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NCT Number: NCT05833217

Obesity, Insulin Resistance, and PASC: Persistent SARS-CoV-2

The investigators are studying the pathophysiologic links between obesity, insulin resistance (IR), adipose tissue infection, and post-acute sequelae of COVID-19 (PASC). This study looks at whether adipose (fat) tissue contributes to PASC by driving chronic inflammation or by serving as a reservoir for SARS-CoV-2 persistence. The results will not only determine whether obesity and IR are risk factors for PASC, but will also define fundamental biology that sets the stage for the investigation of novel or existing therapies that target the causal pathways identified.

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Key information

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Ages 18 to 80
  • BMI ≥ 25 kg/m2
  • not currently pregnant

Exclusion criteria

Arm 2 (Adipose Tissue Biopsy) exclusions include

  • pregnancy
  • prior liposuction
  • recent change in weight (> 2 kg in one month)
  • bleeding disorders
  • anticoagulant use

Arm 3 (healthy controls only) exclusions include patients with

  • major organ disease
  • diabetes
  • history of liposuction
  • bariatric surgery
  • eating disorders
  • psychiatric disorders
  • pregnancy or lactation
  • recent change in weight (over the past 12 weeks),
  • use of weight loss medication or oral steroids
  • hematocrit < 33%
  • fasting glucose >= 126 mg/dL
  • blood pressure >160/100 mmHg

Treatment and study plan

Adipose tissue biopsy

Procedure

After an overnight fast, approximately 1-2 grams of subcutaneous fat will be removed by a needle. Participants will have a local anesthetic prior to the procedure. The needle fat biopsy will be repeated at quarterly intervals for one year (every 3 months). We will also draw 1 10mL tube of blood at each biopsy for measurement of inflammatory cytokines.

Steady State Plasma Glucose (SSPG) Test

Diagnostic Test

An Insulin Sensitivity Test (SSPG: Steady State Plasma Glucose) is performed to determine if participants are insulin sensitive or insulin resistant. This test is approximately 5-6 hours in length. Participants will be asked to fast for 12 hours. The insulin sensitivity test is designed to measure how well your cells remove glucose from your blood in response to insulin. During this test participants will have two small catheters (tubing) placed in their veins (I.V. lines). The total amount of blood that will be drawn during this test will be 140 mL of blood (approximately 9.5 tablespoons). Insulin is a natural hormone, and octreotide (a synthetic hormone) is a drug that temporarily blocks the secretion of insulin from your pancreas. A member of the research team is present and monitoring the results along with the nursing staff.

Other names: Insulin Sensitivity Test

Primary outcomes

  1. Triglyceride/HDL-cholesterol ratio

    Time frame: 2 years

    Investigate the relationship between insulin resistance, as described by triglyceride/HDL-cholesterol ratio, and incident PASC (long COVID).

  2. Concentration of Viral RNA in Adipose Tissue

    Time frame: 2 years

    Investigate the expression of viral RNA in adipose tissue in response to COVID-19 infection. Compare adipose tissue transcripts such as known MODY transcription factors measured by PCR between COVID-19 infected participants and healthy controls.

  3. Rate of Inflammatory Response

    Time frame: 2 years

    Investigate inflammatory response to PPARgamma agonist (drug) and other compounds tested in vitro in human fat cells. Compare plasma inflammatory cytokine levels in serum samples as measured by Luminex immunoassay between participants identified as Insulin Sensitive (IS) and Insulin Resistant (IR) using the 2-stage Steady State Plasma Glucose test.

  4. Rate of Inflammatory Gene Expression in Adipose Tissue

    Time frame: 2 years

    Investigate the expression of inflammatory genes in adipose tissue in response to COVID-19 infection. Compare adipose tissue transcripts such as defensin chemokine receptors and platelet activation factors measured by PCR between COVID-19 infected participants and healthy controls.

Study contacts

Contact information is provided by the study sponsor or research team.

Nicole Turk, BS

CONTACT

[email protected]

6508880144

Sponsors and collaborators

Lead sponsor

Stanford University

Other

Registry information

Official study title

Obesity, Insulin Resistance, and PASC: Persistent SARS-CoV-2 Infection and Inflammation in Human Adipose Tissue

Important dates

Study start
2023
Primary completion
2025
Study completion
2025
First posted
Apr 27, 2023
Registry last updated
Dec 4, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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