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COVID-19TherMoCoVNCT04363541

Local Thermotherapy for Patients With Mild-to-moderate COVID-19

A study testing Electric pad for human external pain therapy in people with COVID-19 and Thermotherapy, run by Instituto Nacional de Perinatologia at 3 sites in Mexico.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

The etiological agent of the current pandemic is a (+)ssRNA virus. SARS-CoV-2 is infecting thousands of people in the world with a fatality rate that varies from 0.1 to 5% in affected countries, thereby causing enormous economic losses. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
COVID-19, Thermotherapy
What is being tested?
Electric pad for human external pain therapy
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
274 participants
Where
3 sitesMexico
Study dates
27 Aug 2020to Jun 2022
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patient with symptoms of COVID-19 (fever, headache, cough, sore throat, myalgias, arthralgias, shortness of breath, anosmia, fatigue, diarrhea, vomit, or conjunctivitis) meeting criteria for mild or moderate COVID-19 according to the following criteria:
  • Mild COVID-19: With or without mild pneumonia. Peripheral oxygen arterial saturation (SaO2) greater than or equal to 94% (90% in Mexico City and Guadalajara) at room air. Does not meet criteria of moderate, severe, or critical COVID-19.
  • Moderate COVID-19: Patient with pneumonia and risk factors for disease progression; meeting all the following: Shortness of breath, peripheral oxygen arterial saturation (SaO2) greater than or equal to 94% (90% in Mexico City and Guadalajara) with a maximum 3 L/min of supplementary oxygen, does not meet criteria for severe, or critical COVID-19.
  • Patient with less than or equal to 5 days from symptom onset
  • Participant understands the intervention and procedures and accepts randomization.

Who cannot join

  • Suspected or confirmed pregnancy at evaluation
  • Severe decompensation of any of the patient's underlying diseases
  • Previous diagnosis of COVID-19 with complete resolution of symptoms for at least 2 days.
  • Patients meeting criteria for severe or critical COVID-19 at evaluation:
  • Severe COVID-19 - Patient with ≥1 of the following: tachypnea (≥30 breaths per minute), peripheral oxygen arterial saturation (SaO2) less than or equal to 93% (89% in Mexico City and Guadalajara) with a maximum 3 L/min of supplementary oxygen (patients requiring ≥4 L/min will be considered to have progressed to severe COVID-19), or PaO2/FiO2 ratio <300.
  • Critical COVID-19 - Patient with ARDS, shock, multiorgan failure, or any other condition requiring admission to an intensive care unit.
Show all 12Show fewer
  • Elimination Criteria:
  • Participant retires consent to participate in the study
  • Patient requiring ≥4 L/min of supplementary oxygen in the 24 hours of hospitalization (in the case that randomization occurred in the first 24 hours of hospitalization)
  • Two negative tests against SARS-CoV-2 (a sequential diagnostic strategy will be implemented to reduce losses due to false negative tests).
  • Patient that do not tolerate thermotherapy and requests to stop receiving the intervention.
  • Transfer to another medical unit in the first 5 days of inclusion in the study.

Trial locations and contacts

3 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Norma del Carmen Galindo Sevilla, PhD contact

+525539968217

ngalindosevilla@gmail.com

Javier Mancilla-Galindo, MBBS contact

javimangal@gmail.com

Mexico3 sites, 3 recruiting
  • Hospital Dr. Ángel Leaño

    Guadalajara, Jalisco, 45200

    Juan Pablo Cuellar Robledo, MD

    Alfonso Gutiérrez Padilla, MD

    Recruiting
  • Unidad Temporal Movil COVID-19 Autódromo Hermanos Rodríguez IMSS

    Mexico City, 08400

    Javier Michael García Acosta, MD, michxal1@gmail.com

    Yanira Saralee Nava Serrano, MD, MSc, male.sevilla.25@gmail.com

    Recruiting
  • Hospital Regional de Alta Especialidad "Dr. Juan Graham Casasus"

    Villahermosa, Tabasco, 86126

    Julio César Robledo Pascual, MD, jrobledopascual@yahoo.com

    Víctor Manuel Narváez Osorio, MD, vnarvaezosorio@hotmail.com

    Recruiting

Other trials in Mexico

About this study

Official title: A Multicenter, Open-label, Parallel-group, Randomized, Adaptive Trial to Evaluate Local Thermotherapy in Patients With Mild-to-moderate COVID-19, to Prevent Disease Progression

The etiological agent of the current pandemic is a (+)ssRNA virus. SARS-CoV-2 is infecting thousands of people in the world with a fatality rate that varies from 0.1 to 5% in affected countries, thereby causing enormous economic losses. Few antibiotics have shown any efficacy in their combat, but have not yet proven adequate to stop the spread of the disease, nor are there any approved vaccines at the moment. From experiments in plants ongoing infections by RNA viruses, using thermotherapy, which is the application of heat at a temperature between 35-43 °C, the investigators know that raising the temperature affects the transcription of viral proteins due to the formation of small RNA molecules that interrupt the replication process by grouping in specific regions of the RNA molecule, preventing and inhibiting transcription. These small molecules are called small interfering RNAs (siRNAs). This feature has been used through thermotherapy in humans to combat the rapid replication of cells (i.e. cancer cells), attack cells infected by RNA viruses, and in the treatment of some parasitic infections.There are various commercially available devices for thermotherapy use in humans; they are mainly being used to ease muscle pain. They work by increasing the temperature in the range recommended for thermotherapy in humans 39-43 ° C. Therefore, the investigators consider this treatment modality can be used to aid in the elimination of SARS-CoV-2 from the human body, decreasing viral load, which could allow the immune system time for its control and elimination.

