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dc.contributor.authorArabi, Yaseen Men_AU
dc.contributor.authorGordon, Anthony Cen_AU
dc.contributor.authorDerde, Lennie P Gen_AU
dc.contributor.authorNichol, Alistair Den_AU
dc.contributor.authorMurthy, Srinivasen_AU
dc.contributor.authorBeidh, Farah Alen_AU
dc.contributor.authorAnnane, Djillalien_AU
dc.contributor.authorSwaidan, Lolowa Alen_AU
dc.contributor.authorBeane, Abien_AU
dc.contributor.authorBeasley, Richarden_AU
dc.contributor.authorBerry, Lindsay Ren_AU
dc.contributor.authorBhimani, Zahra|Bonten, Marc J Men_AU
dc.contributor.authorBradbury, Charlotte Aen_AU
dc.contributor.authorBrunkhorst, Frank Men_AU
dc.contributor.authorBuxton, Meredithen_AU
dc.contributor.authorBuzgau, Adrianen_AU
dc.contributor.authorCheng, Allenen_AU
dc.contributor.authorDe Jong, Mennoen_AU
dc.contributor.authorDetry, Michelle Aen_AU
dc.contributor.authorDuffy, Eamon Jen_AU
dc.contributor.authorEstcourt, Lise Jen_AU
dc.contributor.authorFitzgerald, Marken_AU
dc.contributor.authorFowler, Roben_AU
dc.contributor.authorGirard, Timothy Den_AU
dc.contributor.authorGoligher, Ewan Cen_AU
dc.contributor.authorGoossens, Hermanen_AU
dc.contributor.authorHaniffa, Rashanen_AU
dc.contributor.authorHiggins, Alisa Men_AU
dc.contributor.authorHills, Thomas Een_AU
dc.contributor.authorHorvat, Christopher Men_AU
dc.contributor.authorHuang, David Ten_AU
dc.contributor.authorKing, Andrew Jen_AU
dc.contributor.authorLamontagne, Francoisen_AU
dc.contributor.authorLawler, Patrick Ren_AU
dc.contributor.authorLewis, Rogeren_AU
dc.contributor.authorLinstrum, Kelseyen_AU
dc.contributor.authorLitton, Edwarden_AU
dc.contributor.authorLorenzi, Elizabethen_AU
dc.contributor.authorMalakouti, Salimen_AU
dc.contributor.authorMcAuley, Daniel Fen_AU
dc.contributor.authorMcGlothlin, Annaen_AU
dc.contributor.authorMcguinness, Shayen_AU
dc.contributor.authorMcVerry, Bryanen_AU
dc.contributor.authorMontgomery, Stephanie Ken_AU
dc.contributor.authorMorpeth, Susan Cen_AU
dc.contributor.authorMouncey, Paul Ren_AU
dc.contributor.authorOrr, Katrinaen_AU
dc.contributor.authorParke, Rachaelen_AU
dc.contributor.authorParker, Jane Cen_AU
dc.contributor.authorPatanwala, Asad Een_AU
dc.contributor.authorRowan, Kathryn Men_AU
dc.contributor.authorSantos, Marlene Sen_AU
dc.contributor.authorSaunders, Christina Ten_AU
dc.contributor.authorSeymour, Christopher Wen_AU
dc.contributor.authorShankar-Hari, Manuen_AU
dc.contributor.authorTong, Steven Y Cen_AU
dc.contributor.authorTurgeon, Alexis Fen_AU
dc.contributor.authorTurner, Anne Men_AU
dc.contributor.authorVan de Veerdonk, Frank Leoen_AU
dc.contributor.authorZarychanski, Ryanen_AU
dc.contributor.authorGreen, Cameronen_AU
dc.contributor.authorBerry, Scotten_AU
dc.contributor.authorMarshall, John Cen_AU
dc.contributor.authorMcArthur, Colinen_AU
dc.contributor.authorAngus, Derek Cen_AU
dc.contributor.authorWebb, Steven Aen_AU
dc.contributor.authorREMAP-CAP Investigatorsen_AU
dc.date.accessioned2021-07-22T22:38:58Z
dc.date.available2021-07-22T22:38:58Z
dc.date.issued2021
dc.identifier.urihttps://hdl.handle.net/2123/25738
dc.description.abstractPURPOSE: To study the efficacy of lopinavir-ritonavir and hydroxychloroquine in critically ill patients with coronavirus disease 2019 (COVID-19). METHODS: Critically ill adults with COVID-19 were randomized to receive lopinavir-ritonavir, hydroxychloroquine, combination therapy of lopinavir-ritonavir and hydroxychloroquine or no antiviral therapy (control). The primary endpoint was an ordinal scale of organ support-free days. Analyses used a Bayesian cumulative logistic model and expressed treatment effects as an adjusted odds ratio (OR) where an OR > 1 is favorable. RESULTS: We randomized 694 patients to receive lopinavir-ritonavir (n = 255), hydroxychloroquine (n = 50), combination therapy (n = 27) or control (n = 362). The median organ support-free days among patients in lopinavir-ritonavir, hydroxychloroquine, and combination therapy groups was 4 (- 1 to 15), 0 (- 1 to 9) and-1 (- 1 to 7), respectively, compared to 6 (- 1 to 16) in the control group with in-hospital mortality of 88/249 (35%), 17/49 (35%), 13/26 (50%), respectively, compared to 106/353 (30%) in the control group. The three interventions decreased organ support-free days compared to control (OR [95% credible interval]: 0.73 [0.55, 0.99], 0.57 [0.35, 0.83] 0.41 [0.24, 0.72]), yielding posterior probabilities that reached the threshold futility (>= 99.0%), and high probabilities of harm (98.0%, 99.9% and > 99.9%, respectively). The three interventions reduced hospital survival compared with control (OR [95% CrI]: 0.65 [0.45, 0.95], 0.56 [0.30, 0.89], and 0.36 [0.17, 0.73]), yielding high probabilities of harm (98.5% and 99.4% and 99.8%, respectively). CONCLUSION: Among critically ill patients with COVID-19, lopinavir-ritonavir, hydroxychloroquine, or combination therapy worsened outcomes compared to no antiviral therapy.en_AU
dc.language.isoenen_AU
dc.subjectCOVID-19en_AU
dc.subjectCoronavirusen_AU
dc.titleLopinavir-ritonavir and hydroxychloroquine for critically ill patients with COVID-19: REMAP-CAP randomized controlled trial.en_AU
dc.typeArticleen_AU
dc.identifier.doi10.1007/s00134-021-06448-5


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