Official Title
A Randomized Controlled Basket Study for Evaluating Immunomodulatory Interventions in Post-Acute Sequelae of SARS-CoV-2 InfEction (RISE)
Brief Summary

This study is a prospective, randomized controlled, basket trial. Patients diagnosed withPost-Acute Sequelae of SARS-CoV-2 Infection who meet the inclusion and exclusion criteriaare recruited and divided into three symptom clusters: Inflammatory Cardiac involvementsymptoms cluster, cough symptoms cluster and fatigue symptoms cluster. Each symptomcluster is randomly divided into an experimental group and a control group, Patients whodo not accept treatment can be included in the observational cohort. Subjects in theexperimental group receive immunomodulatory interventions plus conventional treatment,while subjects in the control group receive conventional treatment only. Subjects in eachsymptom cluster undergo clinical medical record data collection, laboratory tests, andimaging examinations at specified time points, as well as records of adverse events.

Detailed Description

Not Provided

Not yet recruiting
Post-acute Sequelae of SARS-CoV-2 Infection

Drug: Prednisone

Total 4 weeks of treatment

Drug: Budesonide/Formoterol

Total 8 weeks of treatment

Drug: Vitamin C combined with Coenzyme Q10 oral treatment

Total 4 weeks of treatment

Drug: Montelukast tablets oral treatment

Total 8 weeks of treatment

Eligibility Criteria

Inclusion Criteria:

-

1. Age ≥18 years;

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2. Post-infection with SARS-CoV-2 for more than 3 months and meets the World
Health Organization (WHO) definition of Long COVID;

-

3. Symptom criteria: Meet the inclusion and exclusion criteria for each symptom
cluster;

-

4. Fertile female subjects are not breastfeeding or pregnant at the time of
enrollment (negative urine pregnancy test);

-

5. Willing and able to provide informed consent, complete surveys, clinical
assessments, and all necessary follow-up visits;

Symptom Cluster Inclusion Criteria:

- Inflammatory Cardiac Involvement Symptom Cluster

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1) Age: 18-75 years old;

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2) Presence of cardiac symptoms at the time of enrollment (e.g., Chest tightness
after physical activity, chest pain, difficulty breathing, palpitations,
fatigue, etc.);

-

3) CMR shows the following abnormal findings based on any of the following
criteria:

- a) Native T1 increase ≥ 1130 milliseconds at 3.0 T (or an increase of 1030
milliseconds at 1.5 T) and/or;

- b) Native T2 ≥ 39.5 milliseconds at 3.0 T (or 49.5 milliseconds at 1.5 T) and/or;

- c) Presence of non-ischemic myocardial and pericardial late gadolinium enhancement
and/or;

- d) Left ventricular ejection fraction ≥ 40% and ≤50%.

- Cough Symptom Cluster

-

1) Clinical assessment of cough according to ACCP guidelines indicates no cough
caused by other diseases such as COPD, asthma, chronic bronchitis,
gastroesophageal reflux, bronchiectasis, etc.;

-

2) Chest X-ray or CT scan shows no abnormalities that could lead to cough or other
serious lung diseases;

-

3) FENO ≥25 ppb, or the proportion of eosinophils in sputum cytology ≥2.5%; or the
blood eosinophil count >0.3×10⁹/L.

- Fatigue Symptom Cluster

-

1) Fatigue Severity Scale (FSS) average score ≥ 4;

-

2) Any inflammatory marker (CRP, ESR, PCT, ferritin, IL-6, TNFα) is above the
upper limit of normal.