Read the detailed description

Considering the nature of the causative agent of COVID-19, a (+)ssRNA virus, the investigators propose the use of thermotherapy as a modality for viral containment, thereby preventing the progression of the infection to severe cases. The investigators consider applying the intervention with thermotherapy mainly as an adjuvant therapy in high-risk patients. The most accessible thermotherapy delivery method the investigators have identified is the use of an electric chest pad for its wide and known clinical use, including its recommended use for patients with arthritis. The intensity of temperature delivered by the electric cushion should be placed on the first level (lowest level), to avoid discomfort to the patient. The electric cushion provides a continuous hour of regulated heat, with enough penetration to raise the external temperature of the area to 40-42 ° C, a temperature range at which facilitation of elimination of the virus is expected.

Being tested
Electric pad for human external pain therapy
Keywords
SARS-CoV-2, Hyperthermia
Medical subject headings
COVID-19, Hyperthermia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Electric pad for human external pain therapyDevice

    An electric pad for local heat production will be put on the back of the patient for two hours

Study groups in NCT04363541
Study groupRoleWhat they receive
ThermotherapyExperimentalElectric heat pad applied in the thorax for 90 minutes, twice daily, for 5 days. + Usual in-hospital care
Receives: Device: Electric pad for human external pain therapy
ControlNo interventionUsual in-hospital care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Progression of disease (composite outcome)

    Progression to any of the following:

    1. Severe COVID-19 - Patient with ≥1 of the following: tachypnea (≥30 breaths per minute), peripheral oxygen arterial saturation (SaO2) less than or equal to 93% (89% in Mexico City and Guadalajara) with a maximum 3 L/min of supplementary oxygen (patients requiring ≥4 L/min will be considered to have progressed to severe COVID-19), or PaO2/FiO2 ratio <300.
    2. Critical COVID-19 - Patient with ARDS, shock, multiorgan failure, or any other condition requiring admission to an intensive care unit.
    3. Death

    Measured: 28 days

Secondary outcomes (17)
  1. Mortality at day 15

    Proportion of participants deceased by day 15 after enrollment

    Measured: 15 days

  2. Mortality at day 28

    Proportion of participants deceased by day 28 after enrollment

    Measured: 28 days

  3. Time to progression to severe COVID-19

    Days from symptom onset to progression to severe COVID-19

    Measured: Up to 33 days

  4. Time to progression to critical COVID-19

    Days from symptom onset to progression to critical COVID-19

    Measured: Up to 33 days

  5. Hospitalization time

    In-hospital stay in days

    Measured: Up to 33 days

  6. Percentage of participants at each clinical status in the Ordinal Scale at Day 15

    Ordinal scale of 7 categories: 1) Not hospitalized, without limitations on daily activities; 2) Not hospitalized, with limitations on daily activities; 3) Hospitalized, not requiring supplementary oxygen; 4) Hospitalized, requiring low-flow supplementary oxygen; 5) Hospitalized, requiring supplementary oxygen with high-flow nasal cannula or non-invasive ventilation; 6) Hospitalized, under invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 7) Death

    Measured: 15 days

  7. Percentage of participants at each clinical status in the Ordinal Scale at Day 28

    Ordinal scale of 7 categories: 1) Not hospitalized, without limitations on daily activities; 2) Not hospitalized, with limitations on daily activities; 3) Hospitalized, not requiring supplementary oxygen; 4) Hospitalized, requiring low-flow supplementary oxygen; 5) Hospitalized, requiring supplementary oxygen with high-flow nasal cannula or non-invasive ventilation; 6) Hospitalized, under invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 7) Death

    Measured: 28 days

  8. Time (days) to last requiring supplementary oxygen according to modality

    Modalities: 1) Simple nasal cannula or face mask; 2) Face mask with reservoir; 3) High-flow nasal cannula; 4) Non-invasive mechanical ventilation; 5) Invasive mechanical ventilation

    Measured: 28 days

  9. Change in National Early Warning Score 2 (NEWS-2) with respect to baseline

    Change in the National Early Warning Score 2 (NEWS-2) with respect to baseline (Day 1), measured at day 5 for all patients, and days 15 \& 28 only for patients that remain hospitalized.

    This score evaluates 7 parameters (respiratory rate, peripheral arterial oxygen saturation, supplementary oxygen requirements, systolic arterial blood pressure, heart rate, consciousness, and body temperature). Assigned values for every parameter may range from 0 to 3 points, except for supplementary oxygen for which possible values are 0 (not requiring supplementary oxygen) and 2 (requiring supplementary oxygen). The total sum of points for this score may range from 0 to 20 points. Higher scores reflect increasing clinical deterioration.

