Efficacy of Captopril in Covid-19 Patients With Severe Acute Respiratory Syndrome (SARS) CoV-2 Pneumonia (CAPTOCOVID) (CAPTOCOVID)
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ClinicalTrials.gov Identifier: NCT04355429 |
Recruitment Status : Unknown
Verified April 2020 by Assistance Publique - Hôpitaux de Paris.
Recruitment status was: Not yet recruiting
First Posted : April 21, 2020
Last Update Posted : April 28, 2020
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Pneumonia Coronavirus Infection COVID-19 | Drug: captopril 25mg | Phase 2 |
Coronavirus Disease 2019 (COVID-19) is due to SARS-CoV-2 infection. The main cause of death is refractory acute respiratory distress syndrome (ARDS) secondary to SARS-CoV-2 pneumonia. The SARS-CoV-2 may have specific virulence factors to achieve mortality rates around 3%. As the SARS-CoV, virus responsible of the Severe Acute Respiratory Syndrome in 2003 (which mortality was around 10%), the SARS-CoV-2 uses angiotensin-converting enzyme 2 (ACE2) as the receptor binding domain for its spike protein making ACE2 the gateway in the alveolar epithelial cells1. Angiotensin-converting enzyme (ACE) and ACE2 are known to be present in respiratory epithelium and to have antagonist physiological functions. ACE2 has an anti-inflammatory, anti-fibrosing role, anti-oxydant and vasodilatator activity, while ACE has the opposite characteristics. These two enzymes have a negative control on each other, one inhibiting the other. Demonstrated that SARS-CoV is responsible of a downregulation of ACE2 functions by using ACE2 as cell receptor2. While ACE2 is downregulated, ACE activity increase leading to more alveolar damage and acute respiratory failure.
ACE inhibitors are common drugs used to treat hypertension worldwide. Using an ACE inhibitor as treatment against SARS-CoV-2 could be counter-intuitive because increasing ACE2 expression would open the cellular gate to the virus3,4. However, ACE2 was described as protecting lung injury2, leading Recombinant Human ACE2 as a perspective for SARS-CoV-2 treatment.
A simple way to increase ACE2 in patients with SARS-CoV-2 pneumonia could be an inhalation of ACE inhibitor.
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 230 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Efficacy of Captopril Nebulization in Covid-19 Patients Suffering of SARS CoV-2 Pneumonia. A Randomized Phase II Study |
Estimated Study Start Date : | May 5, 2020 |
Estimated Primary Completion Date : | July 2020 |
Estimated Study Completion Date : | August 2020 |

Arm | Intervention/treatment |
---|---|
Experimental: CAPTOPROL
Inhalation administration by nebulization
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Drug: captopril 25mg
Drug administration
Other Name: Any |
No Intervention: STANDARS CARE
According to surviving covid-Campaign guidelines
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- Efficacy of captopril nebulization addition to standard of care compared to standard of care. [ Time Frame: 14 Days ]To assess determine the efficacy of captopril nebulization addition to standard of care compared to standard of care in term of 14-day ventilation free survival

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Hospitalization for acute respiratory failure requiring oxygen administration ≥3L/mn
- Age > 18 years or older
- Presence of pneumonia
- PCR SARS-CoV-2 positive in any biological sample in the last 7 days
- Patient affiliated to social security regime
- Written informed consent provided by the patient or alternatively by next-of-kin, or in emergency situations, prior to any protocol-specific procedures
Exclusion Criteria:
- Decision of withholding invasive mechanical ventilation
- Shock requiring vasopressor infusion
- Co-infection with another respiratory pathogen which could be responsible of pneumonia
- Hypersensitivity to captopril, to any other angiotensin converting enzyme inhibitor or any of the excipients of the specialty used
- History of angio-oedema
- History of ACE-inhibitor allergy
- Known pregnancy or current lactation: Female subject of childbearing potential should have a negative serum pregnancy test prior to receiving the first dose of study medication.
- Patient who is currently enrolled in other investigational study;
- Persons deprived of their liberty by judicial or administrative decision,
- Persons under legal protection/safeguard of justice,
- Patients under duress psychiatric care,
- Persons admitted to a health or social institution
- Patient on state medical aid

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04355429
Contact: Mohammed RAHAOUI, PM | +33 1 48 95 59 77 | mohammed.rahaoui@aphp.fr | |
Contact: Yacine TANDJAOUI-LAMBIOTTE, MD | yacine.tandjaoui-lambiotte@aphp.fr |
France | |
CH Victor Dupuy- Argenteuil | |
Argenteuil, France | |
Contact: Pascale LONGUET, MD | |
Hôpital Avicenne, | |
Bobigny, France, 93000 | |
Contact: Olivier BOUCHAUD, Pr | |
Hôpital Avicenne | |
Bobigny, France, 93000 | |
Contact: Yacine TANDJAOUI-LAMBIOTTE, MD yacine.tandjaoui-lambiotte@aphp.fr | |
Hôpital Avicenne | |
Bobigny, France | |
Contact: Nunes HILARIO, MD | |
Hôpital Antoine Béclère | |
Clamart, France | |
CH de Compiègne-Noyon | |
Compiègne, France | |
Contact: Anne-Lise LECAPITAINE, MD | |
Groupe hospitalier Sud Ile de France | |
Melun, France | |
Contact: Sylvain DIAMANTIS, MD | |
Hôpital de la Pitié- Salpêtrière | |
Paris, France | |
Contact: Alexandre BLEIBTREU, MD | |
Hôpital Tenon | |
Paris, France | |
Contact: Gilles PIALOUX, Pr | |
CHRU de Tours, Hôpital Bretonneau | |
Tours, France | |
Contact: Louis BERNARD, MD | |
Hôpital de Tours | |
Tours, France | |
Contact: Laurent PLANTIER, Pr |
Principal Investigator: | Yacine TANDJAOUI-LAMBIOTTE, MD | Assistance Publique - Hôpitaux de Paris |
Other Publications:
Responsible Party: | Assistance Publique - Hôpitaux de Paris |
ClinicalTrials.gov Identifier: | NCT04355429 |
Other Study ID Numbers: |
APHP200410 |
First Posted: | April 21, 2020 Key Record Dates |
Last Update Posted: | April 28, 2020 |
Last Verified: | April 2020 |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
COVID-19 Pneumonia Coronavirus Infections Pneumonia, Viral Respiratory Tract Infections Infections Virus Diseases Coronaviridae Infections Nidovirales Infections |
RNA Virus Infections Lung Diseases Respiratory Tract Diseases Captopril Angiotensin-Converting Enzyme Inhibitors Protease Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Antihypertensive Agents |