CClinicalTrials.gg
Status unknownNCT04802044CARAMELUpdated Apr 18, 2022

COVID-19, Aging, and Cardiometabolic Risk Factors Study

An observational study in Covid19, Obesity and Diabetes Mellitus, sponsored by Indonesia University. Status unknown at 2 sites in Indonesia. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2022-04-18.

Sponsored by Indonesia University · Observational

The sponsor has not verified this record recently (last verified Apr 2022), so the status shown — last known as Active, not recruiting — may be out of date.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
440
Ages
18 Years and older
Sex
All
01

Study summary

COVID-19 pandemic has made a tremendous impact on Indonesian economic and health care system especially with the double burden of diseases facing by Indonesia as a developing country. The prevalence of non-communicable diseases such as obesity, type diabetes, and cardiovascular diseases is increasing. These diseases along with older age have been known as an established risk factors for higher mortality and severe clinical disease entity in COVID-19 infection. Although, there is still some part of patients with these co-morbidities that only present with mild symptoms when infected with SARS-CoV-2, even for some without any symptoms. Thus, it would be very interesting to evaluate how are these role of aging and cardiometabolic parameters in the clinical disease course of COVID-19 infection, and how are the relationship with the immune system.

Read the detailed description

Indonesia is a country in transition where the burden of non-communicable diseases is taking over the infectious diseases problem, mostly due to the changes in lifestyle and increase in life expectancy.

However, the unprecedented rising numbers of COVID-19 patients in Indonesia has impacted the Indonesian healthcare system heavily. It has been reported that older age and the presence of cardiometabolic risk factors pose a poor prognostic factor of COVID-19. It is also important to note that in Indonesia, the presence of cardiometabolic risk factors is often observed at a younger age. Thus, this might also contribute to the higher mortality of COVID19 infected patients despite their relatively younger age in comparison to other countries. Nevertheless, specific data on the impact of aging and cardiometabolic risk factors on COVID-19 are fragmentary, justifying the achievement of a dedicated prospective observational study.

The CARAMEL study aims to specifically describe the phenotypic aging and cardiometabolic characteristics of patients with COVID-19 infection, in relation with the changes in the mucosal and systemic immune system. Particular attention will be devoted to obesity, central obesity, prediabetes, diabetes, hypertension, dyslipidemia, as well as anti-diabetic, antihypertensive, and anti-dyslipidemia therapies.

This study will provide answers to researchers, medical professionals, and especially patients, regarding the impact of aging and cardiometabolic risk factors for COVID-19 prognosis. This pilot study will be used for the development of new studies and for the establishment of recommendations for the care of patients with cardiometabolic risk factors and COVID-19.

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Conditions studied

  • Covid19
  • Obesity
  • Diabetes Mellitus
  • Aging
  • Cardiometabolic Syndrome
  • Immune System Disorder

Keywords

  • COVID-19
  • adiposity
  • diabetes
  • insulin resistance
  • aging
  • inflammation
  • immune system
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In context

COVID-19

7,640 studies on the registry are indexed under COVID-19; 488 are open to participants now.

This study's enrollment of 440 is above the median of 261 across 3,136 observational studies indexed under COVID-19.

Browse COVID-19 studies →

Lead sponsor

Indonesia University is the lead sponsor of 448 studies on the registry; 56 are open to participants now.

Of its 6 completed or terminated interventional studies of FDA-regulated products, 1 (17%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

COVID-19 patients in hospital and community setting

Inclusion criteria

  • Patients newly diagnosed with COVID-19 at hospital setting or community screening, confirmed with biological proof (RT-PCR)

Exclusion criteria

Exclusion Criteria:

  • Subjects opposed to the use of their data
  • Minors, adults under guardianship, protected persons
  • History of malignancy
  • History of autoimmune disease
  • Pregnancy
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Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
440 participants (actual)
Patient registry
No
Biospecimen retention
Samples with dna
06

What researchers measure

Primary outcomes

  1. Correlation of Body Mass Index with Clinical Disease Severity

    To compare the body mass index, which calculated from body height (in meters) and body weight (in kilograms), in groups of COVID-19 patients with various disease severity based on WHO criteria

    Time frame: Baseline

  2. Correlation of Visceral Fat with Clinical Disease Severity

    To compare the visceral fat that measures using a bio-impedance analyzer, in groups of COVID-19 patients with various disease severity based on WHO criteria

    Time frame: Baseline

  3. Correlation of Blood Glucose Levels with Clinical Disease Severity

    To compare the random blood glucose levels during admission in groups of COVID-19 patients with various disease severity based on WHO criteria

    Time frame: Baseline

  4. Correlation of HbA1c with Clinical Disease Severity

    To compare the HbA1c levels during admission in groups of COVID-19 patients with various disease severity based on WHO criteria

    Time frame: Baseline

Secondary outcomes

  1. Changes of Insulin Resistance Levels in COVID-19 Patients Overtime

    To compare the changes of HOMA-IR, a surrogate marker for whole-body insulin resistance which calculated from fasting blood glucose (IU/mL) and fasting insulin (mg/dL), between COVID-19 patients and healthy control subjects

