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The goal of this clinical trial is to evaluate the safety, tolerability, and efficacy of allogeneic SARS-CoV-2-Specific T cells (LB-DTK-COV19) in patients with persistent clinical symptoms following a positive SARS-CoV-2 PCR test for 14 days or longer. The main questions it aims to answer are:
Participants will:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| LB-DTK-COV19 | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| LB-DTK-COV19 | Biological | LB-DTK-COV19 is an allogeneic SARS-CoV-2-specific T cell therapy product derived from third-party donors and is stored frozen in a colorless, transparent freeze-dried vial until thawed into liquid before administration. |
| Measure | Description | Time Frame |
|---|---|---|
| NCI-CTCAE v5.0 ≥ Grade 3 Rate | The incidence rate of Grade 3 or higher adverse events, as defined by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), is assessed to evaluate the safety of LB-DTK-COV19. Grade 3-5 adverse events include severe or medically significant, life-threatening, and fatal adverse events. | From baseline visit through 24 weeks after treatment initiation. |
| Adverse Events | The investigator must confirm the occurrence of adverse events through medical examinations, including interviews and medical history reviews, during regular visits throughout the clinical trial period. Adverse events shall be assessed at each visit starting from the administration of the investigational drug at the baseline visit. | From the baseline visit through 24 weeks after treatment initiation. |
| Disease Progression Rate | Proportion of patients with disease progression (defined as the need for mechanical ventilation, extracorporeal membrane oxygenation [ECMO], or death) at 1 month following LB-DTK-COV19 administration. | From the screening visit through 24 weeks after treatment initiation. |
| WHO Ordinal Scale | The time to improvement in the WHO Ordinal Scale, defined as an improvement of at least 1 point from baseline, is assessed. The outcome is summarized by both the time to improvement and the proportion of participants achieving the improvement by four weeks following LB-DTK-COV19 infusion. | From the screening visit through 24 weeks after treatment initiation. |
| NEWS2 Score | The time to achievement of a NEWS2 score of 0 sustained for at least 24 hours is assessed. The outcome is summarized by both the time to achievement and the proportion of participants achieving the endpoint by four weeks following LB-DTK-COV19 infusion. |
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Inclusion Criteria:
Adults aged 19 years or older at the time of screening (Visit 1).
Individuals confirmed positive for COVID-19 by Reverse Transcription-Polymerase Chain Reaction (RT-PCR) testing. If the test was conducted more than 10 days prior to the screening date, retesting is required for enrollment. The testing criteria follow the "Guidelines for Laboratory Diagnosis of COVID-19".
Individuals who have received treatment with two or more antiviral drugs.
Patients who are refractory to standard-of-care.
Individuals who meet all the following criteria of persistent COVID-19:
Viral Criteria: Positive COVID-19 PCR test results persisting for more than 14 days after the initial positive test
Clinical Criteria: Individuals with two or more of the following symptoms for 14 days or more either intermittently or continuously
Imaging Criteria: Clinically significant change in lung parenchyma based on chest CT.
Medical History Criteria: Individuals who meet any of the following criteria
Female participants or male participants with female partners who agree to maintain the following contraception methods during the clinical trial period, and who meet one of the following criteria:
The female participant or the female partner of the male participant is postmenopausal (defined as non-therapy-induced amenorrhea for 12 months or more, or as medically confirmed menopause)
The female participant or the female partner of the male participant is infertile due to surgical sterilization (ex. removal of ovaries and/or uterus)
Agrees to absolute abstinence during the clinical trial period [For female participants, intermittent abstinence (ex. ovulation timing, symptom-based temperature monitoring, or withdrawal methods) is not considered as agreeing to abstinence]
If the female participant or the female partner of the male participant is a woman of childbearing potential (WOCBP) who has not undergone sterilization surgery, one of the following contraception methods must be used:
For women of childbearing potential or women who are less than 12 months postmenopausal, a negative pregnancy test (blood test) confirmed at the screening visit.
Individuals who have at least one HLA match with the investigational drug in MHC class I.
