- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04381936
Randomised Evaluation of COVID-19 Therapy (RECOVERY)
RECOVERY is a randomised trial of treatments to prevent death in patients hospitalised with pneumonia.
The treatments being investigated are:
COVID-19: Lopinavir-Ritonavir, Hydroxychloroquine, Corticosteroids, Azithromycin, Colchicine, IV Immunoglobulin (children only), Convalescent plasma, Casirivimab+Imdevimab, Tocilizumab, Aspirin, Baricitinib, Empagliflozin, Sotrovimab, Molnupiravir, Paxlovid or Anakinra (children only)
Influenza: Baloxavir marboxil, Oseltamivir, Corticosteroids (dexamethasone)
Community-acquired pneumonia: Corticosteroids (dexamethasone)
Study Overview
Status
Conditions
Intervention / Treatment
- Drug: Corticosteroid
- Drug: Hydroxychloroquine
- Drug: Lopinavir-Ritonavir
- Drug: Azithromycin
- Biological: Convalescent plasma
- Drug: Tocilizumab
- Biological: Immunoglobulin
- Drug: Aspirin
- Drug: Colchicine
- Drug: Baricitinib
- Drug: Anakinra
- Drug: Dimethyl fumarate
- Drug: High Dose Corticosteroid
- Drug: Empagliflozin
- Drug: Molnupiravir
- Drug: Paxlovid
- Drug: Synthetic neutralising antibodies
- Drug: Sotrovimab
- Drug: Baloxavir Marboxil
- Drug: Oseltamivir
- Drug: Corticosteroids (dexamethasone)
- Drug: Corticosteroids (dexamethasone)
Detailed Description
The RECOVERY trial has already shown that:
- Dexamethasone (a type of steroid) reduces the risk of dying for patients hospitalised with COVID-19 receiving oxygen.
- Regeneron's monoclonal antibody combination reduces deaths for hospitalised COVID-19 patients who have not mounted their own immune response.
- Tocilizumab reduces the risk of death when given to hospitalised patients with severe COVID-19. It also shortens the time until patients are successfully discharged from hospital and reduces the need for a mechanical ventilator.
- Baricitinib reduces the risk of death when given to hospitalised patients with severe COVID-19.
- In patients hospitalised for COVID-19 with clinical hypoxia but requiring either no oxygen or simple oxygen only, higher dose corticosteroids significantly increased the risk of death compared to usual care, which included low dose corticosteroids.
- Sotrovimab reduces the risk of death in some patients (specifically those with higher levels of the virus in their blood) hospitalised with COVID-19.
- In patients hospitalised with COVID-19, dexamethasone (at a dose of 6mg daily in hypoxic patients), tocilizumab (in hypoxic patients with CRP ≥75 mg/L), baricitinib, casirivimab-imdevimab (in seronegative patients), and sotrovimab (in high antigen patients) reduced 6-month mortality. Dexamethasone at a dose of 6mg daily was associated with an increase in major non-COVID infection but there was no evidence of other later emerging harms. Other treatments tested in RECOVERY did not reduce 6-month mortality.
The trial also concluded that there is no beneficial effect of hydroxychloroquine, lopinavir-ritonavir, azithromycin, convalescent plasma, colchicine, aspirin, dimethyl fumarate, empagliflozin, molnupiravir, or paxlovid in patients hospitalised with COVID-19, and these arms have been closed to recruitment with results reported.
BACKGROUND: In early 2020, as the RECOVERY Trial was being set-up, there were no approved treatments for COVID-19, a disease induced by the novel coronavirus SARSCoV-2 that emerged in China in late 2019. Opening in March 2020, RECOVERY evaluated twenty SARS-CoV-2 therapies, providing reliable evidence about their efficacy and safety that has informed the treatment of patients worldwide.
Since then, the progress in COVID-19 treatment has highlighted the need for better evidence for the treatment of pneumonia caused by other pathogens, such as influenza and bacteria, for which therapies are widely used without good evidence of benefit or safety.
ELIGIBILITY AND RANDOMISATION: This protocol (version 28.0) includes treatment comparisons for influenza and community-acquired pneumonia. No COVID-19 comparisons are currently open in the trial. Eligible patients are randomly allocated between one or more treatment arms, each to be given in addition to the usual standard of care in the participating hospital. The study is dynamic, and treatments are added and removed as results and suitable treatments become available, or as new infectious respiratory threats emerge. For patients for whom not all the trial arms are appropriate or at locations where not all are available, randomisation will be between fewer comparisons.
All COVID-19 arms of the protocol (Part A to F, and J to L) have now been discontinued with results reported.
The arms currently open to recruitment are as follows:
Part G (Influenza): UK patients ≥12 years old (≥18 years old in other countries), with or without SARS-CoV-2 co-infection, randomised to baloxavir marboxil vrs no additional treatment.
