Lay summary
Severe pneumonia is common, especially for Māori who also have more complications after hospital discharge. REMAP-CAP identifies optimal treatments for severe pneumonia and influenza and can quickly adapt for a pandemic. Funded by the Health Research Council since 2016, REMAP-CAP has evaluated the best use of antibiotics, anti-inflammatory medications, and antivirals for patients in intensive care. In 2020, REMAP-CAP adapted to study COVID-19 treatments providing evidence of effective (corticosteroids, immune modulators, optimal blood thinning dose), ineffective (convalescent plasma, aspirin, vitamin C) and harmful treatments (hydroxychloroquine, high-dose blood thinning, angiotensin system inhibitors). REMAP-CAP will now expand to evaluate treatments to reduce complications after discharge and improve outcomes for Māori; baloxavir, another influenza antiviral; use of immune modulation in influenza; and the optimal use of COVID-19 antivirals. Less unwell patients hospitalised with pneumonia, influenza or COVID-19 will now be included while maintaining the ability to respond in the event of another pandemic.