peer Education COVID-19 (HOPE COVID-19) intervention will assesswhether a peer-led online support community can improve behavioral health outcomesrelated to COVID-19.

To evaluate the safety, toxicity and immunological effects of infusion of allogeneic bonemarrow-derived human mesenchymal stem (stromal) cells (MSCs) and whether this therapy hasan influence on the resolution processes in ARDS patients infected with Severe acuterespiratory syndrome coronavirus 2 (SARS-CoV-2).

The coronavirus disease 2019 (COVID-19) global pandemic caused by the severe acuterespiratory syndrome coronavirus 2 (SARS-CoV-2) has caused considerable morbidity andmortality in over 170 countries. Increasing age and burden of cardiovascularcomorbidities are associated with a worse prognosis among patients with COVID-19. Inaddition, serologic markers of more severe disease including coagulation abnormalitiesand thrombocytopenia, are not uncommon among patients hospitalized with severe COVID-19infection and are more common in patients who died in-hospital. As the COVID-19 pandemiccontinues to grow, there is a pressing need to identify safe, effective, and widelyavailable therapies that can be scaled and rapidly incorporated into clinical practice.Understanding the putative mechanism of increased mortality risk associated with abnormalcoagulation function and cardiac injury is critical to guide studies of promisingtherapeutic interventions. Published and anecdotal reports indicate that endothelialdysfunction and thrombosis are common in critically ill patients with COVID-19, includingreports of diffuse microvascular thrombosis in the lungs, heart, liver, and kidneys.Patients with cardiovascular disease (CVD) and CVD risk factors are known to haveendothelial dysfunction and a heightened risk of thrombosis. A recent study of COVID-19inpatients from Wuhan, China observed that an elevated D-dimer level greater than 1 ug/mLwas associated with an 18 times higher risk of in-hospital death, underscoring theimportance of increased coagulation activity as a potential modifiable risk marker thatmay drive end-organ injury. Given the established link between endothelial dysfunctionand thrombosis in patients with cardiovascular disease, and the association betweencoagulopathy and adverse outcomes in patients with sepsis, the association betweenincreased coagulation activity, end-organ injury, and mortality risk may represent amodifiable risk factor among COVID-19 patients with critical illness. Therefore, wepropose to conduct a randomized, open-label trial of therapeutic anticoagulation inCOVID-19 patients with an elevated D-dimer to evaluate the efficacy and safety.

This retrospective study aims to perform a medication risk stratification using drugclaims data and to simulate the impact of the addition of various repurposed drugs on theMedication Risk Score (MRS) in a health insurance population. Our clinical tool wouldenable us to identify potential multi-drug interactions and potentially reduce the riskof adverse drug events (ADE) developing in these patients infected with COVID-19.

Prospective study evaluating the outcomes of implementation of a protective protocol forCovid-19 for patients and staff in a large endoscopy unit.

The primary objective of the study is to evaluate cardiac and pulmonary hemodynamicchanges over time as predictor of disease progression and outcome in COVID-19 patientsadmitted to ICU.The primary endpoint is the occurrence of a major event predefined as either: death(all-cause mortality) or discharge from ICU (limit of 4 months).This is a uni-center prospective observational cohort study with an inclusion period of 2months. The end of the study is foreseen in 6 months.

The COVID-19 CHAMPS Study will obtain data on the physical and mental health andwell-being of workers potentially exposed to the SARS-CoV-2 virus in the course of theirduties. Included are a broad range of occupations including those working in thecommunity (police officers, firefighters, emergency personnel, screening staff) as wellas in permanent or temporary sites that care for patients (service staff, nurses,physicians and other health professionals). CHAMPS will obtain data on various exposurefactors and health and create a registry of participants for extended follow up andsub-studies.