Part H (Influenza): UK patients any age (≥18 years old in other countries), with or without SARS-CoV-2 co-infection, randomised to oseltamivir vrs no additional treatment.
Part I (Influenza): UK patients any age (≥18 years old in other countries), without suspected or confirmed SARS-CoV-2 infection, and with clinical evidence of hypoxia (i.e. receiving oxygen or with oxygen saturations <92% on room air), randomised to corticosteroids (dexamethasone) vrs no additional treatment.
Part M (Community-acquired pneumonia with planned antibiotic treatment and without suspected or confirmed SARS-CoV-2, influenza, active pulmonary tuberculosis, or Pneumocystis pneumonia): Patients ≥18 years old randomised to corticosteroids (dexamethasone) vs no additional treatment.
For patients for whom not all the trial arms are appropriate or at locations where not all are available, randomisation will be between fewer arms.
ADAPTIVE DESIGN: The interim trial results will be monitored by an independent Data Monitoring Committee (DMC). The most important task for the DMC will be to assess whether the randomised comparisons in the study have provided evidence on mortality that is strong enough (with a range of uncertainty around the results that is narrow enough) to affect national and global treatment strategies. In such a circumstance, the DMC will inform the Trial Steering Committee who will make the results available to the public and amend the trial arms accordingly. New trial arms can be added as evidence emerges that other candidate therapeutics should be evaluated.
OUTCOMES: The main outcomes will be death, discharge, need for ventilation and need for renal replacement therapy. For the main analyses, follow-up will be censored at 28 days after randomisation. Additional information on longer term outcomes may be collected through review of medical records or linkage to medical databases where available (such as those managed by NHS England and equivalent organisations in the devolved nations).
SIMPLICITY OF PROCEDURES: To facilitate collaboration, even in hospitals that suddenly become overloaded, patient enrolment (via the internet) and all other trial procedures are greatly streamlined. Informed consent is simple and data entry is minimal. Randomisation via the internet is simple and quick, at the end of which the allocated treatment is displayed on the screen and can be printed or downloaded. Key follow-up information is recorded at a single timepoint and may be ascertained by contacting participants in person, by phone or electronically, or by review of medical records and databases.
DATA TO BE RECORDED: At randomisation, information will be collected on the identity of the randomising clinician and of the patient, age, sex, major co-morbidity, pregnancy, illness onset date and severity, and any contraindications to the study treatments. The main outcomes will be death (with date and probable cause), discharge (with date), need for ventilation (with number of days recorded) and need for renal replacement therapy.
Other information to be recorded relevant to safety will include acute kidney or liver injury, cardiac arrhythmia, infection, thrombosis, bleeding, metabolic disturbances, and seizures.
Reminders will be sent if outcome data have not been recorded by 28 days after randomisation. Suspected Serious Adverse Reactions (SSARs) to one of the study medications (eg, Stevens-Johnson syndrome, anaphylaxis, aplastic anaemia) will be collected and unexpected SSARs (SUSARs) will be reported in an expedited fashion. Other adverse events will not be recorded but may be available through linkage to medical databases.
NUMBERS TO BE RANDOMISED: The larger the number randomised the more accurate the results will be, but the numbers that can be randomised will depend critically on the epidemiology of the relevant infections over the next few years. If substantial numbers are hospitalised in the participating centres then it may be possible to randomise several thousand with mild disease and a few thousand with severe disease, but realistic, appropriate sample sizes could not be estimated at the start of the trial.
HETEROGENEITY BETWEEN POPULATIONS: If sufficient numbers are studied, it may be possible to generate reliable evidence in certain patient groups (e.g. those with major comorbidity or who are older). To this end, data from this study may be combined with data from other trials of treatments for viral or bacterial pneumonia.
ADD-ON STUDIES: Particular countries or groups of hospitals, may well want to collaborate in adding further measurements or observations, such as serial blood gases or chemistry, or serial documentation of other aspects of disease status. While well-organised additional research studies of the natural history of the disease or of the effects of the trial treatments could well be valuable (although the lack of placebo control may bias the assessment of subjective side-effects, such as gastrointestinal problems), they are not core requirements.
