Anticoagulation and Convalescent Plasma ICU Trials in REMAP-CAP

Current recommendations for managing critically ill patients struggling with COVID-19 focus on supportive care and prevention of complications. As the development of vaccines and new drugs against SARS-CoV-2 virus will take several months to years, there is an urgent need to optimize the management of hospitalized COVID-19 patients. Recently, two existing interventions have been proposed to treat patients afflicted with COVID-19: 1) therapeutic anticoagulation with heparin to counteract the increased risk of blood clots in these patients, and 2) convalescent plasma from patients cured from COVID-19 to provide direct antibodies against SARS-CoV-2. Our two trials will assess the efficacy of these two different therapies to prevent clinical deterioration and improve survival, and will use existing research infrastructure, the international REMAP-CAP platform, to leverage Canada's investment and put our country at the forefront of our fight against COVID-19. Our research team is already recruiting patients with COVID-19 in 150 centres from 15 countries and we are planning to expand recruitment in low- and middle-income countries in Asia, Africa and South America. Our study a unique opportunity to scale-up an existing international research effort, enhance the scope of a large adaptive clinical trial platform, make major economies of scale, rigorously and quickly evaluate promising but unproven relatively inexpensive and readily available interventions that may improve the health of hundreds of thousands of patients around the world.