    Time frame: Baseline, 6, and 12 month

  2. Changes of Leptin/Adiponectin Ratio in COVID-19 Patients Overtime

    To compare the changes of leptin/adiponectin ratio, which calculated from leptin levels (ng/mL) divided by adiponectin levels (mikrogram/dL), between COVID-19 patients and healthy control subjects

    Time frame: Baseline, 6, and 12 month

  3. Systemic Immune Profiles in Diabetic COVID-19 Patients

    To compare the systemic immune profiles using mass cytometry between diabetic/COVID-19, non-diabetic/COVID-19, and healthy control subjects

    Time frame: Baseline

  4. Nasal Mucosal Immune Profiles in Diabetic COVID-19 Patients

    To compare the nasal-mucosal immune profiles using mass cytometry between diabetic/COVID-19, non-diabetic/COVID-19, and healthy control subjects

    Time frame: Baseline

  5. Aging Parameter (ACE-2 gene expression) in COVID-19 Patients

    To compare the nasal epithelial ACE-2 gene expression in groups of COVID-19 patients with various disease severity based on WHO criteria

    Time frame: Baseline

  6. Aging Parameter (Telomere Length) in COVID-19 Patients

    To compare the aging parameter using telomere length in groups of COVID-19 patients with various disease severity based on WHO criteria

    Time frame: Baseline

  7. Immune Cells Exhaustion in COVID-19 Patients

    To compare the immune cells exhaustion marker (T-cell immunoglobulin mucin-3/TIM-3 expressions) in groups of COVID-19 patients with various disease severity based on WHO criteria

    Time frame: Baseline

  8. Changes of Pro-Inflammatory Cytokine (IL-6) in COVID-19 Patients

    To compare the changes of pro-inflammatory cytokine (IL-6) levels overtime, measured from the supernatant of stimulated PBMC isolation in groups of patients with various clinical disease severity based on WHO criteria

    Time frame: Baseline, 1, 3, and 6 months

  9. Changes of Anti-Inflammatory Cytokine (IL-10) in COVID-19 Patients

    To compare the changes of anti-inflammatory cytokine (IL-10) levels overtime, measured from the supernatant of stimulated PBMC isolation in groups of patients with various clinical disease severity based on WHO criteria

    Time frame: Baseline, 1, 3, and 6 months

  10. Antibody Kinetics in COVID-19 Patients

    To compare the changes of antibody titers in groups of patients with various clinical disease severity based on WHO criteria

    Time frame: Baseline, 1, 3, and 6 months

  11. Proportion of Long COVID Syndrome

    Percentage of COVID-19 patients still present with symptoms compared to whole study subjects

    Time frame: 3, 6, and 12 months

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Study locations

2 sites
  • Dr. Cipto Mangunkusumo National General Hospital
    Jakarta Pusat, DKI Jakarta 10430, Indonesia
  • Metabolic Disorder, Cardiovascular, and Aging Research Cluster IMERI-FKUI, Research Tower, 5th Floor
    Jakarta Pusat, DKI Jakarta 10430, Indonesia
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References and documents