Study Type
Enrollment (Estimated)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Leon Peto
- Phone Number: +44 (0)1865 743743
- Email: recoverytrial@ndph.ox.ac.uk
Study Locations
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Brussels, Belgium
- Recruiting
- Belgian sites are managed by the European Clinical Research Alliance on Infectious Diseases
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Contact:
- Email: info@ecraid.eu
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Tallinn, Estonia
- Recruiting
- Estonian sites are managed by the European Clinical Research Alliance on Infectious Diseases
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Contact:
- Email: info@ecraid.eu
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Paris, France
- Recruiting
- French sites are managed by the European Clinical Research Alliance on Infectious Diseases
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Contact:
- Email: info@ecraid.eu
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Kumasi, Ghana
- Recruiting
- Kumasi Center for Collaborative Research in Tropical Medicine KNUST
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Contact:
- Phone Number: +233 278 364 389
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New Delhi, India, ICMR-110029
- Completed
- Indian Council of Medical Research, Division of Epidemiology and Communicable Diseases
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Jakarta, Indonesia
- Recruiting
- Eijkman Oxford Clinical Research Unit (EOCRU), Eijkman Institute for Molecular Biology
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Roma, Italy
- Recruiting
- Italian sites are managed by the European Clinical Research Alliance on Infectious Diseases
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Contact:
- Email: info@ecraid.eu
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Kathmandu, Nepal
- Recruiting
- Clinical Trial Unit, Oxford University Clinical Research Unit-Nepal, Patan Academy of Health Sciences
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Utrecht, Netherlands, 3584 BA
- Recruiting
- Dutch sites are managed by the European Clinical Research Alliance on Infectious Diseases
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Contact:
- Email: info@ecraid.eu
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Lisbon, Portugal
- Recruiting
- Portuguese sites are managed by the European Clinical Research Alliance on Infectious Diseases
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Contact:
- Email: info@ecraid.eu
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Bucharest, Romania
- Recruiting
- Romanian sites are managed by the European Clinical Research Alliance on Infectious Diseases
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Contact:
- Email: info@ecraid.eu
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Johannesburg, South Africa
- Recruiting
- Wits Health Consortium
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Contact:
- Phone Number: +27 11 274 9200
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Barcelona, Spain
- Recruiting
- Spanish sites are managed by the European Clinical Research Alliance on Infectious Diseases
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Contact:
- Email: info@ecraid.eu
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Stockholm, Sweden
- Recruiting
- Swedish sites are managed by the European Clinical Research Alliance on Infectious Diseases
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Contact:
- Email: info@ecraid.eu
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Oxford, United Kingdom, OX3 7LF
- Recruiting
- Nuffield Department of Population Health, University of Oxford
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Contact:
- Peter W Horby
- Email: recoverytrial@ndph.ox.ac.uk
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Principal Investigator:
- Peter W Horby
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Ho Chi Minh City, Vietnam
- Recruiting
- Oxford University Clinical Research Unit, Centre for Tropical Medicine
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Contact:
- Phone Number: +84 8 39241983
- Email: recoverytrial@oucru.org
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Eligibility Criteria (as per Protocol v28.0):
Patients are eligible for the study if all of the following are true:
(i) Hospitalised
(ii) Pneumonia syndrome
In general, pneumonia should be suspected when a patient presents with:
- typical symptoms of a new respiratory tract infection (e.g. influenza-like illness with fever and muscle pain, or respiratory illness with cough and shortness of breath); and
- objective evidence of acute lung disease (e.g. consolidation or ground-glass shadowing on X-ray or CT, hypoxia, or compatible clinical examination); and
- alternative causes have been considered unlikely or excluded (e.g. heart failure).
However, the diagnosis remains a clinical one based on the opinion of the managing doctor (the above criteria are just a guide).
(iii) One of the following diagnoses:
- Confirmed influenza A or B infection (including patients with SARS-CoV-2 co-infection)
- Community-acquired pneumonia (CAP) with planned antibiotic treatment (excluding patients with suspected or confirmed SARS-CoV-2, influenza, active pulmonary tuberculosis or Pneumocystis jirovecii pneumonia)
(iv) No medical history that might, in the opinion of the attending clinician, put the patient at significant risk if he/she were to participate in the trial
Patients with suspected or confirmed active pulmonary tuberculosis or Pneumocystis jirovecii pneumonia (also known as PCP or PJP) are excluded from the CAP comparison, as these infections are caused by specific organisms with distinct pathologies, and so are not usually categorised as CAP. Eligibility for the CAP comparison also requires planned antibiotic treatment, so patients being treated solely for fungal or viral pneumonia are not eligible.
Patients with SARS-CoV-2 and influenza co-infection are eligible, but would be excluded from certain comparisons if the attending clinician believes that there is a specific contra-indication to one of the active drug treatment arms (see Protocol Appendix 2, Appendix 3 for children, and Appendix 4 for pregnant and breastfeeding women), or that the patient should definitely be receiving one of the active drug treatment arms then that arm will not be available for randomisation for that patient. For patients who lack capacity, an advanced directive or behaviour that clearly indicates that they would not wish to participate in the trial would be considered sufficient reason to exclude them from the trial.
Patients who have been previously recruited into RECOVERY are eligible to be recruited again as long as their previous randomisation was >6 months ago. Patients will not be recruited into the same randomised comparison (e.g. sotrovimab vs. usual care) on more than one occasion, regardless of how far apart they occur.
In some locations, children (aged <18 years) will not be recruited, to comply with local and national regulatory approvals (see Appendix 6).
