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. 2023 Jul 25;2023(7):CD015078. doi: 10.1002/14651858.CD015078

NCT04703608.

Study name Prevention and Treatment for COVID ‐19 (Severe Acute Respiratory Syndrome Coronavirus 2 SARS‐CoV‐2) Associated Severe Pneumonia in the Gambia (PaTS‐COVID)
Methods
  • Trial design: RCT, single‐blinded, phase 3

  • Type of publication: trial registry

  • Setting: hospitals and private households

  • Recruitment dates: still recruiting

  • Country: Gambia and other part of Western Africa

  • Language: English

  • Number of centres: multicentre

  • Inclusion criteria

    • Cohort1: individuals ≥ 5 years of age with confirmed COVID‐19 mild disease or moderate pneumonia defined as: mild disease ‐ influenza‐like illness, with any of the following symptoms cough, fever, headache, sore throat, nasal congestion/runny nose, body pains (myalgia), fatigue (malaise), diarrhoea, abdominal pain, anorexia, nausea or vomiting without evidence of pneumonia or hypoxia, moderate pneumonia, clinical signs of pneumonia (fever, cough, dyspnoea, fast breathing) with no need for supplemental oxygen (oxygen saturation ≥ 90% on room air or RR between 20 and 30 bpm), household contacts, individuals ≥ 5 years of age living in the same household with the index cases from cohort 1 will be offered to participate into the study, living in the same household is defined as those individuals who are planning to sleep in and eat from same 'cooking pot' during the following 2 weeks

    • Cohort 2: individuals ≥ 12 years of age with suspected or confirmed COVID‐19 associated severe pneumonia defined as signs of pneumonia (fever, cough, dyspnoea or fast breathing) plus one of: oxygen saturation (SpO2) < 90% on room air OR respiratory rate > 30 breaths/minute, suspected COVID‐19 disease is defined as clinically or radiologically suspected as determined by the most senior clinician available: clinically suspected signs and symptoms of pneumonia (as defined above) AND patient living in or recent travel to region with community transmission OR close contact with known COVID‐19 patient AND no alternative diagnosis to explain the clinical picture OR, radiologically suspected typical radiological signs of COVID‐19 on chest X‐ray or lung ultrasound

  • Exclusion criteria: pregnant women will be excluded from both Cohort 1 and Cohort 2. Patients with allergies to the investigational products will be excluded Cohort 1 (Ivermectin). Lactating mothers will be excluded. Cohort 2 (aspirin): taking aspirin or other non‐steroidal anti‐inflammatory drugs for any reason, any bleeding disorder (e.g. frequent nose bleeds, haemophilia), active or recurrent peptic ulcer disease (defined as currently on triple therapy or had more than 1 course of triple therapy in the past 12 months, does not count symptoms of gastritis or on omeprazole as peptic ulcer disease), current active gastrointestinal haemorrhage, severe liver disease or severe kidney disease (severe liver disease defined as cirrhosis with portal hypertension and history of variceal bleeding; severe kidney disease defined as stage 4/5 KD, eGFR < 30 mL/min), gout, suspected intra‐cerebral haemorrhage, diagnosed with a stroke on this admission

  • Trial registration number: NCT04703608

  • Date of trial registration: 11 January 2021

  • Prospective completion date: March 2022

Participants
  • Age: > 5 years

  • Gender: NR

  • Ethnicity: NR

  • Number of participants (recruited/allocated/evaluated): 1200/NR/NR

  • Severity of disease: SARS‐CoV‐2 infection (COVID‐19)

  • Additional diagnoses: NR

  • Previous treatments (e.g. experimental drug therapies, oxygen therapy, ventilation): NR

Interventions
  1. Aspirin 150 mg daily for 28 days or until hospital discharge or death

  2. Placebo comparator

  • Concomitant therapy: NR

  • Treatment cross‐overs: NR

  • Duration of follow‐up: NR

  • Treatment cross‐overs: NR

  • Compliance with assigned treatment: NR

Outcomes Primary outcomes
  1. Cohort 1 Index case: percentage of patients with COVID‐19 associated mild disease/moderate pneumonia progressing to severe pneumonia + Percentage of patients with COVID‐19 associated mild disease/moderate pneumonia progressing within 14 days after recruitment into severe pneumonia

  2. Cohort 1 Household contacts: percentage of HH members that get infected with SARS‐CoV‐2 + percentage of HH members that get infected with SARS‐CoV‐2 during the 14 days following recruitment

  3. Cohort 2: percentage of COVID‐19 associated severe pneumonia patients worsening their condition + percentage of COVID‐19 associated severe pneumonia patients meeting the criteria of failure defined as worsening their condition from baseline (on admission) for a period of at least 24 hours, scale as follows:

    1. On or requiring supplemental oxygen given by nasal cannula or face mask to maintain SpO2 within target range

    2. On or requiring non‐invasive (e.g. CPAP or BiPAP) or invasive ventilatory support to maintain SpO2 within target range (or not maintaining SpO2 within target range with supplemental oxygen given by nasal cannula or face mask)

  4. Death during hospitalisation


Secondary outcomes
  1. Cohort 1 index cases: days from recruitment to virological clearance ± days from recruitment to virological clearance defined as one negative SARS‐CoV2 virus RT‐PCRs

  2. Days from recruitment until clinical recovery ± days from recruitment until clinical recovery defined as 2 consecutive days of no fever (T ≤ 37.5 °C) and normal respiratory rate (as per normal range for age and WHO definitions) (only once if day 28 as end of follow‐up

  3. IgG geometric mean titre

  4. Household contacts IgG geometric mean titre

  5. Percentage of HH members infected that develop COVID‐19 symptoms

  6. Cohort 2 ‐ hours from recruitment to hospital discharge

  7. Hours of duration on oxygen supplementation

  8. Death ratio during hospitalisation

  9. Death ratio at 28 days after enrolment

  10. Death ratio at 90 days after enrolment

  11. Occurrence of clinical thrombotic and embolic events

  12. Occurrence of clinical episodes of gastrointestinal bleeding

  13. Change in CRP and D‐dimer levels between baseline (enrolment) and day 3 to 5

  14. Persisting breathlessness at 28 days and 90 days after enrolment

  15. Self‐reported health at 28 days and 90 days


Additional outcomes
  1. Poor self‐reported health assessed by a linear self‐reported health scale from the EQ‐5D questionnaire in person or by telephone

Starting date 22 January 2021
Contact information Contact: Anna Roca, PhD, +220 4495442 ext 2305, aroca@mrc.gm
Notes
  • Sponsor/funding: London School of Hygiene and Tropical Medicine

  • COIs: NR

  • Other: NR