Fewer people are eligible for the massive studies needed to test treatments for severe COVID-19.
Credit: Chris Sweda/Chicago Tribune/Tribune News Service via Getty, scientists have amassed a collection of therapies to treat people with COVID-19. But now, researchers fear that development of new treatments could falter as the clinical trials needed to test them become increasingly difficult.
Vaccinations in many places have led to a decline in severe disease, shrinking the pool of potential study participants. Hesitance to enrol in trials is rising, and the existence of potent treatments is making statistical analysis more difficult, too. “It was definitely easier to do research in the past. Now you’ve got to design a study that meets the standards of care, doctors want to do, and patients want to do. And it’s a lot harder,” says Elizabeth Hohmann, an infectious-disease expert at Massachusetts General Hospital in Boston.
At the beginning of the pandemic, health researcher Edward Mills from McMaster University in Hamilton, Canada, and his colleagues set up a trial in Brazil to learn whether existing drugs could prevent the most serious outcomes of COVID-19. When they launched the trial, called TOGETHER, in early 2020, the share of study participants who eventually died or had to be hospitalized was 16%. But the number dropped to 3–5% after vaccines became available.
When Hohmann began overseeing a trial called ACTT to test COVID-19 treatments in early 2020, recruitment was quick: ill people had no better option. By April 2020, the trial had enrolled 1,062 people. And by the end of 2020, it had shown that the antiviral drug remdesivir speeds recovery and prevents deathBut Hohmann says that, as effective treatments such as remdesivir became available, it became more and more difficult to recruit participants for subsequent trials.
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