2024 Here we go again., page-590

I posted similar thoughts at the time of the trial. I would have preferred a much more specific inclusion criteria based on disease progression rather than waiting till people are on ventilators. I recall in the early days Covid patients with serious chest infection being reported as having x-rays images showing Ground Glass Opacity (GGO) in the lungs. I think inclusion should have been for patients having a certain % of the lungs showing GGO. And it would have been easier to show some visible efficacy if subsequent X-rays were able to image a slowdown or reversal of GGO progression in lungs. It would have also helped with separation of end point confounding cases cases where lung infection was reduced markedly but the patient died anyway due to weakness, age or an unrelated issue. Since the treatment was for Covid induced ARDS the end point could have been left at significant reduction in GGO in patients, easily measured by rather cheap imaging and not subject to opinions, the overall health of the patient or the delay in ventilation.