Note: the eligibility criteria has changed from COVID-19 to pneumonia (Influenza & CAP). For detailed information about previous eligibility criteria please see the previous Protocol's on the study website: https://www.recoverytrial.net/uk/for-site-staff/site-set-up-1/regulatory-documents
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Factorial Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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No Intervention: Standard Care
Patient receives usual hospital care
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Active Comparator: Tocilizumab
Participants with progressive COVID-19 (as evidenced by hypoxia and an inflammatory state) may undergo randomisation between Tocilizumab and no additional treatment. (Children with COVID-19 pneumonia are not eligible for this comparison). [This arm is now closed to recruitment] |
Tocilizumab by intravenous infusion with the dose determined by body weight (see Protocol for dosage)
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Active Comparator: Intravenous Immunoglobulin
First (main) randomisation part A (children only) [This arm is now closed to recruitment] |
Intravenous immunoglobulin (IVIg) for children >44 weeks gestational age and <18 years with PIMS-TS only (see Protocol for dosage)
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Active Comparator: Anakinra
Randomisation for children only with PIMS-TS (Children with COVID-19 pneumonia are not eligible for this comparison). [This arm is now closed to recruitment] |
For children ≥1 <18 years old only: subcutaneously or intravenously once daily for 7 days or discharge (if sooner).
NB Anakinra will be excluded from the randomisation of children <10 kg in weight.
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Active Comparator: Baloxavir marboxil
Randomisation part G (influenza)
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Patients ≥12 years old in the UK (or ≥18 years old in other countries), with or without SARS-CoV-2 co-infection. 40mg (or 80mg if weight ≥80kg) once daily by mouth or nasogastic tube to be given on day 1 and day 4.
Other Names:
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Active Comparator: Oseltamivir
Randomisation part H (influenza)
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Any age in the UK (or ≥18 years old in other countries), with or without SARS-CoV-2 co-infection. 75mg twice daily by mouth or nasogastric tube for five days. (See Protocol for detailed dosage information)
Other Names:
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Active Comparator: Corticosteroids
First (main) randomisation part A (COVID-19) [This arm is now closed to recruitment] |
Corticosteroid in the form of dexamethasone administered as an oral (liquid or tablets) or intravenous preparation 6 mg once daily for 10 days.
In pregnancy or breastfeeding women, prednisolone 40 mg administered by mouth (or intravenous hydrocortisone 80 mg twice daily) should be used instead of dexamethasone.
Corticosteroid (in children ≤44 weeks gestational age, or >44 weeks gestational age with PIMS-TS only) in the form of Hydrocortisone or Methylprednisolone sodium succinate (see Protocol for timing and dosage)
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Active Comparator: Hydroxychloroquine
First (main) randomisation part A (COVID-19) [This arm is now closed to recruitment] |
Hydroxychloroquine by mouth for a total of 10 days (see Protocol for timing and dosage).
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Active Comparator: Lopinavir-Ritonavir
First (main) randomisation part A (COVID-19) [This arm is now closed to recruitment] |
Lopinavir 400mg-Ritonavir 100mg by mouth (or nasogastric tube) every 12 hours for 10 days.
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Active Comparator: Azithromycin
First (main) randomisation part A (COVID-19) [This arm is now closed to recruitment] |
Azithromycin 500mg by mouth (or nasogastric tube) or intravenously once daily for 10 days.
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Active Comparator: Convalescent plasma
First (main) randomisation part B (COVID-19) [This arm is now closed to recruitment] |
Single unit of ABO compatible convalescent plasma (275mls +/- 75 mls) intravenous per day on study days 1 (as soon as possible after randomisation) and 2 (with a minimum of 12 hour interval between 1st and 2nd units).
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Active Comparator: Synthetic neutralising antibodies
First (main) randomisation part B (COVID-19) [This arm is now closed to recruitment] |
Patients ≥12 years only with COVID-19 pneumonia: A single dose of REGN10933 + REGN10987 8 g (4 g of each monoclonal antibody) in 250ml 0.9% saline infused intravenously over 60 minutes +/- 15 minutes as soon as possible after randomisation
Other Names:
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Active Comparator: Aspirin
First (main) randomisation part C (COVID-19) [This arm is now closed to recruitment] |
150 mg by mouth (or nasogastric tube) or per rectum once daily until discharge, for adults ≥18 years old.
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Active Comparator: Colchicine
First (main) randomisation part A (COVID-19) [This arm is now closed to recruitment] |
1 mg after randomisation followed by 500mcg 12 hours later and then 500 mcg twice daily by mouth or nasogastric tube for 10 days in total, for men ≥18 years old and women ≥55 years old only
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Active Comparator: Baricitinib
First (main) randomisation part D (COVID-19) [This arm is now closed to recruitment] |
UK [age ≥2 years with COVID pneumonia] and India [age ≥18 years with COVID-19 pneumonia]: 4 mg once daily by mouth or nasogastric tube for 10 days in total.