Exclusion Criteria:

-

1. Known SARS-CoV-2 infection within 3 months prior to the date of informed
consent signature;

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2. Systemic fungal infection and active infections that cannot be controlled by
anti-infective agents;

-

3. Current or recent (within the last 10 weeks) use of glucocorticoids, other
immunosuppressants, or biologic agents;

-

4. Known allergy/sensitivity or any hypersensitivity reaction to the study
intervention or control components;

-

5. Known contraindications to the study intervention;

-

6. Any persistent central nervous system disorders, psychiatric illnesses, chronic
respiratory or cardiac diseases, Underlying diseases (poorly controlled
diabetes, poorly controlled hypertension, peripheral edema, cataracts or
glaucoma, peptic ulcer disease, femoral head necrosis, low bone density, or
osteoporosis);

-

7. For female participants: pregnant or breastfeeding at screening, or expecting
to become pregnant during the study period; women of childbearing age who are
unwilling to use effective contraceptive measures (defined as PEARL index <1,
such as birth control pills, intrauterine devices);

-

8. Known alcohol, drug, or chemical abuse;

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9. Currently participating in another clinical trial;

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10. Deemed ineligible to participate in this study by the investigator's
assessment.

Symptom Cluster Exclusion Criteria:

- Inflammatory Cardiac Involvement Symptom Cluster

-

1) Past medical history or cardiac magnetic resonance (CMR) evidence indicating
significant cardiac disease, including:

- a) Known left ventricular ejection fraction (LVEF) <40% indicating cardiac
dysfunction;

- b) Congestive heart failure (New York Heart Association Class III-IV);

- c) Ongoing treatment for heart failure (including HFrEF and HFpEF);

- d) Confirmed ischemic heart disease, peripheral artery disease, and/or
cerebrovascular disease;

- e) Persistent or permanent atrial fibrillation or significant arrhythmias;

- f) Congenital or clinically relevant valvular heart disease (moderate or severe);

- g) Specific cardio myopathies (hypertrophic, hypertensive heart disease,
amyloidosis, previous myocarditis, non-ischemic dilated cardiomyopathy,
arrhythmogenic right ventricular cardiomyopathy, non-compacted cardiomyopathy,
etc.);

-

2) Contraindications for contrast-enhanced cardiac magnetic resonance (CMR)
imaging, such as: use of implanted devices not compatible with MRI; known
allergy to gadolinium-based contrast agents (CBGA);

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3) Patients with structural heart disease or incidental arrhythmias detected on
cardiac magnetic resonance imaging will be advised to consult their physicians.

- Cough Symptom Cluster

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1) Current smoker or having quit smoking for less than 6 months;

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2) Intolerance to pulmonary function testing and/or FeNO;

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3) Chest CT showing acute pulmonary infection-related diseases;

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4) Forced expiratory volume in 1 second (FEV1) / Forced vital capacity (FVC) ratio
less than 60%;

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5) Currently taking or having used angiotensin-converting enzyme inhibitors (ACEI)
within the past 3 months of screening;

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6) Received any relevant traditional Chinese or Western medical treatment within
the last month.

- Fatigue Symptom Cluster

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1) Received any relevant traditional Chinese or Western medical treatment within
the last month, taking sedatives, hypnotics, melatonin, or antidepressants;

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2) Known previous diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome
unrelated to SARS-CoV-2 infection;

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3) Known previous autonomic dysfunction unrelated to SARS-CoV-2 infection;

-

4) Fatigue caused by metabolism-related diseases (such as hyperthyroidism or
hypothyroidism, malnutrition) that developed following SARS-CoV-2 infection.

Eligibility Gender
All
Eligibility Age
Minimum: 18 Years ~ Maximum: 75 Years
Countries
China
Locations

Huashan Hospital of Fudan University
Shanghai, Shanghai, China

Investigator: Wenhong Zhang, PhD, MD
Contact: +86 21 52889999
zhangwenhong@fudan.edu.cn

Not Provided

Huashan Hospital
NCT Number
Keywords
Post-acute Sequelae of SARS-CoV-2 infection
long COVID
Immunomodulatory Interventions
MeSH Terms
Infections
Communicable Diseases
COVID-19
Post-Acute COVID-19 Syndrome
Coenzyme Q10
Ubiquinone
Prednisone
Budesonide
Formoterol Fumarate
Montelukast