Research response to COVID-19 needed better coordination and collaboration: a living mapping of registered trials

Nguyen, Van Thu; Rivière, Philippe; Ripoll, Pierre; Barnier, Julien; Vuillemot, Romain; Ferrand, Gabriel; Cohen-Boulkia, Sarah; Ravaud, Philippe; Boutron, Isabelle; Alawadhi, Solaf; Amer-Yahia, Sihem; Ávila, Camila; Bafeta, Aïda; Baudry, Julia; Bollig, Claudia; Bonnet, Hillary; Bouet, Marinette; Cabanac, Guillaume; Chaimani, Anna; Chavalarias, David; Chen, Yaolong; Chevance, Astrid; Cohen-Boulakia, Sarah; Coquery, Emmanuel; Conil, Francoise; Davidson, Mauricia; De Nale, Laura; Devane, Declan; Diard, Elise; Doreau, Bastien; Evrenoglou, Theodoros; Fabri, Alice; Feron, Gilles; Fezeu, Leopold; Fouet, Mathilde; El Chall, Lina Ghosn; Graña, Carolina; Grasselli, Giacomo; Grolleau, François; Hacid, Mohand-Said; Haddy, Loubna; Hansen, Camilla; Hohlfeld, Ameer; Hróbjartsson, Asbjørn; Julia, Chantal; Mavridis, Dimitris; Meerpohl, Joerg J.; Meyer, Brice; Naidoo, Nivantha; Thu, Van Nguyen; Oikonomidi, Theodora; Pienaar, Elizabeth; Quirke, Fiona; Rada, Gabriel; Riveros, Carolina; Sauvant, Marie; Schmucker, Christine; Toumani, Farouk; Tovey, David; Xia, Jun; Yu, Xuan; Zoletic, Emina; Zweigenbaum, Pierre

Background Researchers worldwide are actively engaging in research activities to search for preventive and therapeutic interventions against COVID-19. Our aim was to describe the planning of randomized controlled trials (RCTs) in terms of timing related to the course of the COVID-19 epidemic and research question evaluated. Method We performed a living mapping of RCTs registered in the WHO International Clinical Trials Registry Platform. We systematically search the platform every week for all RCTs evaluating preventive interventions and treatments for COVID-19 and created a publicly available interactive mapping tool at https://covid-nma.com to visualize all trials registered. Results By August 12, 2020, 1,568 trials for COVID-19 were registered worldwide. Overall, the median ([Q1-Q3]; range) delay between the first case recorded in each country and the first RCT registered was 47 days ([33-67]; 15-163). For the 9 countries with the highest number of trials registered, most trials were registered after the peak of the epidemic (from 100% trials in Italy to 38% in the United States). Most trials evaluated treatments (1,333 trials; 85%); only 223 (14%) evaluated preventive strategies and 12 post-acute period intervention. A total of 254 trials were planned to assess different regimens of hydroxychloroquine with an expected sample size of 110,883 patients. Conclusion This living mapping analysis showed that COVID-19 trials have relatively small sample size with certain redundancy in research questions. Most trials were registered when the first peak of the pandemic have passed.