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Active Comparator: Dimethyl fumarate
First (main) randomisation part A (COVID-19) (UK adults only; early phase assessment) [This arm is now closed to recruitment] |
Early phase assessment.
UK adults ≥18 years old only (excluding those on ECMO).
120 mg every 12 hours for 4 doses followed by 240 mg every 12 hours by mouth for 8 days (10 days in total).
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Active Comparator: High Dose Corticosteroids
First (main) randomisation part E (COVID-19) [This arm is now closed to recruitment] |
Adults ≥18 years old with hypoxia only.
Dexamethasone 20 mg (base) once daily by mouth, nasogastric tube or intravenous infusion for 5 days follow by dexamethasone 10 mg (base) once daily by mouth, nasogastric tube or intravenous infusion for 5 days.
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Active Comparator: Empagliflozin
First (main) randomisation part F (COVID-19) [This arm is now closed to recruitment] |
Adults ≥18 years old only.
10 mg once daily by mouth for 28 days (or until discharge, if earlier).
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Active Comparator: Sotrovimab
First (main) randomisation part J (COVID-19) [This arm is now closed to recruitment] |
UK patients ≥12 years old.
1000 mg in 100 mL 0.9% sodium chloride or 5% dextrose by intravenous infusion over 1 hour as soon as possible after randomisation.
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Active Comparator: Molnupiravir
First (main) randomisation part K (COVID-19) [This arm is now closed to recruitment] |
Patients ≥18 years old.
800 mg twice daily for 5 days by mouth.
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Active Comparator: Paxlovid
First (main) randomisation part L (COVID-19) [This arm is now closed to recruitment] |
UK patients ≥18 years old.
300/100 mg twice daily for 5 days by mouth.
Other Names:
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Active Comparator: Corticosteroids (dexamethasone) (influenza arm)
Randomisation part I (influenza)
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Any age in the UK (or ≥18 years old in other countries), without suspected or confirmed SARS-CoV-2 infection, and with clinical evidence of hypoxia (i.e.
receiving oxygen or with oxygen saturations <92% on room air) 6mg once daily given orally or intravenously for ten days or until discharge (whichever happens earliest)
Patients ≥18 years old with a diagnosis of community-acquired pneumonia (with planned antibiotic use and without suspected or confirmed SARS-CoV-2, influenza, active pulmonary tuberculosis, or Pneumocystis jirovecii infection) 6mg once daily given orally or intravenously for ten days or until discharge (whichever happens earliest)
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Active Comparator: Corticosteroids (dexamethasone) (community-acquired pneumonia arm)
Randomisation part M (community-acquired pneumonia)
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Any age in the UK (or ≥18 years old in other countries), without suspected or confirmed SARS-CoV-2 infection, and with clinical evidence of hypoxia (i.e.
receiving oxygen or with oxygen saturations <92% on room air) 6mg once daily given orally or intravenously for ten days or until discharge (whichever happens earliest)
Patients ≥18 years old with a diagnosis of community-acquired pneumonia (with planned antibiotic use and without suspected or confirmed SARS-CoV-2, influenza, active pulmonary tuberculosis, or Pneumocystis jirovecii infection) 6mg once daily given orally or intravenously for ten days or until discharge (whichever happens earliest)
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Influenza co-primary outcome: All-cause mortality (with subsidiary analysis of cause of death and death at various timepoints following discharge)
Time Frame: Within 28 days after randomisation
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Within 28 days after randomisation
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Influenza co-primary outcome: Time to discharge alive from hospital
Time Frame: Within the first 28-days
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Within the first 28-days
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Community-acquired pneumonia: All-cause mortality (with subsidiary analyses of cause of death and of death at various timepoints following discharge)
Time Frame: Within 28 days after randomisation
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For each pairwise comparison with the 'no additional treatment' arm, the primary objective is to provide reliable estimates of the effect of study treatments on all-cause mortality.
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Within 28 days after randomisation
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Influenza: Composite endpoint of death or need for mechanical ventilation or ECMO
Time Frame: Within 28 days and up to 6 months after the main randomisation
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Among patients not on invasive mechanical ventilation at baseline, the number of patients with a composite endpoint of death or need for invasive mechanical ventilation or ECMO.
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Within 28 days and up to 6 months after the main randomisation
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Community-acquired pneumonia: Duration of hospital stay
Time Frame: Within 28 days and up to 6 months after the main randomisation
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To assess the effects of study treatment on number of days stay in hospital
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Within 28 days and up to 6 months after the main randomisation
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Community-acquired pneumonia: Composite endpoint of death or need for mechanical ventilation or ECMO
Time Frame: Within 28 days and up to 6 months after the main randomisation
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Among patients not on invasive mechanical ventilation at baseline, the number of patients with a composite endpoint of death or need for invasive mechanical ventilation or ECMO.