Individuals who voluntarily agree to participate in this clinical trial and provide written consent to comply with the restrictions.
Individuals deemed suitable as study subjects through screening tests (vital signs, physical examination, medical and surgical history, electrocardiogram, laboratory tests, etc).
Exclusion Criteria:
Severely ill patients who meet the following criteria:
Uncontrolled pulmonary diseases other than COVID-19 pneumonia (ex. chronic obstructive pulmonary disease, asthma, cystic fibrosis, tuberculosis, etc.)
Patients requiring intubation, mechanical ventilation (WHO 8-OS stage 6), or ECMO (stage 7) at the time of screening.
Individuals who have received treatment with ATG (Antithymocyte Globulin), Campath, or other T-cell immunosuppressive monoclonal antibodies within 28 days prior to the screening visit.
Patients with uncontrollable hypertension, uncontrollable diabetes, other viral infections (ex. Human immunodeficiency virus (HIV), Hepatitis B virus (HBV), Hepatitis C virus (HCV), etc), syphilis, refractory malignancy, moderate or severe liver damage [Aspartate aminotransferase (AST) or Alanine aminotransferase (ALT) > 5 Lab normal range (LNR)], or chronic kidney diseases (estimated Glomerular filtration rate (eGFR) < 30 mL/min/1.73m^2) based on medical history or at the time of screening.
Uncontrollable hypertension is defined as Systolic BP ≥160mmHg or Diastolic BP ≥100 mmHg despite taking blood pressure medications (Up to 3 measurements with a minimum interval of 5 minutes)
Severe diabetes is defined as follows:
Patients with a history of substance abuse within 6 months prior to the administration of the investigational product, or those suspected of taking drugs prone to misuse based on medical interviews and physical examinations.
Patients who require vasopressors.
Patients with a history of hypersensitivity to T-cell therapy.
Patients with a history of autoimmune diseases.
Patients with hemophilia or receiving anticoagulant therapy who are at significant risk of bleeding during injection.
Patients who participated in another clinical study within 24 weeks prior to the administration of the investigational product.
Patients with a life expectancy of less than 24 hours at the time of screening.
Other patients deemed unsuitable for participation in this clinical trial by the investigator.
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| Name | Affiliation | Role |
|---|---|---|
| Dong-Gun Lee, MD-PhD | Department of Infectious Disease, The Catholic University of Korea Seoul St.Mary's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Catholic University of Korea Seoul St.Mary's Hospital | Seoul | 06591 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | HG Lee and HE Chung. [COVID-19 Scientific Report]_Vol.9: Coronavirus, in the end, it is immunity <Part 2>. IBS Institute for Basic Science, 2020. | ||
| Background | MY Kim, GS Park, YJ Kim, et al. First Analysis Report on Clinical Information of COVID-19. Public Health Weekly Report 2020; 13(28): 2047-2058 | ||
| Background | P Lulla, Baylor College of Medicine. Anti-SARS Cov-2 T Cell Infusions for COVID 19 (BATIT) (https://www.clinicaltrials.gov/ct2/show/NCT04401410). 2020. | ||
| 33668003 | Background | Akbar MR, Pranata R, Wibowo A, Lim MA, Sihite TA, Martha JW. The prognostic value of elevated creatine kinase to predict poor outcome in patients with COVID-19 - A systematic review and meta-analysis. Diabetes Metab Syndr. 2021 Mar-Apr;15(2):529-534. doi: 10.1016/j.dsx.2021.02.012. Epub 2021 Feb 11. |
