RECOVER-VITAL: Platform Protocol to Measure the Effects of Antiviral Therapies on Long COVID Symptoms (RECOVER-VITAL)

Overview

About this study

This study is a platform protocol designed to be flexible so that it is suitable for a wide range of settings within health care systems and community settings where it can be integrated into COVID-19 programs and subsequent treatment plans.

This protocol describes a prospective, multi-center, multi-arm, double-blind, randomized, controlled, platform trial, with different interventions organized as appendices to the protocol. Each appendix evaluates potential mechanisms of action, efficacy, and safety of antivirals and other therapeutics in individuals with PASC, according to the platform protocol objectives. The hypothesis is that persistent viral infection and/or overactive/chronic immune response and inflammation are underlying contributors to PASC and that antiviral and other applicable therapies may result in viral clearance or decreased inflammation and improvement in PASC symptoms.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

1. ≥ 18 years of age at the time of enrollment.

2. Previous suspected, probably or confirmed SARS-CoV-2 infection, as defined by the Pan American Health Organization.*

*Suspected and probable cases will only be allowed if it occurred before May 1, 2021, and will be limited to 10% of the study population. Otherwise, confirmed cases are
required.

Suspected case of SARS-CoV-2 infection - Three options, A through C:

A. A person who meets the clinical OR epidemiological criteria.

Clinical criteria:

Acute onset of fever AND cough (influenza-like illness) OR Acute onset of ANY THREE OR
MORE of the following signs or symptoms: fever, cough, general, weakness/fatigue, headache, myalgia, sore throat, coryza, dyspnea, nausea, diarrhea, anorexia.

Epidemiological criteria:

Contact of a probable or confirmed case or linked to a COVID-19 cluster; or

B. Acute respiratory infection with history of fever or measured fever of ≥ 38°C; and cough; with onset within the last 10 days; and who requires hospitalization); or

C. With no clinical signs or symptoms, NOR meeting epidemiologic criteria with a positive professional use or self-test SARS-CoV-2 antigen-Rapid Diagnostic Test.

Probable case of SARS-CoV-2 infection:

A. A patient who meets clinical criteria above AND is a contact of a probable or confirmed case or is linked to a COVID-19 cluster.

Confirmed case of SARS-CoV-2 infection - Two options, A through B:

A. A person with a positive nucleic acid amplification test, regardless of clinical criteria OR epidemiological criteria; or

B. Meeting clinical criteria AND/OR epidemiological criteria (See suspect case A).  With a positive professional use or self-test SARS-CoV-2 Antigen-Rapid Diagnostic Test.

3. At least two moderate symptoms from the same symptom cluster or one severe cluster-associated symptom identified via the Cluster Targeted COVID-19 Symptom Questions (CTCSQ), with participant identifying new symptoms since COVID-19 illness
and having persisted for at least 12 weeks

4. Meeting PRO Symptom Cluster criteria for at least one Symptom Cluster.

5. Willing and able to provide informed consent, complete the surveys, clinical assessments, and return for all of the necessary follow-up visits.

Exclusion Criteria:

An individual who meets any of the following criteria will be excluded from participation in this study. Refer to appendices for additional appendix-level criteria:

1. Known active acute SARS-CoV-2 infection ≤ 4 weeks from consent

2. Known severe anemia, defined as < 8 g/dL

3. Meeting the following symptom cluster exclusion for all eligible clusters*:

a. Cognitive dysfunction: known stroke that resulted in cognitive impairment within 3 months of enrollment;

b. Autonomic dysfunction: atrial fibrillation or significant cardiac arrhythmia, more than moderate alcohol consumption**, pre-existing sustained
severe hypertension (BP> 180/110 mmHg in the sitting position);

c. Exercise intolerance: i. any of the following within 4 weeks of consent - an acute myocardial infarction or unstable angina, uncontrolled arrhythmias causing symptoms or hemodynamic compromise, acute myocarditis or pericarditis, uncontrolled acutely
decompensated heart failure (acute pulmonary edema), acute pulmonary embolism, suspected dissecting aneurysm, severe hypoxemia at rest, any acute or chronic disorder that may affect exercise performance ii. if the participant is aggravated by exercise (e.g., infection, thyrotoxicosis, unable to cooperate)

*Participants who are eligible for > 1 cluster must meet all inclusion and no exclusion criteria for an individual symptom cluster. If not, the participant will be excluded from that individual symptom cluster.

** Defined as greater than 2 drinks a day for men and 1 drink a day for women. A drink is equivalent to 12 ounces of beer (5% alcohol content), 8 ounces of malt liquor (7% alcohol content), 5 ounces of wine (12% alcohol content), 1.5 ounces or a "shot" of 80-proof (40% alcohol content) distilled spirits or liquor (e.g., gin, rum, vodka, whiskey). 

4. Known diagnosis of Lyme disease

5. Any non-marijuana illicit drug use within 30 days of informed consent

6. Current or recent use (within the last 14 days) of study intervention*

7. Known allergy/sensitivity or any hypersensitivity to components of the study
intervention (s) or control*

8. Known contraindication(s) to study intervention(s),

9. Inability to discontinue symptomatic medications for the identified time periods

10. Moderate or severe immunocompromised patients, such as those described in the NIH COVID-19 Treatment Guidelines  (https://www.covid19treatmentguidelines.nih.gov/ special populations/immunocompromised/)

11. Enrolled into another study intervention appendix in this platform protocol***

***Participants may re-enroll in the trial for a different study intervention appendix if the participant has completed an  appropriate washout period and efficacy has been determined for the appendix in which the participant was previously enrolled.

12. Any condition that would make the participant, in the opinion of the investigator, unsuitable for the study

- If only one study intervention appendix is open at the time of enrollment. If multiple study intervention appendices are open, a participant may be excluded from any study intervention appendix based on contraindications listed in the study intervention appendix, current use of study intervention, or known allergy/sensitivity/hypersensitivity and still remain eligible for the remaining study intervention appendices.

Eligibility last updated 8/9/23. Questions regarding updates should be directed to the study team contact.

 

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Rochester, Minn.

Mayo Clinic principal investigator

Ryan Hurt, M.D., Ph.D.

Open for enrollment

Contact information:

Shawn Fokken CCRP

(507) 293-2740

GIMResearchStudies@mayo.edu

More information

Publications

Publications are currently not available
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CLS-20552577

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