{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T16:12:07Z","timestamp":1783959127146,"version":"3.55.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine whether ivermectin improves outcomes for critically and noncritically ill hospitalized patients with COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>An ongoing international, multifactorial, adaptive platform, randomized, controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Hospitals in Pakistan, India, and Ireland between June 11, 2021, and September 9, 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>Critically and noncritically ill patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions:<\/jats:title>\n                    <jats:p>Randomized to ivermectin or no ivermectin (control).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results:<\/jats:title>\n                    <jats:p>The primary outcome was respiratory and cardiovascular organ support-free days, assessed on an ordinal scale combining in-hospital death (assigned a value of \u20131) and days free of organ support through day 21 in survivors. Analyses used a Bayesian cumulative logistic model. Enrollment was closed for operational futility, following external evidence suggesting no benefit with ivermectin in nonhospitalized patients with COVID-19. Among 61 critically ill patients, the median number of organ support-free days was \u20131, indicating death was the most common vital outcome (interquartile range [IQR], \u20131 to 17), for the ivermectin group and \u20131 (IQR, \u20131 to 17.25) for the control group (adjusted proportional odds ratio [OR], 0.94; 95% credible interval [CrI], 0.40\u20132.07) and the posterior probability of superiority to control was 44.2%. Among 89 noncritically ill patients, the median number of organ support-free days was 22 (IQR, 18.5\u201322) for ivermectin and 22 (IQR, 16\u201322) for control (adjusted proportional OR, 1.04; 95% CrI, 0.48\u20132.34) and the posterior probability of superiority was 53.7%. Among critically ill patients, hospital survival was 35.1% (13\/37) for ivermectin and 37.5% (9\/24) for control (adjusted OR, 1.00; 95% CrI, 0.39\u20132.32), posterior probability of superiority was 50.0%. Among noncritically ill patients, hospital survival was 84.1% (37\/44) for ivermectin and 77.8% (35\/45) for control (adjusted OR, 1.16; 95% CrI, 0.5\u20133.07), posterior probability of superiority was 63.3%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>For critically and noncritically ill hospitalized patients with COVID-19, ivermectin was unlikely to improve the primary composite outcome of organ support-free days and hospital survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/ccm.0000000000007134","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T14:03:20Z","timestamp":1778249000000},"page":"1546-1562","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Ivermectin for Critically and Noncritically Ill Hospitalized Patients With COVID-19: Randomized, Embedded, Multifactorial Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP-CAP)"],"prefix":"10.1097","volume":"54","author":[{"given":"Madiha","family":"Hashmi","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, Ziauddin University\u2014Karachi, Sindh, Pakistan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashan","family":"Haniffa","sequence":"additional","affiliation":[{"name":"Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand."},{"name":"Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deva","family":"Jayakumar","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Dr Kamakshi Memorial Hospital, Chennai, Tamil Nadu, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Beane","sequence":"additional","affiliation":[{"name":"Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand."},{"name":"Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Lorenzi","sequence":"additional","affiliation":[{"name":"Berry Consultants, Austin, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay R.","family":"Berry","sequence":"additional","affiliation":[{"name":"Berry Consultants, Austin, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Nasir Khoso","sequence":"additional","affiliation":[{"name":"South City Hospital, Karachi, Pakistan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quratul","family":"Ain Khan","sequence":"additional","affiliation":[{"name":"Critical Care, North Nazimabad Campus, Dr Ziauddin Group of Hospitals, Karachi, 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