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| ID | Term |
|---|---|
| D000086382 | COVID-19 |
| D007239 | Infections |
| D014777 | Virus Diseases |
| D012818 | Signs and Symptoms, Respiratory |
| D011014 | Pneumonia |
| D019337 | Hematologic Neoplasms |
| ID | Term |
|---|---|
| D011024 | Pneumonia, Viral |
| D012141 | Respiratory Tract Infections |
| D018352 | Coronavirus Infections |
| D003333 | Coronaviridae Infections |
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| From the screening visit through 24 weeks after treatment initiation. |
| Viral load | Nasopharyngeal swab samples were used for PCR testing to assess SARS-CoV-2 viral load. | From the screening visit through 24 weeks after treatment initiation. |
| SARS-CoV2-Specific T-cell Responses | SARS-CoV2-specific T-cell responses are assessed using IFN-γ ELISPOT assay and spot-forming units. | From the screening visit through 24 weeks after treatment initiation. |
| Characterization of SARS-CoV-2-Specific T cells | SARS-CoV-2-specific T cell subsets are characterized using flow cytometry. | From the screening visit through 24 weeks after treatment initiation. |
| Background | Centers for Disease Control and Prevention, Reinfection with COVID-19 (https://www.cdc.gov/coronavirus/2019-ncov/your-health/reinfection.html). 2020. |
| 32344011 | Background | Velavan TP, Meyer CG. Mild versus severe COVID-19: Laboratory markers. Int J Infect Dis. 2020 Jun;95:304-307. doi: 10.1016/j.ijid.2020.04.061. Epub 2020 Apr 25. |
| 33237691 | Background | Feingold KR. Lipid and Lipoprotein Levels in Patients with Covid-19 Infections. 2026 Jan 15. In: Feingold KR, Adler RA, Ahmed SF, Anawalt B, Blackman MR, Chrousos G, Corpas E, de Herder WW, Dhatariya K, Dungan K, Hamilton E, Hofland J, Jan de Beur S, Kalra S, Kaltsas G, Kapoor N, Kim M, Koch C, Kopp P, Korbonits M, Kovacs CS, Kuohung W, Laferrere B, Levy M, McGee EA, McLachlan R, Muzumdar R, Purnell J, Rey R, Sahay R, Shah AS, Sperling MA, Stratakis CA, Trence DL, Wilson DP, editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from http://www.ncbi.nlm.nih.gov/books/NBK564657/ |
| Background | Oxford university hospital, Diagnosis and Management of Acute Graft Versus Host Disease. 2018. |
| 27438202 | Background | Villarreal CD, Alanis JC, Perez JC, Candiani JO. Cutaneous graft-versus-host disease after hematopoietic stem cell transplant - a review. An Bras Dermatol. 2016 May-Jun;91(3):336-43. doi: 10.1590/abd1806-4841.20164180. |
| 30880998 | Background | Riegler LL, Jones GP, Lee DW. Current approaches in the grading and management of cytokine release syndrome after chimeric antigen receptor T-cell therapy. Ther Clin Risk Manag. 2019 Feb 28;15:323-335. doi: 10.2147/TCRM.S150524. eCollection 2019. |
| 34396213 | Background | Ghosh AK, Chen DH, Guha A, Mackenzie S, Walker JM, Roddie C. CAR T Cell Therapy-Related Cardiovascular Outcomes and Management: Systemic Disease or Direct Cardiotoxicity? JACC CardioOncol. 2020 Mar 17;2(1):97-109. doi: 10.1016/j.jaccao.2020.02.011. eCollection 2020 Mar. |
| 28330607 | Background | Admiraal R, Nierkens S, de Witte MA, Petersen EJ, Fleurke GJ, Verrest L, Belitser SV, Bredius RGM, Raymakers RAP, Knibbe CAJ, Minnema MC, van Kesteren C, Kuball J, Boelens JJ. Association between anti-thymocyte globulin exposure and survival outcomes in adult unrelated haemopoietic cell transplantation: a multicentre, retrospective, pharmacodynamic cohort analysis. Lancet Haematol. 2017 Apr;4(4):e183-e191. doi: 10.1016/S2352-3026(17)30029-7. Epub 2017 Mar 16. |
