A Randomized Study to Investigate the Effect of Intravenous Imatinib on the Amount of Oxygen in the Lungs and Blood of Adults With COVID-19 Needing Mechanical Ventilation and Supportive Care.

Inclusion Criteria: 1. Male or female patients aged ≥18 years 2. Women of childbearing potential must have a negative serum pregnancy test to confirm eligibility 3. Provision of signed written informed consent from the patient or patient's legally acceptable representative 4. SARS-CoV-2 infection confirmed by RT-PCR laboratory test (which may include results from a test that was performed prior to hospital admission if, in the opinion of the Investigator, it is relevant to ongoing COVID-19) 5. Meet Berlin definition for moderate - severe ARDS 1. Bilateral opacities - not fully explained by effusions, lobar/lung collapse, or nodules 2. Respiratory failure not fully explained by cardiac failure or fluid overload. 3. PaO2/FIO2 ≤200 mmHg with PEEP ≥5 cmH2O 6. Patient requires intubation or is currently intubated and has been for ≤48 hours Exclusion Criteria: 1. Persistent septic shock (\>24 hours) with a Mean Arterial Pressure (MAP) ≤65 mm Hg and serum lactate level \>4 mmol/L (36 mg/dL) despite adequate volume resuscitation and vasopressor use (norepinephrine \>0.2 μg/kg/min) for \>6 hours 2. Major trauma in the past 5 days 3. Presence of any active malignancy (other than non-melanoma skin cancer) that required treatment within the last year 4. Pre-existing severe cardiopulmonary disease including, but not limited to, interstitial lung disease; severe COPD (GOLD Stage IV or FEV1\<30% predicted); heart failure (estimated left ventricular ejection fraction \< 40%); or a chronic lung condition requiring home oxygen treatment 5. An underlying clinical condition that, in the opinion of the Investigator, would make it very unlikely for the patient to be successfully weaned from ventilation due to severe underlying diseases (e.g., severe malnutrition, severe neurological disease) 6. Patients considered inappropriate for critical care (e.g., being considered for palliative care) 7. Currently receiving extracorporeal membrane oxygenation (ECMO) 8. Severe chronic liver disease with Child-Pugh score \>12 (Appendix 1) 9. White blood count \<2.5 x 109/L; Hemoglobin \<4.0 mmol/L (6.5g/dL); Platelets \<50 x 109/L 10. ALT or AST \>10x upper limit of normal (ULN) or bilirubin \>3x ULN 11. Women who are pregnant or breast-feeding 12. Use of drugs with strong CYP3A4 induction potential, such as carbamazepine, efavirenz, enzalutamide, phenobarbital, phenytoin, hypericum, mitotane, nevirapine, primidone, rifabutin and rifampicin 13. Inability of the ICU staff to initiate administration of study treatment within 48 hours of intubation 14. Enrolled in a concomitant clinical trial of an investigational medicinal product 15. In the opinion of the investigator, progression to death is highly probable, irrespective of the provision of treatments