Evidence map›Paper›PMID 40754325›Full record

ArticleBMJ open2025

Canadian Adaptive Platform Trial of Treatments for COVID in Community Settings (CanTreatCOVID): protocol for a randomised controlled adaptive platform trial of treatments for acute SARS-CoV-2 infection in community settings.

Banafshe Hosseini, Amanda Condon, Bruno R da Costa, Peter Daley, Michelle Greiver, Peter Jüni, Todd C Lee, Kerry McBrien, Emily G McDonald, Srinivas Murthy and 57 more

Registry-linked trialAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05614349 (Canadian Adaptive Platform Trial of Treatments for COVID-19 in Community Settings), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05614349 phase3active not recruitingnot on this map

Canadian Adaptive Platform Trial of Treatments for COVID-19 in Community Settings

TypeinterventionalSponsorUnity Health TorontoRan2023 to 2025Enrolled797ConditionsCOVID-19ArmsPaxlovid, Antioxidant
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

67 authors.

Banafshe HosseiniUpstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada.
Amanda CondonDepartment of Family Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Bruno R da CostaClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Peter DaleyFaculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
Michelle GreiverDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Peter JüniClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Todd C LeeDepartment of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.ORCID http://orcid.org/0000-0002-2267-4239
Kerry McBrienDepartment of Family Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
Emily G McDonaldDivision of Experimental Medicine, Department of Medicine, McGill University, Montréal, Quebec, Canada.ORCID http://orcid.org/0000-0003-0783-0624
Srinivas MurthyDepartment of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Peter SelbyDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0001-5401-2996
Melissa AndrewDepartment of Medicine (Division of Geriatric Medicine), Dalhousie University, Halifax, Nova Scotia, Canada.
Kris Aubrey-BasslerPrimary Healthcare Research Unit, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.ORCID http://orcid.org/0000-0001-8680-6838
David BarberDepartment of Family Medicine, Queen's University, Kingston, Ontario, Canada.
Brendan BarrettMedicine Nephrology, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
Christopher C ButlerNuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-0102-3453
Noah CramptonDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Simone DahrougeElisabeth Bruyere Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
Ali DamjiDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Robert FowlerInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Stephanie GariesDepartment of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Catherine HudonUniversité de Sherbrooke, Sherbrooke, Quebec, Canada.ORCID http://orcid.org/0000-0001-6140-9916
Jennifer HulmeDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Jennifer IsenorCollege of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada.
David J A JenkinsDepartment of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0003-1192-9571
Rosemarie LallDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Annie LeBlancVITAM Research Center on Sustainable Health, Sherbrooke, Quebec, Canada.ORCID http://orcid.org/0000-0002-5377-8102
Christine LeongCollege of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.ORCID http://orcid.org/0000-0003-0033-6877
Paul LittlePrimary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK.ORCID http://orcid.org/0000-0003-3664-1873
Aisha LoftersDepartment of Family and Community Medicine, Women's College Hospital, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0002-7322-0894
Sarvesh LogsettyDepartments of Surgery and Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.
Sylvain LotherDepartment of Internal Medicine, University of Manitoba Max Rady College of Medicine, Winnipeg, Manitoba, Canada.
Marie-Thérèse LussierCHUM Research Center, Université de Montréal's affiliated hospital research center, Montréal, Québec, Canada.
Laura MaclarenDepartment of Family Medicine, McGill University Faculty of Medicine and Health Sciences, Montreal, Quebec, Canada.
Dee ManginPublic Health and General Practice, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand.
Emily Gard MarshallFamily Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.ORCID http://orcid.org/0000-0001-8327-0329
John C MarshallDepartment of Surgery, University of Toronto, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0002-7902-6291
Rita McCrackenFamily Medicine, Providence Health Care, Vancouver, British Columbia, Canada.ORCID http://orcid.org/0000-0002-2962-0364
Rahim MoineddinDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0002-5506-084X
Brianna OravaLawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Jean-Sébastien PaquetteVITAM - Research Centre on Sustainable Health, Sherbrooke, Québec, Canada.ORCID http://orcid.org/0000-0002-9524-6761
Jay Jae Hee ParkDepartment of Health Research Methods, Evidence and Impact (HEI), Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Nav PersaudDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0003-3327-5580
Valeria E RacInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Vivian R RamsdenDepartment of Family Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.ORCID http://orcid.org/0000-0002-5845-8634
Jennifer RaynerAlliance for Healthier Communities, Toronto, Ontario, Canada.
Diana C Sanchez-RamirezCollege of Rehabilitation Sciences, Department of Respiratory Therapy, University of Manitoba, Winnipeg, Manitoba, Canada.ORCID http://orcid.org/0000-0003-1637-4309
Lynora SaxingerDepartment of Medicine, Division of Infectious Diseases, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada.ORCID http://orcid.org/0000-0003-4133-9337
Haolun ShiDepartment of Statistics and Actuarial Science, Simon Fraser University, Burnaby, British Columbia, Canada.
Alexander SingerDepartment of Family Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Rae SpiwakDepartment of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.ORCID http://orcid.org/0000-0003-0316-4775
Anita SrivastavaDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Abhimanyu SudDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0001-8354-6153
Jean-Eric TarrideDepartment of Health Research Methods, Evidence and Impact (HEI), Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Deanna TelnerDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Ross E G UpshurDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Sakina WaljiDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Rachel WalshDepartment of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Machelle WilcheskyDepartments of Medicine and of Family Medicine, McGill University, Montreal, Quebec, Canada.
Sabrina T WongCentre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada.ORCID http://orcid.org/0000-0002-9619-9012
Brianne WoodThunder Bay Regional Health Research Institute, Thunder Bay, Ontario, Canada.
Ryan ZarychanskiSections of Critical Care and Hematology/Medical Oncology, University of Manitoba, Winnipeg, Manitoba, Canada.
Barb ZelekDr. Gilles Arcand Centre for Health Equity, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.
Yoav KeynanMedical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada.
Jolanta PiszczekFaculty of Pharmacy, The University of British Columbia, Vancouver, British Columbia, Canada.
Daniel WarshafskySchool of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
Andrew David PintoUpstream Lab, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada andrew.pinto@utoronto.ca.ORCID http://orcid.org/0000-0003-1841-9347

