Continuation of therapeutic dose heparin for critically ill patients with COVID‑19

In this letter we show that in patients who became critically ill while receiving therapeutic-dose heparin initiated when non-critically ill, continuation of therapeutic-dose compared with the lower doses confers no clinical benefit and appears harmful.

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Effect of Angiotensin-Converting Enzyme Inhibitor and Angiotensin Receptor Blocker Initiation on Organ Support–Free Days in Patients Hospitalized With COVID-19

In this randomized clinical trial that included 779 patients, initiation of an ACE inhibitor or ARB did not improve organ support–free days. Among critically ill patients, there was a 95% probability that treatments worsened this outcome.

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Long-term (180-Day) Outcomes in Critically Ill Patients With COVID-19 in the REMAP-CAP Randomized Clinical Trial

Among critically ill patients with COVID-19 randomized to receive one or more therapeutic interventions, treatment with an IL-6 receptor antagonist had a greater than 99.9% probability of improved 180-day mortality compared with the control group. Treatment with an antiplatelet had a 95.0% probability of improved 180-day mortality.

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Brothers talk about surviving COVID-19 and participating in REMAP-CAP

Callum and Sam Spence are twins, but the way COVID-19 affected them was very different. Callum ended up on a ventilator in the ICU fighting for his life, while Sam was at home with aches and pains. Their dramatic experience, chronicled in the Irish Independent, led them to the REMAP-CAP trial.

Continue ReadingBrothers talk about surviving COVID-19 and participating in REMAP-CAP

Effect of Antiplatelet Therapy on Survival and Organ Support–Free Days in Critically Ill Patients With COVID-19

In this trial, antiplatelet therapy met the prespecified criterion for futility in critically ill patients based on very similar outcomes for organ support–free days compared with control.

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European clinical research response during pandemic must be faster

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.

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Lopinavir‑ritonavir and hydroxychloroquine for critically ill patients with COVID‑19: REMAP‑CAP randomized controlled trial

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.

Continue ReadingLopinavir‑ritonavir and hydroxychloroquine for critically ill patients with COVID‑19: REMAP‑CAP randomized controlled trial