The purpose of this Phase 2 study is to test safety, efficacy, and tolerability of an oral preparation of VB-201 in patients with severe COVID-19

Inclusion Criteria:

1. Signed and approved informed consent before initiation of protocol-specified procedures;

2. Male or female subjects, ≥18 to ≤80 years of age with COVID-19

3. SARS-2-CoV-2 infection confirmed by PCR in the last 8 days

4. Hospitalized

5. Symptoms of Severe COVID-19 as demonstrated by one of the following:

   • Respiratory frequency >30 breaths per minute
   • SpO2 <94% on room air at sea level
   • Ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (PaO2/FiO2) <300 mmHg
   • lung infiltrates >50%

6. For a female subject; either:

   • subject is of non-childbearing potential, defined as: menopause with amenorrhea >1 years, hysterectomy, or bilateral oopherectomy or
   • agrees to continue to use highly effective methods of birth control defined as those alone or in combination that result in a low failure rate (<1%) when used consistently and correctly throughout the study and for at least one month following treatment termination and have a negative pregnancy test at screening and before the first dose of study drug; Males must use at least one method of contraception (e.g. condom) throughout the study and for 90 days following the last dose of study drug;

7. In the opinion of the investigator, the subject will be compliant and have a high probability of completing the study and all required procedures.

Exclusion Criteria:

1. Evidence of critical COVID-19 based on any of the following

   • Admission to ICU
   • Assisted ventilation (invasive or non-invasive)
   • ECMO or hemofiltration required
   • ARDS
   • Shock
   • Acute Cardiac Failure

2. Dementia

3. Bacterial co-infection

4. Co-infection with other common viral pneumonias (e.g. Influenza)

5. Participation in another interventional clinical trial or intention to participate in another interventional study during the course of this study;

6. In the opinion of the investigator, unlikely to survive for at least 48 hours from screening or anticipate mechanical ventilation within 48 hours

7. Unable to take oral medication

8. History of gastrointestinal illness that may cause nausea and vomiting

9. Subjects with any laboratory test at screening that common medical practice would deem as significantly abnormal. For example:

   • Alanine transaminase (ALT), aspartate transaminase (AST), or alkaline phosphatase >5.0 times the upper limit of normal (ULN) or
   • Creatinine clearance <30 mL/min

10. The subject has a known allergy or sensitivity to the study treatment or to any of the excipients contained in the study drug formulation (see list of ingredients in the Investigator's Brochure);

11. Female subject with a positive pregnancy test or nursing, or planning a pregnancy during the course of the study;

12. Unwilling or unable to comply with study requirements