NCT05619653Active, not recruitingPhase 3
Myocardial Protection in Patients With Post-acute Inflammatory Cardiac Involvement Due to COVID-19
Randomised Placebo Controlled Clinical Trial of Efficacy of MYOcardial Protection in Patients With Postacute inFLAMmatory Cardiac involvEment Due to COVID-19
Source: ClinicalTrials.gov · Last updated 9 Dec 2025
Brief summary (registry, in English)
Long COVID or Postacute sequelae of COVID-19 infection (PASC) are increasingly recognised complications, defined by lingering symptoms, not present prior to the infection, typically persisting for more than 4 weeks. Cardiac symptoms due to post-acute inflammatory cardiac involvement affect a broad segment of people, who were previously well and may have had only mild acute illness (PASC-cardiovascular syndrome, PASC-CVS). Symptoms may be contiguous with the acute illness, however, more commonly they occur after a delay. Symptoms related to the cardiovascular system include exertional dyspnoea, exercise intolerance chest tightness, pulling or burning chest pain, and palpitations (POTS, exertional tachycardia). Pathophysiologically, Long COVID relates to small vessel disease (endothelial dysfunction) vascular dysfunction and consequent tissue organ hypoperfusion due to ongoing immune dysregulation. Active organs with high oxygen dependency are most affected (heart, brain, kidneys, muscles, etc.). Thus, cardiac symptoms are often accompanied by manifestations of other organ systems, including fatigue, brain fog, kidney problems, myalgias, skin and joint manifestations, etc, now commonly referred to as the Long COVID or PASC syndrome. Phenotypically, PostCOVID Heart involvement is characterised by chronic perivascular and myopericardial inflammation. We and others have shown changes using sensitive cardiac MRI imaging that relate to cardiac symptoms (Puntmann et al, Nature Medicine 2022; Puntmann et al, JAMA Cardiol 2020; Summary of studies included in 2022 ACC PostCOVID Expert Consensus Taskforce Development Statement, JACC 2022, references below). Early intervention with immunosuppression and antiremodelling therapy may reduce symptoms and development of myocardial impairment, by minimising the disease activity and inducing disease remission. Low-dose maintenance therapy may help to maintain the disease activity at the lowest possible level. The benefits of early initiations of antiremodelling therapy to reduce symptoms of exercise intolerance are well recognised, but not commonly employed outside the classical cardiology contexts, such as heart failure or hypertension. As most patients with inflammatory heart disease only have mild or no structural abnormalities, they are left untreated (standard of care). The aim of this study is to examine the efficacy of a combined immunosuppressive / antiremodelling therapy in patients with PASC symptoms and inflammatory cardiac involvement determined by CMR, to reduce the symptoms and inflammatory myocardial injury and thereby stop the progression to reduced LVEF, HF and death.
- Status (registry)
- Active, not recruiting
- Phase (registry)
- Phase 3
- Study type
- Interventional
- Enrollment
- 279 (actual)
- First submitted
- 14 Nov 2022
- Start date
- 12 Dec 2022
- Primary completion date
- 8 Aug 2025
- Lead sponsor
- Valentina Puentmann
- NCT number
- NCT05619653
- EudraCT number
- 2022-001682-12
What you commit to
- Study type: Interventional · Phase 3
- Participants enrolled: 279
- From 12 Dec 2022 to the primary completion date, 8 Aug 2025
- 5 sites in 2 countries
- Visits and tests: ask the trial team, the registry does not list them
Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.
Who cannot take part
Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.
Prior treatment
- Any previous or current use of ACE inhibitors, AR Blockers
- Any previous oral prednisolone, or any other immunosuppressive or biological treatment (within prior 10 weeks)
- Known alcohol, drug or chemical abuse
Other illness
- Severe acute COVID illness requiring hospitalisation
- Known allergy to or intolerance of the study medications
- Contraindications to contrast-enhanced CMR imaging, e.g.
- MR-unsafe implantable device
- known allergy to gadolinium-based contrast agent (CBGA)
- Unable to provide written informed consent
- Patients with CMR evidence of structural heart disease or incidental heart rhythm abnormalities will be advised to see their own doctor for further investigation.
Lab values
- History or CMR evidence of pre-existing significant heart disease, including:
- Known cardiac impairment with LVEF ≤44%
- Congestive heart failure (NYHA III-IV)
- Active heart failure treatment
- Established ischaemic heart disease, peripheral arterial disease and/or cerebrovascular disease
- Persistent or permanent atrial fibrillation or significant heart rhythm abnormalities
- Congenital or clinically relevant valvular heart disease (moderate or severe)
- Specific cardiomyopathy (hypertrophic, hypertensive heart disease, amyloidosis, previous myocarditis, non-ischaemic dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, non-compaction cardiomyopathy, etc).
- Known significant concomitant diseases that are likely to interfere with the evaluation of the patient's safety and of the study outcome (e.g. diabetes, lung or hepatic disease, epilepsy, psychiatric disorders, renal disease with a current estimated GFR \<30 mL/min/1.73 m² using MDRD formula, chronic systemic infection or immunocompromise)
Other
- Symptomatic hypotension (systolic blood pressure less than 90 mm Hg), not reversible with oral hydration
- Exceeding scanner bore and table-holding capacity: Weight \>125 kg, BMI \> 35 kg/m2
- For female participants:
- Pregnant or breastfeeding women
- Persons of childbearing potential not willing to use effective contraception (defined as PEARL index \<1 - e.g. contraceptive pill, IUD)
- Patients currently participating in an investigational study or for whom participation is planned.
Who the study is looking for
- Patients ≥ 18 years
- Patients with documented recent COVID19 infection (\>4 weeks)
- PASC Syndrome, defined by persistence or new symptoms, not present prior to the infection.
- CMR evidence of inflammatory cardiac involvement at BL by any of the following criteria:
- Increased native T1≥ 1130 ms at 3.0 Tesla (or 1030 ms at 1.5 Tesla) and/or;
- Increased native T2 ≥39.5 ms at 3.0 Tesla (or 49.5 at 1.5 Tesla) and/or
- present non-ischaemic myopericardial LGE and/or;
- LVEF ≥45 - ≤50%.
- Willingness to comply with the study procedures and study protocol
Age in the registry: 18 years to 65 years · Sex: All · Does not accept healthy volunteers
Sites (5)
Sites in registry order. Pick your city on the disease page to sort them by distance.
| Site | City | Country | Site status |
|---|---|---|---|
| University Medical Centre Vienna Coordinator of this site? Confirm its status | Vienna | Austria | Unknown status |
| Institute for experimental and translational cardiovascular imaging Coordinator of this site? Confirm its status | Frankfurt am Main | Germany | Unknown status |
| University Hospital Greifswald Coordinator of this site? Confirm its status | Greifswald | Germany | Unknown status |
| University Hospital Schleswig-Holstein, Campus KIEL Coordinator of this site? Confirm its status | Kiel | Germany | Unknown status |
| University Hospital Ulm Coordinator of this site? Confirm its status | Ulm | Germany | Unknown status |
Related publications
- Losartan and prednisolone for post-COVID syndrome and cardiac inflammation: a randomized, double-blind, placebo-controlled trial.Nat Commun · 2026 · PMID 42533000
This page is information, not medical advice. Discuss any trial with your doctor.