enrollment > 72 hours of admission order or positive test result, whichever is later admission to the hospital with a respiratory sofa >=5 , critical covid-19, or disease severity score >5 (requiring extracorporeal membrane oxygenation (ecmo), invasive mechanical ventilation, or all) known hypersensitivity to fenofibrate for female subjects: pregenant, determined by a human chorionic gonadotropin (hcg) rapid detection kit or a blood test breastfeeding undergoing fertility treatments patient-reported history or electronic medical record history of kidney disease, defined as: any history of dialysis history of chronic kidney disease stage iv estimated glomerular filtration rate (egfr) of < 30ml/min/1.73 m2 at the time of enrollment acute pre-renal azotemia at the time of enrollment in the opinion of the investigator or bedside clinician most recent mean arterial blood pressure prior to enrollment <65 mmhg patient-reported history or electronic medical record history of severe liver disease, defined as: cirrhosis history of hepatitis b or c documented ast or alt > 10 times the upper limit of normal measured within 24 hours prior to enrollment patient-reported history or electronic medical record history of gallbladder disease potassium >5.0 within 24 hours prior to enrollment unless a repeat value was <=5.0 treatment with coumarin anticoagulants (e.g., warfarin), immunosuppressants (e.g. cisplatin), bile acid resins, or sulfonylurea. inability to obtain informed consent from participant or legally authorized representative enrollment in another blinded randomized clinical trial for covid

enrollment > 72 hours of admission order or positive test result, whichever is later admission to the hospital with a respiratory sofa >=5 , critical covid-19, or disease severity score >5 (requiring extracorporeal membrane oxygenation (ecmo), invasive mechanical ventilation, or all) known hypersensitivity to fenofibrate for female subjects: pregenant, determined by a human chorionic gonadotropin (hcg) rapid detection kit or a blood test breastfeeding undergoing fertility treatments patient-reported history or electronic medical record history of kidney disease, defined as: any history of dialysis history of chronic kidney disease stage iv estimated glomerular filtration rate (egfr) of < 30ml/min/1.73 m2 at the time of enrollment acute pre-renal azotemia at the time of enrollment in the opinion of the investigator or bedside clinician most recent mean arterial blood pressure prior to enrollment <65 mmhg patient-reported history or electronic medical record history of severe liver disease, defined as: cirrhosis history of hepatitis b or c documented ast or alt > 10 times the upper limit of normal measured within 24 hours prior to enrollment patient-reported history or electronic medical record history of gallbladder disease potassium >5.0 within 24 hours prior to enrollment unless a repeat value was <=5.0 treatment with coumarin anticoagulants (e.g., warfarin), immunosuppressants (e.g. cisplatin), bile acid resins, or sulfonylurea. inability to obtain informed consent from participant or legally authorized representative enrollment in another blinded randomized clinical trial for covid

enrollment > 72 hours of admission order or positive test result, whichever is later admission to the hospital with a respiratory sofa >=5 or disease severity score >=5 (requiring noninvasive mechanical ventilation, requiring extracorporeal membrane oxygenation (ecmo), invasive mechanical ventilation, or all) known hypersensitivity to fenofibrate for female subjects: breastfeeding undergoing fertility treatments patient-reported history or electronic medical record history of kidney disease, defined as: any history of dialysis history of chronic kidney disease stage iv estimated glomerular filtration rate (egfr) of < 30ml/min/1.73 m2 at the time of enrollment acute pre-renal azotemia at the time of enrollment in the opinion of the investigator or bedside clinician most recent mean arterial blood pressure prior to enrollment <65 mmhg patient-reported history or electronic medical record history of severe liver disease, defined as: cirrhosis history of hepatitis b or c documented ast or alt > 10 times the upper limit of normal measured within 24 hours prior to enrollment patient-reported history or electronic medical record history of gallbladder disease potassium >5.0 within 24 hours prior to enrollment unless a repeat value was <=5.0 treatment with coumarin anticoagulants, immunosuppressants, or bile acid resins inability to obtain informed consent from participant or legally authorized representative enrollment in another blinded randomized clinical trial for covid-19