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Within 28 days and up to 6 months after the main randomisation
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Need for (and duration of) ventilation
Time Frame: Within 28 days and up to 6 months after the main randomisation
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To assess the effects of study treatment on number of patients who needed any ventilation and (for invasive mechanical ventilation) the number of days it was required
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Within 28 days and up to 6 months after the main randomisation
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Need for renal replacement
Time Frame: Within 28 days and up to 6 months after the main randomisation
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To assess the effects of study treatment on number of patients who needed renal replacement therapy
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Within 28 days and up to 6 months after the main randomisation
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Number of patients who had thrombotic events
Time Frame: Within 28 days and up to 6 months after the main randomisation
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To assess the effects of study treatment on number of patients who had thrombotic events, defined as either (i) acute pulmonary embolism; (ii) deep vein thrombosis; (iii) ischaemic stroke; (iv) myocardial infarction; or (v) systemic arterial embolism.
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Within 28 days and up to 6 months after the main randomisation
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Peter W Horby, University of Oxford
Publications and helpful links
General Publications
- Mikolajewska A, Fischer AL, Piechotta V, Mueller A, Metzendorf MI, Becker M, Dorando E, Pacheco RL, Martimbianco ALC, Riera R, Skoetz N, Stegemann M. Colchicine for the treatment of COVID-19. Cochrane Database Syst Rev. 2021 Oct 18;10(10):CD015045. doi: 10.1002/14651858.CD015045.
- Kreuzberger N, Hirsch C, Chai KL, Tomlinson E, Khosravi Z, Popp M, Neidhardt M, Piechotta V, Salomon S, Valk SJ, Monsef I, Schmaderer C, Wood EM, So-Osman C, Roberts DJ, McQuilten Z, Estcourt LJ, Skoetz N. SARS-CoV-2-neutralising monoclonal antibodies for treatment of COVID-19. Cochrane Database Syst Rev. 2021 Sep 2;9(9):CD013825. doi: 10.1002/14651858.CD013825.pub2.
- Piechotta V, Iannizzi C, Chai KL, Valk SJ, Kimber C, Dorando E, Monsef I, Wood EM, Lamikanra AA, Roberts DJ, McQuilten Z, So-Osman C, Estcourt LJ, Skoetz N. Convalescent plasma or hyperimmune immunoglobulin for people with COVID-19: a living systematic review. Cochrane Database Syst Rev. 2021 May 20;5(5):CD013600. doi: 10.1002/14651858.CD013600.pub4.
- Kramer A, Prinz C, Fichtner F, Fischer AL, Thieme V, Grundeis F, Spagl M, Seeber C, Piechotta V, Metzendorf MI, Golinski M, Moerer O, Stephani C, Mikolajewska A, Kluge S, Stegemann M, Laudi S, Skoetz N. Janus kinase inhibitors for the treatment of COVID-19. Cochrane Database Syst Rev. 2022 Jun 13;6(6):CD015209. doi: 10.1002/14651858.CD015209.
- Hirsch C, Park YS, Piechotta V, Chai KL, Estcourt LJ, Monsef I, Salomon S, Wood EM, So-Osman C, McQuilten Z, Spinner CD, Malin JJ, Stegemann M, Skoetz N, Kreuzberger N. SARS-CoV-2-neutralising monoclonal antibodies to prevent COVID-19. Cochrane Database Syst Rev. 2022 Jun 17;6(6):CD014945. doi: 10.1002/14651858.CD014945.pub2.
- RECOVERY Collaborative Group. Lopinavir-ritonavir in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2020 Oct 24;396(10259):1345-1352. doi: 10.1016/S0140-6736(20)32013-4. Epub 2020 Oct 5.
- RECOVERY Collaborative Group. Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2021 Feb 13;397(10274):605-612. doi: 10.1016/S0140-6736(21)00149-5. Epub 2021 Feb 2.
- RECOVERY Collaborative Group. Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2021 May 1;397(10285):1637-1645. doi: 10.1016/S0140-6736(21)00676-0.
- RECOVERY Collaborative Group. Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial. Lancet. 2021 May 29;397(10289):2049-2059. doi: 10.1016/S0140-6736(21)00897-7. Epub 2021 May 14.
- RECOVERY Collaborative Group. Colchicine in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet Respir Med. 2021 Dec;9(12):1419-1426. doi: 10.1016/S2213-2600(21)00435-5. Epub 2021 Oct 18.
- RECOVERY Collaborative Group. Aspirin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2022 Jan 8;399(10320):143-151. doi: 10.1016/S0140-6736(21)01825-0. Epub 2021 Nov 17.
