Mavrilimumab to Reduce Progression of Acute Respiratory Failure in COVID-19 Pneumonia and Systemic Hyper-inflammation

This prospective, Phase 2, multi-center, blinded randomized placebo-controlled study is designed to demonstrate that early treatment with mavrilimumab prevents progression of respiratory failure in patients with severe COVID-19 pneumonia and clinical and biological features of hyper-inflammation.

The study population includes patients who have severe pneumonia, defined as hospitalization due to COVID-19 with abnormal chest imaging and SpO2 \<92% on room air or requirement for supplemental oxygen.

Enrollment: The study will be performed in approximately 4 months total, starting from the first patient enrolled with enrollment expected to complete within 2 months.

Follow-up Period: The follow-up period is 60 days for each patient enrolled.

A total of 60 patients will be randomized using 1:1 allocation ratio: 30 subjects will receive mavrilimumab, and 30 subjects will receive placebo infusion. The investigator, clinical team, and subject will be blinded to treatment assignment.

Participants will be identified by regular review of hospitalized COVID 19 patients to evaluate for inclusion and exclusion criteria. Participants will then be approached in this standard manner by study investigator and/or coordinator/research nurse.

Research interventions will take place in the hospital in accordance with privacy standards.

The study team in informed on all study procedures and requirements with daily meetings and the opportunity to continuously update through secure channels.

In this multicenter consortium of 4 academic centers, each participating site will have their own IND for patients enrolled at their site. Data collection will occur at each of the 4 academic centers. Data analysis and randomization scheme will be performed by the Cleveland Clinic C5 Research, data analysis, and randomization scheme will be performed by one site, Cleveland Clinic C5 Research.