enrollment > 72 hours of admission order or positive test result, whichever is later admission to the hospital with a respiratory sofa >=5 or disease severity score >=5 (requiring noninvasive mechanical ventilation, requiring extracorporeal membrane oxygenation (ecmo), invasive mechanical ventilation, or all) known hypersensitivity to fenofibrate for female subjects: breastfeeding undergoing fertility treatments patient-reported history or electronic medical record history of kidney disease, defined as: any history of dialysis history of chronic kidney disease stage iv estimated glomerular filtration rate (egfr) of < 30ml/min/1.73 m2 at the time of enrollment acute pre-renal azotemia at the time of enrollment in the opinion of the investigator or bedside clinician most recent mean arterial blood pressure prior to enrollment <65 mmhg patient-reported history or electronic medical record history of severe liver disease, defined as: cirrhosis history of hepatitis b or c documented ast or alt > 10 times the upper limit of normal measured within 24 hours prior to enrollment patient-reported history or electronic medical record history of gallbladder disease potassium >5.0 within 24 hours prior to enrollment unless a repeat value was <=5.0 treatment with coumarin anticoagulants, immunosuppressants, or bile acid resins inability to obtain informed consent from participant or legally authorized representative enrollment in another blinded randomized clinical trial for covid-19

- enrollment > 72 hours of admission order or positive test result, whichever is later - admission to the hospital with a respiratory sofa >=5 or disease severity score >=5 (requiring noninvasive mechanical ventilation, requiring extracorporeal membrane oxygenation (ecmo), invasive mechanical ventilation, or all) - known hypersensitivity to fenofibrate - for female subjects: 1. breastfeeding 2. undergoing fertility treatments - patient-reported history or electronic medical record history of kidney disease, defined as: 1. any history of dialysis 2. history of chronic kidney disease stage iv 3. estimated glomerular filtration rate (egfr) of < 30ml/min/1.73 m2 at the time of enrollment - acute pre-renal azotemia at the time of enrollment in the opinion of the investigator or bedside clinician - most recent mean arterial blood pressure prior to enrollment <65 mmhg - patient-reported history or electronic medical record history of severe liver disease, defined as: 1. cirrhosis 2. history of hepatitis b or c 3. documented ast or alt > 10 times the upper limit of normal measured within 24 hours prior to enrollment - patient-reported history or electronic medical record history of gallbladder disease - potassium >5.0 within 24 hours prior to enrollment unless a repeat value was <=5.0 - treatment with coumarin anticoagulants, immunosuppressants, or bile acid resins - inability to obtain informed consent from participant or legally authorized representative - enrollment in another blinded randomized clinical trial for covid-19

- enrollment > 72 hours of admission order or positive test result, whichever is later - admission to the hospital with a respiratory sofa >=5 or disease severity score >=5 (requiring noninvasive mechanical ventilation, requiring extracorporeal membrane oxygenation (ecmo), invasive mechanical ventilation, or all) - known hypersensitivity to fenofibrate - for female subjects: 1. breastfeeding 2. undergoing fertility treatments - patient-reported history or electronic medical record history of kidney disease, defined as: 1. any history of dialysis 2. history of chronic kidney disease stage iv 3. estimated glomerular filtration rate (egfr) of < 30ml/min/1.73 m2 at the time of enrollment - acute pre-renal azotemia at the time of enrollment in the opinion of the investigator or bedside clinician - most recent mean arterial blood pressure prior to enrollment <65 mmhg - patient-reported history or electronic medical record history of severe liver disease, defined as: 1. cirrhosis 2. history of hepatitis b or c 3. documented ast or alt > 10 times the upper limit of normal measured within 24 hours prior to enrollment - patient-reported history or electronic medical record history of gallbladder disease - potassium >5.0 within 24 hours prior to enrollment unless a repeat value was <=5.0 - treatment with coumarin anticoagulants, immunosuppressants, or bile acid resins - inability to obtain informed consent from participant or legally authorized representative - enrollment in another blinded randomized clinical trial for covid-19