- RECOVERY Collaborative Group. Casirivimab and imdevimab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2022 Feb 12;399(10325):665-676. doi: 10.1016/S0140-6736(22)00163-5.
- Tume LN, Menzies JC, Ray S, Scholefield BR; UK Paediatric Intensive Care Society Study Group. Research Priorities for U.K. Pediatric Critical Care in 2019: Healthcare Professionals' and Parents' Perspectives. Pediatr Crit Care Med. 2021 May 1;22(5):e294-e301. doi: 10.1097/PCC.0000000000002647.
- RECOVERY Collaborative Group; Horby P, Lim WS, Emberson JR, Mafham M, Bell JL, Linsell L, Staplin N, Brightling C, Ustianowski A, Elmahi E, Prudon B, Green C, Felton T, Chadwick D, Rege K, Fegan C, Chappell LC, Faust SN, Jaki T, Jeffery K, Montgomery A, Rowan K, Juszczak E, Baillie JK, Haynes R, Landray MJ. Dexamethasone in Hospitalized Patients with Covid-19. N Engl J Med. 2021 Feb 25;384(8):693-704. doi: 10.1056/NEJMoa2021436. Epub 2020 Jul 17.
- RECOVERY Collaborative Group; Horby P, Mafham M, Linsell L, Bell JL, Staplin N, Emberson JR, Wiselka M, Ustianowski A, Elmahi E, Prudon B, Whitehouse T, Felton T, Williams J, Faccenda J, Underwood J, Baillie JK, Chappell LC, Faust SN, Jaki T, Jeffery K, Lim WS, Montgomery A, Rowan K, Tarning J, Watson JA, White NJ, Juszczak E, Haynes R, Landray MJ. Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19. N Engl J Med. 2020 Nov 19;383(21):2030-2040. doi: 10.1056/NEJMoa2022926. Epub 2020 Oct 8.
- RECOVERY Collaborative Group. Electronic address: recoverytrial@ndph.ox.ac.uk; RECOVERY Collaborative Group. Higher dose corticosteroids in patients admitted to hospital with COVID-19 who are hypoxic but not requiring ventilatory support (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2023 May 6;401(10387):1499-1507. doi: 10.1016/S0140-6736(23)00510-X. Epub 2023 Apr 13.
- RECOVERY Collaborative Group. Baricitinib in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial and updated meta-analysis. Lancet. 2022 Jul 30;400(10349):359-368. doi: 10.1016/S0140-6736(22)01109-6.
- RECOVERY Collaborative Group. Empagliflozin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet Diabetes Endocrinol. 2023 Dec;11(12):905-914. doi: 10.1016/S2213-8587(23)00253-X. Epub 2023 Oct 18. Erratum In: Lancet Diabetes Endocrinol. 2024 Jan;12(1):e1. doi: 10.1016/S2213-8587(23)00360-1.
- RECOVERY Collaborative Group; Horby PW, Peto L, Staplin N, Campbell M, Pessoa-Amorim G, Mafham M, Emberson JR, Stewart R, Prudon B, Uriel A, Green CA, Dhasmana DJ, Malein F, Majumdar J, Collini P, Shurmer J, Yates B, Baillie JK, Buch MH, Day J, Faust SN, Jaki T, Jeffery K, Juszczak E, Knight M, Lim WS, Montgomery A, Mumford A, Rowan K, Thwaites G, Haynes R, Landray MJ. Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Nat Commun. 2024 Jan 31;15(1):924. doi: 10.1038/s41467-023-43644-x.
- RECOVERY Collaborative Group. Molnupiravir or nirmatrelvir-ritonavir plus usual care versus usual care alone in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet Infect Dis. 2025 Sep;25(9):1000-1010. doi: 10.1016/S1473-3099(25)00093-3. Epub 2025 May 15.
- RECOVERY Collaborative Group. Sotrovimab versus usual care in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet Infect Dis. 2026 Jan;26(1):34-45. doi: 10.1016/S1473-3099(25)00361-5. Epub 2025 Aug 28.
- RECOVERY Collaborative Group. Long-term follow-up of treatment comparisons in RECOVERY: a randomised, open-label, platform trial for patients hospitalised with COVID-19. MedRxiv. 02 Sep 2025. doi.org/10.1101/2025.08.29.25334732
- RECOVERY Collaborative Group. Higher dose corticosteroids in hospitalised COVID-19 patients requiring ventilatory support (RECOVERY): a randomised, controlled, open-label, platform trial. EClinicalMedicine. 2025 Feb 12;81:103080. doi: 10.1016/j.eclinm.2025.103080. eCollection 2025 Mar.
- Pessoa-Amorim G, Goldacre R, Crichton C, Stevens W, Nunn M, King A, Murray D, Welsh R, Pinches H, Rees A, Morris EJA, Landray MJ, Haynes R, Horby P, Wallendszus K, Peto L, Campbell M, Harper C, Mafham M. Clinical trial results in context: comparison of baseline characteristics and outcomes of 38,510 RECOVERY trial participants versus a reference population of 346,271 people hospitalised with COVID-19 in England. Trials. 2024 Jun 29;25(1):429. doi: 10.1186/s13063-024-08273-9.
