VSL#3® vs Placebo in the Treatment of Fatigue and Other Symptoms in Long Covid (DELong#3) (DELong#3)
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ClinicalTrials.gov Identifier: NCT05874089 |
Recruitment Status :
Recruiting
First Posted : May 24, 2023
Last Update Posted : May 24, 2023
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Long COVID | Dietary Supplement: VSL#3® Dietary Supplement: Placebo | Not Applicable |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 96 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Intervention Model Description: | This is a single-center randomized, double-blind, placebo-controlled trial. Patients will be recruited from Long Covid out-patient Clinics at Policlinico di Milano Hospital (Milan, Italy) and randomly assigned (1:1) to receive VSL#3® or placebo at the dosage of 2 sachets/die for 28 days. Fasting blood samples and feces will be collected before (t0) and after treatment (t4). Primary and secondary outcome will be assessed at baseline (t0), end of treatment (t4) and end of follow-up (t8) using validated questionnaires (i.e. CFS- Chalder Fatigue Scale; HAD- Hospital Anxiety and Depression Scale, SF36 - Short Form Health Survey, Structured Assessment of Gastrointestinal Symptoms Scale - SAGIS; Symptoms Check List 12 - SCL-12; Karnofsky Performance Status - KPS; Visual Analogue Scale- VAS). Subject participation in this study will be approximately 10 weeks, which include 2-weeks screening/run in period, 4-weeks treatment period and 4-weeks follow-up period. |
Masking: | Double (Participant, Investigator) |
Masking Description: | Double blinding is achieved by packaging probiotics and placebo in the same sealed and consecutively numbered containers with sachets similar in packaging, smell, and taste. All study participants and on-site study personnel will remain masked for the treatment allocation (randomized controlled trial phase) until database lock and signature of the statistical analysis plan. |
Primary Purpose: | Treatment |
Official Title: | The Role of VSL#3® in the Treatment of Fatigue and Other Symptoms in Long Covid-19 Syndrome: a Randomized, Double-blind, Placebo-controlled Study (DELong#3) |
Actual Study Start Date : | November 3, 2022 |
Estimated Primary Completion Date : | September 3, 2023 |
Estimated Study Completion Date : | November 3, 2023 |

Arm | Intervention/treatment |
---|---|
Active Comparator: VSL#3®
VSL#3® 450 billion sachets, two sachets per day (900 billion of bacteria per day) for 28 days
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Dietary Supplement: VSL#3®
VSL#3® 450 billions/sachets |
Placebo Comparator: Placebo
Placebo sachets, two sachets per day for 28 days
|
Dietary Supplement: Placebo
Placebo sachets with maltose, cornstarch and dioxide
Other Name: Placebo (for VSL#3®) |
- Assessment of Fatigue variation after 4 weeks of treatment (t4) [ Time Frame: 4 weeks ]To determine if there is a statistically significant variation in the scores on the Chalder Fatigue Scale between the treated group and the placebo group after 4 weeks of treatment (t4)
- Assessment of Fatigue variation after 4 weeks of follow-up (t8) [ Time Frame: 8 weeks ]To determine if there is a statistically significant difference in the scores on the Chalder Fatigue Scale between the treated group and the placebo group after 4 weeks of follow-up
- Evaluation of Anxiety and Depression variation after 4 weeks of treatment (t4) [ Time Frame: 4 weeks ]To determine if there is a statistically significant difference in the scores on the Hospital Anxiety and Depression Scale (HAD) between the treated group and to the placebo group after 4 weeks of treatment
- Evaluation of Anxiety and Depression variation after 4 weeks of follow-up (t8) [ Time Frame: 8 weeks ]To determine if there is a statistically significant difference in the scores on the Hospital Anxiety and Depression Scale (HAD) between the treated group and to the placebo group after 4 weeks of follow-up
- Measurement of Quality of Life variation after 4 weeks of treatment (t4) [ Time Frame: 4 weeks ]To determine if there is a statistically significant difference in the scores on the Short Form Health Survey (SF)-36 between the treated group and placebo group after 4 weeks of treatment
- Measurement of Quality of Life variation after 4 weeks of follow-up (t8) [ Time Frame: 8 weeks ]To determine if there is a statistically significant difference in the scores on the Short Form Health Survey (SF)-36 between the treated group and the placebo group after 4 weeks of follow-up
- Assessment of Gastrointestinal Symptoms variation after 4 weeks of treatment (t4) [ Time Frame: 4 weeks ]To determine if there is a statistically significant difference in the scores on the Structured Assessment of Gastrointestinal Symptoms Scale (SAGIS) between the placebo group and the treated group after 4 weeks of treatment
- Assessment of Gastrointestinal Symptoms variation after4 weeks of follow-up (t8) [ Time Frame: 8 weeks ]To determine if there is a statistically significant difference in the scores on the Structured Assessment of Gastrointestinal Symptoms Scale (SAGIS) between the placebo group and the treated group after 4 weeks of follow-up
- Analysis of Somatization variation after 4 weeks of treatment (t4) [ Time Frame: 4 weeks ]To identify the level of somatization of symptoms by comparing the scores on the SCL-12 for the somatization of Symptom Checklist-90 (SCL-90) between the treated group and the placebo group after 4 weeks of treatment
- Analysis of Somatization variation after 4 weeks of treatment (t4) [ Time Frame: 8 weeks ]To identify the level of somatization of symptoms by comparing the scores on the SCL-12 for the somatization of Symptom Checklist-90 (SCL-90) between the treated groups and the placebo group after 4 weeks of follow-up
- Evaluation of Functional Status variation after 4 weeks of treatment (t4) [ Time Frame: 4 weeks ]To assess the general functional status of the patients by comparing the scores on the Karnofsky Performance Status (KPS) Scale between the treated group and the placebo group after 4 weeks of treatment
- Evaluation of Functional Status variation after 4 weeks of follow-up (t8) [ Time Frame: 8 weeks ]To assess the general functional status of the patients by comparing the scores on the Karnofsky Performance Status (KPS) Scale between the treated group and the placebo group after 4 weeks of follow-up
- Physician's Assessment of General Health variation after 4 weeks of treatment (t4) [ Time Frame: 4 weeks ]To determine the physician's evaluation of the patient's general state of health using a visual-analogue scale (VAS) and comparing it between the treated group and the placebo group after 4 weeks of treatment
- Physician's Assessment of General Health variation after 4 weeks of follow-up (t8) [ Time Frame: 8 weeks ]To determine the physician's evaluation of the patient's general state of health using a visual-analogue scale (VAS) and comparing it between the treated group and the placebo group after 4 weeks of follow-up
- Analysis of PBMC and Serum Expression of inflammatory mediators at baseline (t0) and after 4 weeks of treatment (t4) [ Time Frame: 4 weeks ]Evaluation of multiple cytokines and chemokines in plasma samples and of immune cell phenotypes in peripheral blood mononuclear cells (PBMCs)
- Investigation of Faecal Microbiota Variation after 4 weeks of treatment (t4) [ Time Frame: 4 weeks ]To analyze the variation of the bacterial component of the faecal microbiota in terms of alpha and beta diversity and explore its correlation with clinical response on fatigue in both the placebo group and the treated group by using. Shotgun metagenomics and 16S sequencing of faecal samples at baseline and after 4 weeks of treatment (t4) generate serial gut microbial taxonomic and bacterial functional profiles.