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSARS-CoV-2 is now endemic and expected to remain a health threat, with new variants continuing to emerge and the potential for vaccines to become less effective. While effective vaccines and natural immunity have significantly reduced hospitalisations and the need for critical care, outpatient treatment options remain limited, and real-world evidence on their clinical and cost-effectiveness is lacking. In this paper, we present the design of the Canadian Adaptive Platform Trial of Treatments for COVID in Community Settings (CanTreatCOVID). By evaluating multiple treatment options in a pragmatic adaptive platform trial, this study will generate high-quality, generalisable evidence to inform clinical guidelines and healthcare decision-making. METHODS AND ANALYSIS: CanTreatCOVID is an open-label, individually randomised, multicentre, national adaptive platform trial designed to evaluate the clinical and cost-effectiveness of therapeutics for non-hospitalised SARS-CoV-2 patients across Canada. Eligible participants must present with symptomatic SARS-CoV-2 infection, confirmed by PCR or rapid antigen testing (RAT), within 5 days of symptom onset. The trial targets two groups that are expected to be at higher risk of more severe disease: (1) individuals aged 50 years and older and (2) those aged 18-49 years with one or more comorbidities. CanTreatCOVID uses numerous approaches to recruit participants to the study, including a multifaceted public communication strategy and outreach through primary care, outpatient clinics and emergency departments. Participants are randomised to receive either usual care, including supportive and symptom-based management, or an investigational therapeutic selected by the Canadian COVID-19 Outpatient Therapeutics Committee. The first therapeutic arm evaluates nirmatrelvir/ritonavir (Paxlovid), administered two times per day for 5 days. The second therapeutic arm investigates a combination antioxidant therapy (selenium 300 µg, zinc 40 mg, lycopene 45 mg and vitamin C 1.5 g), administered for 10 days. The primary outcome is all-cause hospitalisation or death within 28 days of randomisation. ETHICS AND DISSEMINATION: The CanTreatCOVID master protocol and subprotocols have been approved by Health Canada and local research ethics boards in the participating provinces across Canada. The results of the study will be disseminated to policy-makers, presented at conferences and published in peer-reviewed journals to ensure that findings are accessible to the broader scientific and medical communities. This study was approved by the Unity Health Toronto Research Ethics Board (#22-179) and Clinical Trials Ontario (Project ID 4133). TRIAL REGISTRATION NUMBER: NCT05614349.

Indexed as

Antiviral AgentsCOVID-19COVID-19 Drug TreatmentAdaptive Clinical Trials as TopicAdultCanadaCost-Benefit AnalysisHumansMaleMiddle AgedMulticenter Studies as TopicPragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicAntiviral AgentsClinical ProtocolsCOVID-19Randomized Controlled TrialSARS-CoV-2 Infection

Identifiers

PMID40754325
PMCPMC12320028

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.