Clinical trials registered in India for COVID-19

Clinical trials registered in India for treatment of COVID19

          COVID-19 or also known as coronavirus disease is an infectious disease that was first identified in Wuhan, China, in December 2019. It has spread among patients that presented with a new form of viral pneumonia with the shared history of visiting the Huanan seafood market (1) COVID-19 is now causing a pandemic because of the rapid spread of disease worldwide primarily through human to human transmission. The main reason for the spread of disease is the long incubation period for COVID-19 i.e. it takes about 2 weeks for the symptoms to develop and thus identified. In that period, the infected person can transmit this disease to countless other people they come in contact with through cough or sneeze droplets. Another reason for its danger lies in the survival of viruses causing disease. COVID-19 is caused by the SARS-CoV-2 virus and this virus can remain viable and infectious in aerosols for hours and on surfaces up to days. (2). Currently, intensive care unit ad ventilation is used for complication including pneumonia and COVID-19 cases. A recent method for treatment includes screening/ usage of existing broad-spectrum antiviral drugs, screening of chemical library/ databases and re-development of new drugs base on the new genome and biophysical study of virus.(3)  The exact mechanism for this disease is yet not known and is still under research but there are several theories proposed. The pandemic is the risk to global health with more than 28 lakh confirmed cases and more than 1,98000 deaths globally by WHO. Data as of 27th April 2020 (4) And more cases are emerging has ignited the various countries to develop a vaccine, treatment or supportive care for COVID-19 pandemic. 

          Many countries have officially ordered lockdown while others have recommended self-quarantined. In developing countries like India with severe deficiency Of Healthcare resources, this has led to disruptions of regular outpatients, inpatients, critical care, and emergency services. In the deficiency of healthcare resources, the Paediatric population has been most severely affected as a regular visit for immunization and for common fever, vomiting has been halted countrywide. This situation has led to an increase in complications of the non-COVID-19 disease as reported from various sources. In this correspondence, an objective scoring system is proposed recently. (Outbreak of Respiratory Tract Infection scale-ORTIS).

           In the view of an exponential rise in COVID-19 in India, there are several clinical studies going on in India. The studies have been designed to collect and analyze the data of healthcare workers and in the general population 



Clinical trial
Sponsor
Brief about trial
1.
Max COVID-19 Study.
Max healthcare institute limited, Delhi
To identify individuals with flu-like symptoms in suspicion of COVID-19 and follow them up to 8 weeks until pandemic resolves
2.
Efficacy of convalescent plasma therapy in severely sick COVID-19 patients- Phase2  NCT04346446
Institute of Liver and biliary sciences
To identify individuals receiving convalescent plasma for the benefit and adverse events.
3.
The spectrum and profile of COVID-19 infections and its impact on its liver NCT04345640
Institute of the liver and biliary sciences
To address the clinical presentation, biochemical alteration, and outcomes of COVID-19 infections in subjects with pre-existing liver disease in comparison to those having infections in the absence of pre-existing liver disease.
4.
A clinical trial of Mycobacterium w in critically ill COVID-19 patients - NCT04347174
Cadila pharmaceuticals
To evaluate the safety and efficacy of Mycobacterium w in combination with standard care as per hospital practice versus standard care alone in critically ill adult patients suffering from COVID-19 infection.
5.
Study of the effect of Chloroquine in addition to standard therapy in COVID-19 Patients
Command hospital Airforce, Bangalore
Chloroquine has been demonstrated to have and anti-SARS CoV2 activity in vitro and has shown a significant reduction in Viral load. This has to compare with the control group (Not receiving chloroquine) (500mg)
6.
Hydroxychloroquine, an open-labeled, Randomised intervention for prevention of new infection and adverse outcomes following COVID-19 Infection- A tertiary Hospital-based study (Phase 3) CTRI/2020/03/024402
Aster Malabar Institute Of Medical Sciences (MIMS), Kozhikode, Kerala
It is a randomised, open-labeled study which compares two dosing regimens of hydroxychloroquine sulfate for prophylaxis against COVID-19
1.Hydroxychloroquine (HCQ)- ICMR regimenè400mg bd for one day followed by 400 mg weekly for 7 weeks to be taken with meals.
2. intervention dose è 300mg daily for 7 days followed by 300mg weekly for 7 weeks
7.
Outbreak of Respiratory Tract Infection Score (ORITS): Objective Screening for Children to rule out COVID-19 and prevent nosocomial spread  
Dr. Atul Child hospital Main Shastri Nagar Road, Jaipur, Rajasthan. (Private Hospital)
Visit the link for a detailed description of the study .
8.
An open-labeled trial to evaluate the safety and efficacy of SSV formulation to boost immunity in quarantine patients of COVID19 CTRI/2020/04/024659
Department of Medicine, Niphad Sub-district Hospital, Niphad, Maharashtra
To evaluate the role of SSV formulation to boost immunity in quarantined patients of COVID-19 as judged by the improvement in signs such as axillary temperature, respiratory rate, pulse and blood pressure, etc. and clinical variables such including pro-inflammatory cytokines TNF-alpha and IL-6


            Besides these clinical trials on supportive care of COVID19, there are some trials registered on Vaccine formulation worldwide and everyone is working towards the best combination of existing antiviral and HIV drugs such as Remdesivir, Lopinavir, Ritonavir, ribavirin, penciclovir, nitazoxanide, nafamostat, fapinavir. Several recombinant proteins may also have the potential for diagnosis, prophylaxis and treatment for COVID19. Disulfiram could also inhibit the papain-like proteases of MERS and SARS in cell cultures.(3)
          There are several major gaps in our current knowledge of the origin, epidemiology, duration of disease, human transmission of the virus and clinical spectrum of disease, which could be fulfilled by more studies.

References: 
1.  Peeri, N. C., Shrestha, N., Rahman, M. S., Zaki, R., Tan, Z., Bibi, S., … Haque, U. (2020). The SARS, MERS, and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: what lessons have we learned? International Journal of Epidemiology, 1–10. https://doi.org/10.1093/ije/dyaa033
3.  Mali, S. N. (2020). The Rise of New Coronavirus Infection-(COVID-19): A Recent Update. Eurasian Journal of Medicine and Oncology, (March). https://doi.org/10.14744/ejmo.2020.22222
4. Culp, W. C. (2020). Coronavirus Disease 2019. A & A Practice, 14(6), e01218. https://doi.org/10.1213/xaa.0000000000001218





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