JAMA Netw Open: A randomized clinical trial of losartan in hospitalized patients with COVID-19 lung injury

Background: The novel coronavirus has infected more than 195 million people and caused more than 4 million deaths

Background: The novel coronavirus has infected more than 195 million people and caused more than 4 million deaths

Preclinical models of viral pneumonia affecting ACE2, including the novel coronavirus, have demonstrated that AII type 1 receptor (AT1R) blockade reduces lung injury and death

We hypothesized that losartan treatment might reduce lung injury and improve clinical outcomes in hospitalized patients with COVID-19 by restoring AII and angiotensin-(1-7) homeostasis

Objective: To investigate the reducing effect of losartan on lung injury in hospitalized patients with new coronary pneumonia

Design, Settings, and Participants: This blinded, placebo-controlled, randomized clinical trial was conducted at 13 U.

Intervention: Losartan 50 mg orally twice daily versus an equivalent placebo for 10 days or until discharge

MAIN OUTCOMES AND MEASURES: The primary outcome was the ratio of arterial partial pressure of oxygen to partial pressure of inspired oxygen (PaO2/FiO2) at 7 days

RESULTS: A total of 205 participants (mean age, 55.

Figure 1 The ratio of arterial partial pressure of oxygen to fractional inspired oxygen (PaO2:FiO2) in losartan and placebo groups

Figure 1 The ratio of arterial partial pressure of oxygen to fractional inspired oxygen (PaO2:FiO2) in losartan and placebo groups

Figure 2 Cumulative incidence of death and hospital discharge in losartan and placebo groups

Figure 2 Cumulative incidence of death and hospital discharge in losartan and placebo groups

Table 1 Analysis of survival days and days without intervention

Table 1 Analysis of survival days and days without intervention

Conclusions: This randomized clinical trial found that 7 days after initiation of oral losartan treatment in hospitalized patients with COVID-19 and acute lung injury, the PaO2/FiO2 ratio did not improve

Conclusions: This randomized clinical trial found that 7 days after initiation of oral losartan treatment in hospitalized patients with COVID-19 and acute lung injury, the PaO2/FiO2 ratio did not improve

Original source: Puskarich MA, Ingraham NE, Merck L.
Het al.
Efficacy of Losartan in Hospitalized Patients With COVID-19 -Induced Lung Injury: A Randomized Clinical Trial.
JAMA Netw Open 2022 03 01;5(3) Efficacy of Losartan in Hospitalized Patients With -Induced Lung Injury: A Randomized Clinical Trial.


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