- RECOVERY Collaborative Group. Immunomodulatory therapy in children with paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS, MIS-C; RECOVERY): a randomised, controlled, open-label, platform trial. Lancet Child Adolesc Health. 2024 Mar;8(3):190-200. doi: 10.1016/S2352-4642(23)00316-4. Epub 2024 Jan 22.
- Fischer AL, Messer S, Riera R, Martimbianco ALC, Stegemann M, Estcourt LJ, Weibel S, Monsef I, Andreas M, Pacheco RL, Skoetz N. Antiplatelet agents for the treatment of adults with COVID-19. Cochrane Database Syst Rev. 2023 Jul 25;7(7):CD015078. doi: 10.1002/14651858.CD015078.
- Iannizzi C, Chai KL, Piechotta V, Valk SJ, Kimber C, Monsef I, Wood EM, Lamikanra AA, Roberts DJ, McQuilten Z, So-Osman C, Jindal A, Cryns N, Estcourt LJ, Kreuzberger N, Skoetz N. Convalescent plasma for people with COVID-19: a living systematic review. Cochrane Database Syst Rev. 2023 May 10;5(5):CD013600. doi: 10.1002/14651858.CD013600.pub6.
- Iannizzi C, Chai KL, Piechotta V, Valk SJ, Kimber C, Monsef I, Wood EM, Lamikanra AA, Roberts DJ, McQuilten Z, So-Osman C, Jindal A, Cryns N, Estcourt LJ, Kreuzberger N, Skoetz N. Convalescent plasma for people with COVID-19: a living systematic review. Cochrane Database Syst Rev. 2023 Feb 1;2(2):CD013600. doi: 10.1002/14651858.CD013600.pub5.
- Chevret S, Timsit JF, Biard L. Challenges of using external data in clinical trials- an illustration in patients with COVID-19. BMC Med Res Methodol. 2022 Dec 15;22(1):321. doi: 10.1186/s12874-022-01769-5.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Respiratory Tract Infections
- Infections
- RNA Virus Infections
- Virus Diseases
- Respiratory Tract Diseases
- Lung Diseases
- Pneumonia, Viral
- Coronavirus Infections
- Coronaviridae Infections
- Nidovirales Infections
- Community-Acquired Infections
- COVID-19
- Pneumonia
- Community-Acquired Pneumonia
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Peptides
- Amino Acids, Peptides, and Proteins
- Proteins
- Organic Chemicals
- Heterocyclic Compounds, 1-Ring
- Heterocyclic Compounds
- Heterocyclic Compounds, 2-Ring
- Heterocyclic Compounds, Fused-Ring
- Hydrocarbons
- Cyclohexenes
- Cyclohexanes
- Cycloparaffins
- Hydrocarbons, Alicyclic
- Hydrocarbons, Cyclic
- Biological Factors
- Acids, Acyclic
- Carboxylic Acids
- Alkaloids
- Hydrocarbons, Aromatic
- Polycyclic Compounds
- Amides
- Immunoproteins
- Blood Proteins
- Serum Globulins
- Globulins
- Pyrimidines
- Pregnadienes
- Pregnanes
- Steroids
- Fused-Ring Compounds
- Steroids, Fluorinated
- Phenols
- Benzene Derivatives
- Macrolides
- Lactones
- Pyrimidinones
- Intercellular Signaling Peptides and Proteins
- Pregnadienetriols
- Quinolines
- Acetamides
- Aminoquinolines
- Salicylates
- Hydroxybenzoates
- Cytokines
- Erythromycin
- Polyketides
- Fumarates
- Dicarboxylic Acids
- Chloroquine
- Dimethyl Fumarate
- Dexamethasone
- Aspirin
- Hydroxychloroquine
- Immunoglobulins
- Interleukin 1 Receptor Antagonist Protein
- Azithromycin
- Colchicine
- Oseltamivir
- Lopinavir
- tocilizumab
- empagliflozin
- baricitinib
- molnupiravir
- Adrenal Cortex Hormones
- nirmatrelvir and ritonavir drug combination
- sotrovimab
- baloxavir
- casirivimab and imdevimab drug combination
Other Study ID Numbers
- NDPHRECOVERY
- 2020-001113-21 (EudraCT Number)
- ISRCTN50189673 (Registry Identifier: ISRCTN)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
RECOVERY data are available via the Infectious Diseases Data Observatory (IDDO), or by contacting the study team (for datasets not held by IDDO).
https://www.iddo.org/covid19/data-reuse/accessing-data https://www.ndph.ox.ac.uk/data-access
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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