Publications

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  • Ni W, Yang X, Yang D, Bao J, Li R, Xiao Y, Hou C, Wang H, Liu J, Yang D, Xu Y, Cao Z, Gao Z. Role of angiotensin-converting enzyme 2 (ACE2) in COVID-19. Crit Care. 2020 Jul 13;24(1):422. doi: 10.1186/s13054-020-03120-0. PubMed 32660650 ↗
  • Sungnak W, Huang N, Becavin C, Berg M, Queen R, Litvinukova M, Talavera-Lopez C, Maatz H, Reichart D, Sampaziotis F, Worlock KB, Yoshida M, Barnes JL; HCA Lung Biological Network. SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes. Nat Med. 2020 May;26(5):681-687. doi: 10.1038/s41591-020-0868-6. Epub 2020 Apr 23. PubMed 32327758 ↗
  • Khemais-Benkhiat S, Idris-Khodja N, Ribeiro TP, Silva GC, Abbas M, Kheloufi M, Lee JO, Toti F, Auger C, Schini-Kerth VB. The Redox-sensitive Induction of the Local Angiotensin System Promotes Both Premature and Replicative Endothelial Senescence: Preventive Effect of a Standardized Crataegus Extract. J Gerontol A Biol Sci Med Sci. 2016 Dec;71(12):1581-1590. doi: 10.1093/gerona/glv213. Epub 2015 Dec 15. PubMed 26672612 ↗
  • Song J, Hu B, Qu H, Wang L, Huang X, Li M, Zhang M. Upregulation of angiotensin converting enzyme 2 by shear stress reduced inflammation and proliferation in vascular endothelial cells. Biochem Biophys Res Commun. 2020 May 7;525(3):812-818. doi: 10.1016/j.bbrc.2020.02.151. Epub 2020 Mar 10. Erratum In: Biochem Biophys Res Commun. 2022 Dec 3;632:204-205. doi: 10.1016/j.bbrc.2022.09.102. PubMed 32169277 ↗
  • Bunyavanich S, Do A, Vicencio A. Nasal Gene Expression of Angiotensin-Converting Enzyme 2 in Children and Adults. JAMA. 2020 Jun 16;323(23):2427-2429. doi: 10.1001/jama.2020.8707. PubMed 32432657 ↗
  • Alsufyani HA, Docherty JR. The renin angiotensin aldosterone system and COVID-19. Saudi Pharm J. 2020 Aug;28(8):977-984. doi: 10.1016/j.jsps.2020.06.019. Epub 2020 Jul 2. PubMed 32788834 ↗
  • Al-Benna S. Association of high level gene expression of ACE2 in adipose tissue with mortality of COVID-19 infection in obese patients. Obes Med. 2020 Sep;19:100283. doi: 10.1016/j.obmed.2020.100283. Epub 2020 Jul 18. PubMed 32835126 ↗
  • Michalakis K, Ilias I. SARS-CoV-2 infection and obesity: Common inflammatory and metabolic aspects. Diabetes Metab Syndr. 2020 Jul-Aug;14(4):469-471. doi: 10.1016/j.dsx.2020.04.033. Epub 2020 Apr 29. PubMed 32387864 ↗
  • Telles S, Reddy SK, Nagendra HR. Obesity, Inflammation and Endothelial Dysfunction. J Chem Inf Model. 2019;53(9):1689-99.
  • Cervia C, Nilsson J, Zurbuchen Y, Valaperti A, Schreiner J, Wolfensberger A, Raeber ME, Adamo S, Weigang S, Emmenegger M, Hasler S, Bosshard PP, De Cecco E, Bachli E, Rudiger A, Stussi-Helbling M, Huber LC, Zinkernagel AS, Schaer DJ, Aguzzi A, Kochs G, Held U, Probst-Muller E, Rampini SK, Boyman O. Systemic and mucosal antibody responses specific to SARS-CoV-2 during mild versus severe COVID-19. J Allergy Clin Immunol. 2021 Feb;147(2):545-557.e9. doi: 10.1016/j.jaci.2020.10.040. Epub 2020 Nov 20. PubMed 33221383 ↗
  • Peron JPS, Nakaya H. Susceptibility of the Elderly to SARS-CoV-2 Infection: ACE-2 Overexpression, Shedding, and Antibody-dependent Enhancement (ADE). Clinics (Sao Paulo). 2020;75:e1912. doi: 10.6061/clinics/2020/e1912. Epub 2020 May 15. PubMed 32428113 ↗
  • Lopes-Paciencia S, Saint-Germain E, Rowell MC, Ruiz AF, Kalegari P, Ferbeyre G. The senescence-associated secretory phenotype and its regulation. Cytokine. 2019 May;117:15-22. doi: 10.1016/j.cyto.2019.01.013. Epub 2019 Feb 16. PubMed 30776684 ↗
  • Asghar M, Yman V, Homann MV, Sonden K, Hammar U, Hasselquist D, Farnert A. Cellular aging dynamics after acute malaria infection: A 12-month longitudinal study. Aging Cell. 2018 Feb;17(1):e12702. doi: 10.1111/acel.12702. Epub 2017 Nov 16. PubMed 29143441 ↗
  • Pathai S, Lawn SD, Gilbert CE, McGuinness D, McGlynn L, Weiss HA, Port J, Christ T, Barclay K, Wood R, Bekker LG, Shiels PG. Accelerated biological ageing in HIV-infected individuals in South Africa: a case-control study. AIDS. 2013 Sep 24;27(15):2375-84. doi: 10.1097/QAD.0b013e328363bf7f. PubMed 23751258 ↗
  • van de Berg PJ, Griffiths SJ, Yong SL, Macaulay R, Bemelman FJ, Jackson S, Henson SM, ten Berge IJ, Akbar AN, van Lier RA. Cytomegalovirus infection reduces telomere length of the circulating T cell pool. J Immunol. 2010 Apr 1;184(7):3417-23. doi: 10.4049/jimmunol.0903442. Epub 2010 Feb 22. PubMed 20176738 ↗
  • Robinson MW, McGuinness D, Swann R, Barclay S, Mills PR, Patel AH, McLauchlan J, Shiels PG. Non cell autonomous upregulation of CDKN2 transcription linked to progression of chronic hepatitis C disease. Aging Cell. 2013 Dec;12(6):1141-3. doi: 10.1111/acel.12125. Epub 2013 Aug 12. PubMed 23931242 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 18, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT04802044
Lead sponsor
Indonesia University
Collaborators
Leiden University Medical Center
Responsible party
Dicky L. Tahapary (Principal Investigator, Indonesia University) — Principal investigator
First posted
Mar 17, 2021
Start date
Dec 8, 2020
Primary completion
Dec 31, 2022 (estimated)
Completion
Dec 31, 2023 (estimated)
Last update
Apr 18, 2022

Study contacts

Dicky L Tahapary
principal investigator · Indonesia University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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