Lopinavir-ritonavir and hydroxychloroquine for critically ill patients with COVID-19: REMAP-CAP randomized controlled trial.
Field | Value | Language |
dc.contributor.author | Arabi, Yaseen M | en_AU |
dc.contributor.author | Gordon, Anthony C | en_AU |
dc.contributor.author | Derde, Lennie P G | en_AU |
dc.contributor.author | Nichol, Alistair D | en_AU |
dc.contributor.author | Murthy, Srinivas | en_AU |
dc.contributor.author | Beidh, Farah Al | en_AU |
dc.contributor.author | Annane, Djillali | en_AU |
dc.contributor.author | Swaidan, Lolowa Al | en_AU |
dc.contributor.author | Beane, Abi | en_AU |
dc.contributor.author | Beasley, Richard | en_AU |
dc.contributor.author | Berry, Lindsay R | en_AU |
dc.contributor.author | Bhimani, Zahra|Bonten, Marc J M | en_AU |
dc.contributor.author | Bradbury, Charlotte A | en_AU |
dc.contributor.author | Brunkhorst, Frank M | en_AU |
dc.contributor.author | Buxton, Meredith | en_AU |
dc.contributor.author | Buzgau, Adrian | en_AU |
dc.contributor.author | Cheng, Allen | en_AU |
dc.contributor.author | De Jong, Menno | en_AU |
dc.contributor.author | Detry, Michelle A | en_AU |
dc.contributor.author | Duffy, Eamon J | en_AU |
dc.contributor.author | Estcourt, Lise J | en_AU |
dc.contributor.author | Fitzgerald, Mark | en_AU |
dc.contributor.author | Fowler, Rob | en_AU |
dc.contributor.author | Girard, Timothy D | en_AU |
dc.contributor.author | Goligher, Ewan C | en_AU |
dc.contributor.author | Goossens, Herman | en_AU |
dc.contributor.author | Haniffa, Rashan | en_AU |
dc.contributor.author | Higgins, Alisa M | en_AU |
dc.contributor.author | Hills, Thomas E | en_AU |
dc.contributor.author | Horvat, Christopher M | en_AU |
dc.contributor.author | Huang, David T | en_AU |
dc.contributor.author | King, Andrew J | en_AU |
dc.contributor.author | Lamontagne, Francois | en_AU |
dc.contributor.author | Lawler, Patrick R | en_AU |
dc.contributor.author | Lewis, Roger | en_AU |
dc.contributor.author | Linstrum, Kelsey | en_AU |
dc.contributor.author | Litton, Edward | en_AU |
dc.contributor.author | Lorenzi, Elizabeth | en_AU |
dc.contributor.author | Malakouti, Salim | en_AU |
dc.contributor.author | McAuley, Daniel F | en_AU |
dc.contributor.author | McGlothlin, Anna | en_AU |
dc.contributor.author | Mcguinness, Shay | en_AU |
dc.contributor.author | McVerry, Bryan | en_AU |
dc.contributor.author | Montgomery, Stephanie K | en_AU |
dc.contributor.author | Morpeth, Susan C | en_AU |
dc.contributor.author | Mouncey, Paul R | en_AU |
dc.contributor.author | Orr, Katrina | en_AU |
dc.contributor.author | Parke, Rachael | en_AU |
dc.contributor.author | Parker, Jane C | en_AU |
dc.contributor.author | Patanwala, Asad E | en_AU |
dc.contributor.author | Rowan, Kathryn M | en_AU |
dc.contributor.author | Santos, Marlene S | en_AU |
dc.contributor.author | Saunders, Christina T | en_AU |
dc.contributor.author | Seymour, Christopher W | en_AU |
dc.contributor.author | Shankar-Hari, Manu | en_AU |
dc.contributor.author | Tong, Steven Y C | en_AU |
dc.contributor.author | Turgeon, Alexis F | en_AU |
dc.contributor.author | Turner, Anne M | en_AU |
dc.contributor.author | Van de Veerdonk, Frank Leo | en_AU |
dc.contributor.author | Zarychanski, Ryan | en_AU |
dc.contributor.author | Green, Cameron | en_AU |
dc.contributor.author | Berry, Scott | en_AU |
dc.contributor.author | Marshall, John C | en_AU |
dc.contributor.author | McArthur, Colin | en_AU |
dc.contributor.author | Angus, Derek C | en_AU |
dc.contributor.author | Webb, Steven A | en_AU |
dc.contributor.author | REMAP-CAP Investigators | en_AU |
dc.date.accessioned | 2021-07-22T22:38:58Z | |
dc.date.available | 2021-07-22T22:38:58Z | |
dc.date.issued | 2021 | |
dc.identifier.uri | https://hdl.handle.net/2123/25738 | |
dc.description.abstract | PURPOSE: 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.iso | en | en_AU |
dc.subject | COVID-19 | en_AU |
dc.subject | Coronavirus | en_AU |
dc.title | Lopinavir-ritonavir and hydroxychloroquine for critically ill patients with COVID-19: REMAP-CAP randomized controlled trial. | en_AU |
dc.type | Article | en_AU |
dc.identifier.doi | 10.1007/s00134-021-06448-5 |
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