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Ages Eligible for Study: | 18 Years to 65 Years (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age >18; <65 yo
- Previous diagnosis of SARS-CoV-2 infection, documented by nasopharyngeal or antigenic molecular swab;
- Not currently be in quarantine or isolation;
- No antibiotics treatment in the 30 days prior to the trial;
- Chalder Fatigue Scale (in dichotomous form)>=4 possibly associated with signs and symptoms of Long COVID-19 syndrome: signs and symptoms that develop during or after SARS-CoV-2 infection, which persist for more than 4 weeks and are not reasonably explained otherwise; signs and symptoms include: fatigue, sleep disturbances, cognitive deficits (i.e. brain fogging, loss of concentration and memory, anxiety, depression), strength deficits, arthralgias and myalgias, gastroenterological alterations (reduced appetite, nausea, changes in bowel habits, abdominal pain
Exclusion Criteria:
- Cardiovascular and pulmonary disease with moderately severe organ dysfunction (NYHA>2, Borg scale>=2);
- Decompensated endocrine and metabolic diseases (child cirrhosis >= B, decompensated hypo/hyperthyroidism, decompensated hypoadrenalism)
- Diagnosis of FM, CFS/ME, and/or IBS prior to SARS-CoV-2 infection;
- Confirmed diagnoses of neurological pathologies, psychiatric diseases and cognitive disorders prior to SARS-CoV-2 infection;
- Previous confirmed diagnosis of chronic musculoskeletal pathologies prior to prior to SARS-CoV-2 infection;
- Refusal to participate in the study / refusal to process personal data;
- Pregnancy or breastfeeding;
- Addiction to alcohol or drugs in previous years;
- Use of other probiotics during the trial;
- Use of antibiotics during the trial and in the previous 30 days;
- Substantial change of diet during the trial;
- Participation in another clinical study in the previous 30 days or previous participation in this same trial;
- Known intolerance/hypersensitivity to the investigational drug or to the excipients of the placebo formulation

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): NCT05874089
Contact: Flavio Caprioli, MD, PhD | +39 02 5503 2141 | flavio.caprioli@policlinico.mi.it | |
Contact: Beatrice Marinoni, MD | +39 02 5503 2141 | beatrice.marinoni@unimi.it |
Italy | |
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico | Recruiting |
Milan, MI, Italy, 20122 | |
Contact: Beatrice Marinoni, MD +39 02 5503 2141 beatrice.marinoni@unimi.it |
Study Director: | Flavio Caprioli, MD, PhD | Fondazione IRCCS Cà Granda, Ospedale Policlinico di Milano |
Documents provided by Flavio Caprioli, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico:
Responsible Party: | Flavio Caprioli, Associate Professor of Gastroenterology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico |
ClinicalTrials.gov Identifier: | NCT05874089 |
Other Study ID Numbers: |
DELong#3 |
First Posted: | May 24, 2023 Key Record Dates |
Last Update Posted: | May 24, 2023 |
Last Verified: | May 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Undecided |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Long Covid Fatigue Gut Microbioma |
Dysbiosis COVID-19 Coronavirus Infections |
Post-Acute COVID-19 Syndrome COVID-19 Fatigue Pneumonia, Viral Pneumonia Respiratory Tract Infections Infections Virus Diseases Coronavirus Infections |
Coronaviridae Infections Nidovirales Infections RNA Virus Infections Lung Diseases Respiratory Tract Diseases Post-Infectious Disorders Chronic Disease Disease Attributes Pathologic Processes |