To be better prepared for the next pandemic, leading scientists from the Netherlands, Belgium and the United Kingdom are advocating some radical innovations. They propose the creation of a European authority for clinical research on pandemics to coordinate clinical research in this area thereby avoiding fragmentation of studies.
Among critically ill adults with confirmed COVID-19, treatment with convalescent plasma had a low likelihood of providing improvement in organ support–free days.
In noncritically ill patients with Covid-19, an initial strategy of therapeutic-dose anticoagulation with heparin increased the probability of survival to hospital discharge with reduced use of cardiovascular or respiratory organ support as compared with usual-care thromboprophylaxis.
In critically ill patients with Covid-19, an initial strategy of therapeutic-dose anticoagulation with heparin did not result in a greater probability of survival to hospital discharge or a greater number of days free of cardiovascular or respiratory organ support than did usual-care pharmacologic thromboprophylaxis.
Among critically ill patients with COVID-19, lopinavirritonavir, hydroxychloroquine and combination therapy reduced organ support-free days and survival compared to no COVID-19 antiviral therapy.
This article is a preprint and has not been certified by peer review.
The evidence for benefit of convalescent plasma for critically ill patients with Covid-19 is inconsistent. We hypothesized that convalescent plasma would improve outcomes for critically ill adult patients with Covid-19
In critically ill patients with COVID-19 receiving organ support in ICUs, treatment with the interleukin-6 receptor antagonists tocilizumab and sarilumab improved outcomes, including survival.
Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support–free days within 21 days.
IMPORTANCE Effective therapies for patients with coronavirus disease 2019 (COVID-19) are needed, and clinical trial data have demonstrated that low-dose dexamethasone reduced mortality in hospitalized patients with COVID-19 who required…
University Medical Center Utrecht
Heidelberglaan 100
3584 CX Utrecht
The Netherlands
Email:
EU.remapcap@umcutrecht.nl
REMAP-CAP ClinicalTrials.gov registration NCT02735707
REMAP-CAP EU Clinical Trials Register EUCT number: 2023-507889-89
REMAP-CAP is supported by the ECRAID-Base project which has received funding from the EU Horizon 2020 research and innovation programme (grant number 965313).
Inseparable to the design of this trial, platform conclusions are generated through frequent adaptive analyses as data accrues. To date, REMAP-CAP has contributed to the knowledge about the best treatment of COVID-19 with several results:
ACE2 RAS DOMAIN (27 Feb 2022)
Antiplatelet DOMAIN (23 Jun 2021)
CORTICOSTEROID DOMAIN
COVID-19 IMMUNE MODULATION DOMAIN
COVID-19 ANTI-COAGULATION DOMAIN
COVID-19 IMMUNOGLOBULIN DOMAIN
COVID-19 ANTIVIRAL DOMAIN
