Status:

TERMINATED

Control of COVID-19 Outbreaks in Long Term Care

Lead Sponsor:

Appili Therapeutics Inc.

Collaborating Sponsors:

MOUNT SINAI HOSPITAL

Applied Health Research Centre

Conditions:

COVID-19

SARS-CoV-2

Eligibility:

All Genders

65+ years

Phase:

PHASE2

Brief Summary

To address the need to intervene to prevent the spread of COVID-19 in long-term care homes, we propose a randomized clinical trial of chemoprophylaxis in long-term care homes experiencing COVID-19 out...

Detailed Description

Early in the COVID-19 pandemic, it became apparent that the elderly are disproportionately bearing the burden of disease and mortality. Many outbreaks are occurring in long-term care homes (LTCHs), wi...

Eligibility Criteria

Inclusion

  • Inclusion criteria for LTCHs:
  • LTCH in Ontario with \>80% of residents being adults ≥65 years of age.
  • Residents are or can be routinely assessed at least daily by staff.
  • LTCH has not previously had a unit enrolled in this study.
  • Outbreak of COVID-19 declared on at least one nursing unit, requiring all of the following:
  • ≥2 to ≤4 residents who develop PCR-confirmed symptomatic COVID-19 infection on the same unit within ≤ 7 days at the time when the outbreak is identified as eligible.
  • ≤21 days from symptom onset in the index case at the time when the outbreak is identified as eligible.
  • Cumulative attack rate in residents on the affected unit since the beginning of the pandemic ≤25% at the time when the outbreak is identified as eligible.
  • ≤20% of residents with microbiologically confirmed COVID-19 or line-listed as a presumptive case in a COVID-19 outbreak and not tested for COVID-19 in prior outbreaks within the last six months.
  • Nursing unit with ≥16 and ≤32 residents.
  • Nursing home agrees to work with study coordination to minimize the number of persons who provide care on the unit.
  • Mechanism exists for delivery of medication and recording of administered medication for all residents.
  • ≥80% of residents on outbreak unit are eligible and they or their substitute decision makers consent to participate in the study.
  • Written informed consent of Medical Director, Administrator and a delegate of the Residents' Council of the LTCH for LTCH to be included in the cluster trial.
  • Inclusion criteria for LTCH residents:
  • 1\. Informed consent from resident or substitute decision maker (SDM)
  • Inclusion criteria for LTCH staff:
  • Expected to work at least two 8-hour shifts, or the equivalent time (16 hours on the unit) during the outbreak period.
  • Informed consent.

Exclusion

  • Exclusion criteria for LTCHs:
  • Inability to deliver medication to consenting residents within 96 hours of identification of the outbreak.
  • Inability to define a physically separate unit with ≤32 residents.
  • Any of facility management, medical advisory committee or resident council do not approve participation.
  • Exclusion criteria for LTCH Residents and Staff:
  • Pregnancy (females \< 55 years of age require a negative urine pregnancy test at enrollment, and either menopause or two concurrent reliable methods of contraception need to be confirmed)
  • History of abnormalities of uric acid metabolism, other than gout.
  • History of hypersensitivity to remdesivir or favipiravir
  • Previous diagnosis of hepatic cirrhosis
  • Current use of the following medications, which cannot be discontinued for the duration of the study: pyrazinamide, hydralazine, more than 3000 mg of acetaminophen per day

Key Trial Info

Start Date :

October 16 2020

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

October 30 2021

Estimated Enrollment :

67 Patients enrolled

Trial Details

Trial ID

NCT04448119

Start Date

October 16 2020

End Date

October 30 2021

Last Update

February 21 2023

Active Locations (1)

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1

Mount Sinai Hospital

Toronto, Ontario, Canada