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Methods: Included patients had documented severe acute respiratory syndrome coronavirus 2 infection, required oxygen therapy, and had adequate organ function. The planned sample size was 609 patients. Patients were randomized 1:1:1 to at least 3 days of dexamethasone plus either plitidepsin (1.5 mg/day or 2.5 mg/day, for 3 days) or standard of care (control). The primary endpoint was the time to sustained withdrawal of supplemental oxygen. Secondary endpoints included t Keywords: plitidepsin; SARS-CoV-2; COVID-19; antiviral agents; marine compounds Author: Pedro Landete Creator: Servigistics Arbortext Advanced Print Publisher 11.1.4546/W-x64 Producer: PDFlib+PDI 9.0.7p3 (C++/Win64) CreationDate: Sat Oct 12 13:06:29 2024 CEST ModDate: Mon Oct 14 14:35:43 2024 CEST Custom Metadata: yes Metadata Stream: yes Tagged: yes UserProperties: no Suspects: no Form: none JavaScript: no Pages: 10 Encrypted: no Page size: 593.972 x 782.986 pts Page rot: 0 File size: 601320 bytes Optimized: yes PDF version: 1.6 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- UOPXSR+MinionPro-Regular Type 1C Custom yes yes yes 1447 0 RIRTWU+UniversLTStd-BoldCn Type 1C Custom yes yes yes 1450 0 YJFMSP+UniversLTStd-LightCn Type 1C Custom yes yes yes 1453 0 UHWHQM+SourceSansPro-Regular Type 1C Custom yes yes yes 1456 0 VWKSUR+MinionPro-BoldIt Type 1C Custom yes yes yes 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Lopez-Martin Liliana Preotescu Mihaela-Catalina Luca Anastasia Kotanidou Paula Villares Shirley-Patricia Iglesias Pablo Guisado-Vasco Elena-Maria Saiz-Lou Maria del Carmen Farinas-Alvarez Esperanza Merino de Lucas Eduardo Perez-Alba Jose-Miguel Cisneros Vicente Estrada Carmen Hidalgo-Tenorio Garyfallia Poulakou Miguel Torralba Jesus Fortun Paula Garcia-Ocana Adrien Lemaignen Miguel Marcos-Martin Maria Molina Roger Paredes Maria Teresa Perez-Rodriguez Dimitar Raev Pablo Ryan Fernanda Meira Javier Gomez Nadia Torres Diego Lopez-Mendoza Jose Jimeno Jose-Felipe Varona DOI: 10.1093/cid/ciae227; Clinical Infectious Diseases, 79, 4, 2024-08-26.; Abstract: Background: Plitidepsin has shown potent preclinical activity against severe acute respiratory syndrome coronavirus 2 and was generally well tolerated in a phase I trial of hospitalized patients with coronavirus disease 2019 (COVID-19). NEPTUNO, a phase III, multicenter, randomized, controlled trial, was designed to evaluate the efficacy and safety of plitidepsin in the management of moderate COVID-19 in hospitalized adult patients. Methods: Included patients had documented severe acute respiratory syndrome coronavirus 2 infection, required oxygen therapy, and had adequate organ function. The planned sample size was 609 patients. Patients were randomized 1:1:1 to at least 3 days of dexamethasone plus either plitidepsin (1.5 mg/day or 2.5 mg/day, for 3 days) or standard of care (control). The primary endpoint was the time to sustained withdrawal of supplemental oxygen. Secondary endpoints included t © The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. plitidepsin SARS-CoV-2 COVID-19 antiviral agents marine compounds Journal Clinical Infectious Diseases © The Author(s) 2024. 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