There’s been a fair bit of speculation here about what effect improved standard of care will have on 30 day mortality in the placebo arm of MSB’s Covid-19 ARD’s trial.
A large study from Spain, published a few days ago, may give some clues.
From March 12th to June 1st this year, the researchers monitored the progress of 742 patients aged 18+, in 36 ICU’s. All were followed from the first day of mechanical ventilation and the analysis included 28 day mortality.
The patients were classified into either mild (128), moderate (331) or severe (283) ARD’s with the same Berlin scale used in the MSB trial.
The researchers noted that most patients experienced a range of improved standard of care treatments including proning. No evidence I could see of stem cell treatment though. There were some other differences, for example 11 in the severe group and 9 in the moderate group were on ECMO, an exclusion factor in MSB's trial. Also, 30 day mortality, rather than 28, is analysed in the MSB trial and mild ARD’s patients are ineligible.
Nonetheless, as a point of comparison, imo the data from this study is still interesting.
28 day mortality in the Spanish study was 34% (111/283) in severe and 29% (99/231) in the moderate ARDs groups.
Food for thought imo.
https://link.springer.com/article/10.1007/s00134-020-06192-2
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