    Measured: Days 1, 5, 15, and 28

  10. Proportion of patients requiring invasive mechanical ventilation

    Proportion of patients requiring invasive mechanical ventilation during the entire follow-up period

    Measured: 28 days

  11. Proportion of patients requiring admission to intensive care unit (ICU)

    Proportion of patients requiring admission to intensive care unit (ICU) during the entire follow-up period

    Measured: 28 days

  12. Time to requiring invasive mechanical ventilation

    Days from symptom onset to progression to requiring invasive mechanical ventilation

    Measured: Up to 33 days

  13. Time to requiring admission to intensive care unit (ICU)

    Days from symptom onset to requiring admission to intensive care unit (ICU)

    Measured: Up to 33 days

  14. Proportion of patients with adverse events according to outcome

    • Severe: Causes death of the patient, puts the patient's life at risk in the moment of occurrence, requires hospitalization or prolongs hospitalization, causes persistent or significant disability.
    • Non-severe adverse events: Do not meet the previously outlined criteria.

    Measured: 28 days

  15. Proportion of patients with adverse events according to severity

    • Mild (Grade 1): Present with easily tolerated signs and symptoms, do not need specific treatment, do not prolong hospitalization, nor require suspension of the intervention
    • Moderate (Grade 2): Interfere with daily activities (school or work), do not directly threaten life, require specific pharmacological treatment, and do not necessarily require suspension of the intervention.
    • Severe (Grades 3, 4, and 5): Interfere with daily activities (school and work), require pharmacological treatment and suspension of the intervention.

    Measured: 28 days

  16. Proportion of patients with adverse events according to causality

    • Certain
    • Probable
    • Possible
    • Uncertain
    • Unclassifiable

    Measured: 28 days

  17. Proportion of patients tolerating the intervention (no comparison)

    Proportion of patients tolerating the intervention (number of sessions and minutes per session).

    Measured: 5 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Apr 2020
  2. Study start27 Aug 2020
  3. Primary completionApr 2022 (estimated)
  4. Study completionJun 2022 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
The application of an electric chest pad. The use of an electric cushion was chosen because it is designed to be used in human thermal therapy. The electric cushion provides continuous 90 minutes of regulated heat, with enough penetration to raise the external temperature of the area to 40-42 ° C. It is a therapy designed to detain disease progression. It is not expected to have an effect on concomitant microorganisms such as bacteria or opportunists such as Candida albicans, so that when the concomitant infection is suspected, the antibiotic of choice should be given or continued, depending on the nature of the infection.
Masking
None (open label)
Enrolment
274 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04363541
Sponsor's protocol ID
U1111-1250-7416
Acronym
TherMoCoV
Status last verified
Nov 2020
First submitted
23 Apr 2020
Last updated
5 Nov 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
Undecided

Publications

  • Liu J, Zhang X, Zhang F, Hong N, Wang G, Wang A, Wang L. Identification and characterization of microRNAs from in vitro-grown pear shoots infected with Apple stem grooving virus in response to high temperature using small RNA sequencing. BMC Genomics. 2015 Nov 16;16:945. doi: 10.1186/s12864-015-2126-8.

    PubMed 26573813
  • Wang MR, Cui ZH, Li JW, Hao XY, Zhao L, Wang QC. In vitro thermotherapy-based methods for plant virus eradication. Plant Methods. 2018 Oct 6;14:87. doi: 10.1186/s13007-018-0355-y. eCollection 2018.

    PubMed 30323856
  • Zhu LL, Gao XH, Qi R, Hong Y, Li X, Wang X, McHepange UO, Zhang L, Wei H, Chen HD. Local hyperthermia could induce antiviral activity by endogenous interferon-dependent pathway in condyloma acuminata. Antiviral Res. 2010 Nov;88(2):187-92. doi: 10.1016/j.antiviral.2010.08.012. Epub 2010 Aug 24.

    PubMed 20797409
  • Mancilla-Galindo J, Kammar-Garcia A, Mendoza-Gertrudis ML, Garcia Acosta JM, Nava Serrano YS, Santiago O, Torres Vasquez MB, Martinez Martinez D, Fernandez-Urrutia LA, Robledo Pascual JC, Narvaez Morales ID, Velasco-Medina AA, Mancilla-Ramirez J, Figueroa-Damian R, Galindo-Sevilla N. Regional moderate hyperthermia for mild-to-moderate COVID-19 (TherMoCoV study): a randomized controlled trial. Front Med (Lausanne). 2023 Dec 22;10:1256197. doi: 10.3389/fmed.2023.1256197. eCollection 2023.

    PubMed 38188344

Questions about this trial

What is this clinical trial studying?

A study testing Electric pad for human external pain therapy in people with COVID-19 and Thermotherapy, run by Instituto Nacional de Perinatologia at 3 sites in Mexico.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 5 Nov 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Mexico. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Norma del Carmen Galindo Sevilla, PhD (+525539968217, ngalindosevilla@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Progression of disease (composite outcome) (time frame: 28 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04363541, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Nov 2020.

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