Rationale: There is an urgent need for a platform to rapidly evaluate therapies in the outpatient setting, to prevent disease progression, and reduce serious complications of COVID-19 and transmission [10]. ACTIV-2/A5401 is a phase II/III randomized, blinded, controlled adaptive platform trial to efficiently evaluate agents for the treatment of non-hospitalized persons with COVID-19. This will allow: 

• • comparison of multiple therapies with a common control group, when feasible, thus potentially requiring fewer participants than in independently conducted randomized controlled trials, 
• • continuous introduction of new promising agents as they become available, 
• • generation of separate effect size estimates for each therapy, and 
• • minimized downtime, with rapid movement of promising agents into phase III evaluation. 

Additionally, the trial will facilitate the exploration of virologic endpoints as possible future primary endpoints in COVID-19 trials by assessing the correlation between changes in viral shedding and clinical outcomes. 

Adults