ARBs CORONA II
Trial question
What is the effect of losartan in patients hospitalized for acute COVID-19 infection?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
30.0% female
70.0% male
N = 341
341 patients (102 female, 239 male).
Inclusion criteria: adult patients hospitalized for acute COVID-19 infection.
Key exclusion criteria: hypotension; hyperkalemia; AKI; use of ARBs or ACEis within 7 days.
Interventions
N=171 losartan (at a dose of 25-100 mg/day PO for the hospital duration or 3 months).
N=170 usual care (usual care for duration of hospitalization for up to 3 months).
Primary outcome
Death at day 28
6.5%
5.9%
6.5 %
4.9 %
3.3 %
1.6 %
0.0 %
Losartan
Usual
care
No significant
difference ↔
No significant difference in death at day 28 (6.5% vs. 5.9%; OR 1.11, 95% CI 0.47 to 2.64).
Secondary outcomes
No significant difference in days alive and free of ICU at 28 days (25 days vs. 26 days; AD -1 days, 95% CI -3.1 to 1.1).
No significant difference in vasopressor use (22.4% vs. 18.2%; OR 1.29, 95% CI 0.76 to 2.18).
No significant difference in severe ARDS (55.8% vs. 64%; OR 0.72, 95% CI 0.37 to 1.37).
Safety outcomes
No significant differences in hyperkalemia, AKI, severe hypersensitivity reactions, ARDS.
Significant differences in serious adverse events (39.8% vs. 27.2%), hypotension (30.4% vs. 15.3%).
Conclusion
In adult patients hospitalized for acute COVID-19 infection, losartan was not superior to usual care with respect to death at day 28.
Reference
Karen C Tran, Pierre Asfar, Matthew Cheng et al. Effects of Losartan on Patients Hospitalized for Acute Coronavirus Disease 2019: A Randomized Controlled Trial. Clin Infect Dis. 2024 Jul:ciae306.
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