| Background | Korean Society for Laboratory Medicine, Korean Disease Control and Prevention Agency. Guidelines for the Laboratory Diagnosis of Coronavirus Disease-2019, 4th Edition. 2020 |
| Background | The Korean Society of Infectious Diseases. Korean Society of Infectious Diseases Guidelines for the Pharmacological Treatment of Coronavirus Disease 2019 (COVID-19) (Summary) (version 2.0). 2020 |
| Background | Ministry of Food and Drug Safety. Considerations in COVID-19 Drug Development. 2020 |
| 31538024 | Background | Simmons HZ, Bazzell AF, Dains JE. Adverse Effects of Virus-Specific T-Cell Therapy: An Integrative Review. J Adv Pract Oncol. 2019 Mar;10(2):120-131. Epub 2019 Mar 1. |
| 20429793 | Background | Cruz CR, Hanley PJ, Liu H, Torrano V, Lin YF, Arce JA, Gottschalk S, Savoldo B, Dotti G, Louis CU, Leen AM, Gee AP, Rooney CM, Brenner MK, Bollard CM, Heslop HE. Adverse events following infusion of T cells for adoptive immunotherapy: a 10-year experience. Cytotherapy. 2010 Oct;12(6):743-9. doi: 10.3109/14653241003709686. |
| Background | Park, S.-H., & Han, S. H. Effect of oral cryotherapy for reducing oral mucositis in hematopoietic stem cell transplantation: A systematic review and meta-analysis. Korean Journal of Adult Nursing 2018, 30(4), 362-375. |
| 33022076 | Background | Esmaeilzadeh A, Elahi R. Immunobiology and immunotherapy of COVID-19: A clinically updated overview. J Cell Physiol. 2021 Apr;236(4):2519-2543. doi: 10.1002/jcp.30076. Epub 2020 Oct 6. |
| 32641700 | Background | Song JW, Zhang C, Fan X, Meng FP, Xu Z, Xia P, Cao WJ, Yang T, Dai XP, Wang SY, Xu RN, Jiang TJ, Li WG, Zhang DW, Zhao P, Shi M, Agrati C, Ippolito G, Maeurer M, Zumla A, Wang FS, Zhang JY. Immunological and inflammatory profiles in mild and severe cases of COVID-19. Nat Commun. 2020 Jul 8;11(1):3410. doi: 10.1038/s41467-020-17240-2. |
| 32728222 | Background | Chen Z, John Wherry E. T cell responses in patients with COVID-19. Nat Rev Immunol. 2020 Sep;20(9):529-536. doi: 10.1038/s41577-020-0402-6. Epub 2020 Jul 29. |
| 32702415 | Background | Lee JY, Hong SW, Hyun M, Park JS, Lee JH, Suh YS, Kim DH, Han SW, Cho CH, Kim HA. Epidemiological and clinical characteristics of coronavirus disease 2019 in Daegu, South Korea. Int J Infect Dis. 2020 Sep;98:462-466. doi: 10.1016/j.ijid.2020.07.017. Epub 2020 Jul 21. |
| 32935333 | Background | Toor SM, Saleh R, Sasidharan Nair V, Taha RZ, Elkord E. T-cell responses and therapies against SARS-CoV-2 infection. Immunology. 2021 Jan;162(1):30-43. doi: 10.1111/imm.13262. Epub 2020 Oct 27. |
| Background | WS Yoo and HK Chung. The Management of Thyroid Disease in COVID-19 Pandemic, International Journal of Thyroidology 2020; 13(2): 65-71 |
| Background | Korean Pharmaceutical Information Center Library and Information. Understanding of Coronavirus, 2020 |
| Background | Korea Disease Control and Prevention Agency. Coronavirus Disease-2019 (COVID 19), http://ncov.mohw.go.kr/ |
| Background | Korean Pharmaceutical Information Center, Understanding of Novel Coronavirus Disease (2019-nCoV), 2020 |
| Background | YR Kim, SH Nam, SR Kim. Impact Factors and Validity of Blood Variables on Death in COVID-19 patient: Using Data of Korea Disease Control and Prevention Agency, Journal of The Korea Society of Computer and Information 2020; 25(11): 179-185 |
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| Background | PG Choe. Vaccines and Treatment of Coronavirus Disease 2019, The Korean Journal of Medicine 2020; 95(6): 364-369. |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |