NGS Diagnostic in COVID-19 Hosts - Genetic Cause Relating to the Course of Disease Progression (COVID-19 NGS)
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ClinicalTrials.gov Identifier: NCT04364828 |
Recruitment Status :
Recruiting
First Posted : April 28, 2020
Last Update Posted : May 18, 2022
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Condition or disease | Intervention/treatment | Phase |
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COVID-19 | Genetic: Whole Genome Analysis Genetic: T-cell receptor (TCR) repertoire Genetic: SARS-CoV-2 viral composition | Not Applicable |
This study aims to recruit adult persons with diagnostically confirmed Corona-Virus- Disease-19 (COVID-19) infection and with different disease manifestation who are included into diagnostic or therapeutic care at the University Hospital Tübingen (UKT).
The COVID-19 Next-Generation-Sequencing (NGS) study aims to cover as many patients in Germany as possible. It is expected to include in Phase 1 (pilot study): 250 patients with different disease manifestation (extreme phenotypes) and individual risk factors by whole genome analysis Phase 2 (verification study): 1.000 clinically well-defined patients to ensure a broader range of overlapping phenotypes, to verify data from the pilot study.
Phase 3 (confirmation study): > 10.000 patients to increase the power (anticipated).
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 1000 participants |
Allocation: | Non-Randomized |
Intervention Model: | Sequential Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Diagnostic |
Official Title: | NGS Diagnostic in COVID-19 Hosts - Genetic Cause Relating to the Course of Disease Progression |
Actual Study Start Date : | October 21, 2020 |
Estimated Primary Completion Date : | April 2023 |
Estimated Study Completion Date : | August 2023 |

Arm | Intervention/treatment |
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Host Genome Analysis
For 150 patients from the extreme phenotypes - complementary to Whole Genome Analysis of each patient also Whole Transcriptome will performed Analysis; DNA methylation analysis using EPIC arrays will be performed in the pilot study (phase 1). Identically, in phase 2 starting from month 4, will be generated WGS, Whole transcriptome sequencing (WTS), and methylation data of the 500 patients. Epigenetic changes are likely to occur upon Corona infection. Subsequently, genome and epigenome data with RNA expression pattern will be correlated.
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Genetic: Whole Genome Analysis
Whole Genome Analysis with whole transcriptome analysis and deoxyribonucleic acid (DNA) methylation analysis using Methylation beadchip (EPIC) arrays |
Host Response to SARS-CoV-2 Infection
Focus on longitudinal analysis of TCR repertoire of CD4+ and CD8+ T cells from blood samples (PBMCs) from clinically characterized patients (n = 24). The bulk- T-cell receptor (TCR) sequencing will be performed at different time points during the course of disease progression and recovery.
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Genetic: T-cell receptor (TCR) repertoire
Longitudinal analysis of TCR repertoire of Cluster of Differentiation 4+ (CD4+) and CD8+ T cells from blood samples (Peripheral Blood Mononuclear Cells, PBMCs) from clinically characterized patients |
Viral Sequence Composition
The Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2) viral composition is determined by Next Generation sequencing (different protocols for enrichment are available, and are currently being tested to successfully analyse the virus from different isolates). It is known that SARS-CoV-2 sequence is changing at least one position every second passing from person to person. Numerous variants have been described deriving from 3 different ancestral viruses (named A, B, and C) reflecting different distributions in East Asia, Europeans and Americans. At it is anticipated that other (super)infections may add to the severity of the infection and disease course, the entire metagenome of the throat is being sequenced and analyzed as well.
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Genetic: SARS-CoV-2 viral composition
Determined by Next Generation sequencing |
- Viral evolution [ Time Frame: Day 1, Day 3-5, Day 7-9, 48 hours after recovery ]The change in the genetic makeup of a virus population (measured in numbers) as the viruses mutate and multiply over time at different time points
- Immune response [ Time Frame: Day 1, Day 3-5, Day 7-9, 48 hours after recovery ]CD4+ and CD8+ T cells from blood (per µl) at different time points measured
- Disease severity [ Time Frame: Day 1, Day 3-5, Day 7-9, 48 hours after recovery ]
Clinical classification according to severity:
- Light and uncomplicated (mild symptoms)
- Moderate (mild pneumonia)
- Severe pneumonia
- Critical (Acute Respiratory Distress Syndrome (ARDS), sepsis, septic shock) Evaluated at several time points

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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:
- COVID-19 infection confirmed
- COVID-19 disease manifestation
- Age > 18 years
Exclusion Criteria:
- Missing informed consent of the patient/ legal guardian/ relatives

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): NCT04364828
Contact: Olaf Rieß, Prof. Dr. | +49 (0)7071-29- ext 72288 | olaf.riess@med.uni-tuebingen.de | |
Contact: Michael Bitzer, Prof. Dr. | +49 (0)7071-29- ext 80583 | m.bitzer@med.uni-tuebingen.de |
Germany | |
University Hospital Tübingen | Recruiting |
Tübingen, Germany, 72076 | |
Contact: Olaf Rieß, Prof. Dr. +49 7071 29 olaf.riess@med.uni-tuebingen.de | |
Contact: Michael Bitzer, Prof. Dr. +49 7071 29 ext 80583 m.bitzer@med.uni-tuebingen.de |
Study Director: | Olaf Rieß, Prof. Dr. | University Hospital Tübingen |
Responsible Party: | University Hospital Tuebingen |
ClinicalTrials.gov Identifier: | NCT04364828 |
Other Study ID Numbers: |
COVID-19 NGS |
First Posted: | April 28, 2020 Key Record Dates |
Last Update Posted: | May 18, 2022 |
Last Verified: | May 2022 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Yes |
Plan Description: | The COVID-19 NGS study will provide data in a pseudonymized manner to national and international databases set up to increase the diagnostic yield through advanced analysis tools. |
Supporting Materials: |
Analytic Code |
Time Frame: | Data will become available after analysis and unlimited. |
Access Criteria: | Authorized users within the participating organizations. |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
COVID-19 SARS-CoV-2 Next-Generation-Sequencing |
Whole Genome Analysis MultiOmics Extreme phenotypes |
COVID-19 Disease Progression Respiratory Tract Infections Infections Pneumonia, Viral Pneumonia Virus Diseases Coronavirus Infections |
Coronaviridae Infections Nidovirales Infections RNA Virus Infections Lung Diseases Respiratory Tract Diseases Disease Attributes Pathologic Processes |