ACTIV-2: A Study for Outpatients With COVID-19

Open to people ages 18 years and up

• Signed informed consent.
• Documentation of laboratory-confirmed SARS-CoV-2 infection, as determined by a molecular (nucleic acid) or antigen test from any respiratory tract specimen (e.g. oropharyngeal, nasopharyngeal (NP), or nasal swab, or saliva) collected ≤240 hours (10 days) prior to study entry and conducted an any US clinic or laboratory that has a Clinical Laboratory Improvement Amendments (CLIA) certification or its equivalent or any non-US DAIDS-approved laboratory.
• Able to begin study treatment no later than 8 days from self-reported onset of COVID-19 related symptom(s) or measured fever, where the first day of symptoms is considered symptom day 0 and defined by the self-reported date of first reported sign/symptom from the following list:
• fever or feeling feverish
• cough
• shortness of breath or difficulty breathing at rest or when active
• sore throat
• body pain or muscle pain/aches
• fatigue
• headache
• chills
• blocked nose/nasal congestion
• runny nose
• loss of taste or smell
• nausea or vomiting
• diarrhea
• temperature ≥ 38°C (100.4°F)
• One or more of the following signs/symptoms within 24 hours of participating in the study:
• fever or feeling feverish
• cough
• shortness of breath or difficulty breathing at rest or when active
• sore throat
• body pain or muscle pain/aches
• fatigue
• headache
• chills
• blocked nose/nasal congestion
• runny nose
• loss of taste or smell
• nausea or vomiting
• diarrhea
• temperature ≥ 38°C (100.4°F)
• Oxygen levels of ≥92% when resting (measured by study staff within 24 hours of participating in the study). For a potential participant who regularly receives chronic supplementary oxygen for an underlying lung condition, their oxygen saturation should be measured while on their standard home oxygen supplementation level.
• Participant must agree not to participate in another clinical trial for the treatment of COVID-19 or SARS-CoV-2 during the study period until hospitalization or 28 days after the start of the study, whichever occurs first.
• Meet the protocol definition of being at "higher" risk of progression to severe COVID-19 (BRII-196/BRII-198).
• For participants of reproductive potential, negative serum or urine pregnancy test within 48 hours prior to study entry by any clinic or laboratory that has a CLIA certification or its equivalent, or by a point of care (POC)/CLIA-waived test. Note: Participants not of reproductive potential are eligible without requiring the use of a contraceptive method (BRII-196/BRII-198. AZD7442 [IV], AZD7442 [IM], SNG001, Camostat, SAB-185, CL135-LS+C144-LS).
• Participants that engage in sexual activity that may lead to pregnancy in their partner must agree to either remain abstinent or use male contraceptives. They are strongly advised to inform their non-pregnant sexual partners of reproductive potential to use effective contraceptives for 24 weeks after investigational product is administered. Participants with pregnant partners should use condoms during vaginal intercourse through 24 weeks after investigational agent administration. Participants should refrain from sperm donation for 24 weeks after investigational agent administration (BRII-196/BRII-198, AZD7442 [IV], AZD7442 [IM], SAB-185).
• Participants that engage in sexual activity that may lead to pregnancy in their partner must agree to either remain abstinent or use male contraceptives for 30 days after investigational agent administration. They are also strongly advised to inform their non-pregnant sexual partners of reproductive potential to sue effective contraceptives for 30 days after investigational agent is administered to the participant. Participants with pregnant partners should use condoms during vaginal intercourse through 30 days after last dose of investigational agent administration. Participants should refrain from sperm donation for 30 days after investigational agent administration (SNG001).
• Participants that engage in sexual activity that may lead to pregnancy in their partner must agree to either remain abstinent or use male contraceptives. They are also strongly advised to inform their non-regnant sexual partners of reproductive potential to use effective contraceptives from study entry through 90 days after study treatment. Participants with pregnant partners should use condoms during vaginal intercourse from study entry through 90 days after the last dose of the study treatment. Participants should refrain from sperm donation from study entry through 90 days after the last dose of study treatment (Camostat).
• If participating in sexual activity that could lead to pregnancy, participants who are of reproductive potential must agree to use highly effective contraception for 24 weeks after investigational agent is administered (AZD7442 [IV], AZD7442 [IM], SAB-185).
• If participating in sexual activity that could lead to pregnancy, participants who are of reproductive potential must agree to use effective contraception for 30 days after investigational agent is administered (SNG001).
• If participating in sexual activity that could lead to pregnancy, participants who are of reproductive potential must agree to use effective contraception for 90 days after the last dose of treatment (Camostat).
• If participating in sexual activity that could lead to pregnancy, participants who are of reproductive potential must agree to use highly effective contraception for at least 48 weeks after the investigational agent is administered (C135-LS+C144-LS).

• History of or current hospitalization for COVID-19.
• For the current SARS-CoV-2 infection, any positive SARS-CoV-2 molecular test from any respiratory tract specimen collected more than 10 days prior to study entry.
• Current need for hospitalization or immediate medical attention.
• Any use of the following medications up to 30 days before participating in the study:
• Hydroxychloroquine (except for long-term autoimmune diseases)
• Chloroquine and/or ivermectin (unless used for parasitic infection)
• Remdesivir, systemic and inhaled steroids (unless used for long-term conditions)
• HIV protease inhibitors (unless used long-term for HIV infection)
• Receipt of convalescent COVID-19 plasma or other antibody-based anti-SARS-CoV-2 treatment or prophylaxis at any time prior to study entry.
• Receipt of other investigational treatments for SARS-CoV-2 any time before participating in the study (not including drugs approved and taken for other conditions/diseases).
• Known allergy/sensitivity or hypersensitivity to study drug or placebo.
• Any condition requiring surgery up to 7 days before participating in the study, or that is considered life threatening up to 30 days before participating in the study.
• Currently pregnant or breastfeeding (BRII-196/BRII-198, AZD7442 [IV], AZD7442 [IM], SNG001, Camostat, SAB-185, C135-LS+C144-LS).
• In phase II, meeting the protocol definition of being at "higher risk of progression to severe COVID-19" (AZD7442 [IV], AZD7442 [IM], SNG001, Camostat, SAB-185, C135-LS+C144-LS).
• Inflammatory skin conditions that compromise the safety of intramuscular (IM) injections, or other overlying skin conditions or tattoos that would preclude the assessment of injection site reactions, per the discretion of the investigator (AZD7442 [IM]).
• Inflammatory skin conditions that compromise the safety of subcutaneous (SC) injections, or other overlying skin conditions or tattoos that would preclude the assessment of infection site reactions, per the discretion of the investigator (C135-LS+C144-LS).
• History of coagulopathy which, in the opinion of the investigator, would preclude IM injection, or use of oral or injectable anticoagulants (protocol provides more information on prohibited medications) (AZD7442 [IM]).
• Use of or need for chronic supplemental oxygen (SNG001).
• Known severe liver disease prior to enrollment (defined as ALT or AST > 5 times upper limit of normal or end stage liver disease with Child-Pugh Class C or Child-Pugh-Turcotte score ≥ 10) (Camostat).
• Known severe kidney disease prior to enrollment (defined as estimated glomerular filtration rate (eGFR) <30 ml/min/1.73m² or on renal-replacement therapy such as peritoneal dialysis or hemodialysis (Camostat)

Other investigational drug protocol-defined inclusion/exclusion criteria may apply.