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An Open Label Trial to Assess Safety of Losartan for Treating Worsening Respiratory Illness in COVID-19.
Bengtson, Charles D; Montgomery, Robert N; Nazir, Usman; Satterwhite, Lewis; Kim, Michael D; Bahr, Nathan C; Castro, Mario; Baumlin, Nathalie; Salathe, Matthias.
  • Bengtson CD; Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Kansas Medical Center, Kansas City, KS, United States.
  • Montgomery RN; Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Kansas Medical Center, Kansas City, KS, United States.
  • Nazir U; Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS, United States.
  • Satterwhite L; Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Kansas Medical Center, Kansas City, KS, United States.
  • Kim MD; Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Kansas Medical Center, Kansas City, KS, United States.
  • Bahr NC; Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Kansas Medical Center, Kansas City, KS, United States.
  • Castro M; Department of Internal Medicine, Division of Infectious Diseases, University of Kansas Medical Center, Kansas City, KS, United States.
  • Baumlin N; Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Kansas Medical Center, Kansas City, KS, United States.
  • Salathe M; Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Kansas Medical Center, Kansas City, KS, United States.
Front Med (Lausanne) ; 8: 630209, 2021.
Article in English | MEDLINE | ID: covidwho-1121692
Semantic information from SemMedBD (by NLM)
1. losartan TREATS COVID-19
Subject
losartan
Predicate
TREATS
Object
COVID-19
2. Pulmonary capillary LOCATION_OF Extravasation
Subject
Pulmonary capillary
Predicate
LOCATION_OF
Object
Extravasation
3. Lung LOCATION_OF COVID-19
Subject
Lung
Predicate
LOCATION_OF
Object
COVID-19
4. Angiotensin II receptor antagonist TREATS Respiratory Failure
Subject
Angiotensin II receptor antagonist
Predicate
TREATS
Object
Respiratory Failure
5. losartan TREATS Respiratory Failure
Subject
losartan
Predicate
TREATS
Object
Respiratory Failure
6. Respiratory Failure COEXISTS_WITH COVID-19
Subject
Respiratory Failure
Predicate
COEXISTS_WITH
Object
COVID-19
7. losartan TREATS Adverse event
Subject
losartan
Predicate
TREATS
Object
Adverse event
8. losartan TREATS COVID-19
Subject
losartan
Predicate
TREATS
Object
COVID-19
9. Pulmonary capillary LOCATION_OF Extravasation
Subject
Pulmonary capillary
Predicate
LOCATION_OF
Object
Extravasation
10. Lung LOCATION_OF COVID-19
Subject
Lung
Predicate
LOCATION_OF
Object
COVID-19
11. Angiotensin II receptor antagonist TREATS Respiratory Failure
Subject
Angiotensin II receptor antagonist
Predicate
TREATS
Object
Respiratory Failure
12. losartan TREATS Respiratory Failure
Subject
losartan
Predicate
TREATS
Object
Respiratory Failure
13. Respiratory Failure COEXISTS_WITH COVID-19
Subject
Respiratory Failure
Predicate
COEXISTS_WITH
Object
COVID-19
14. losartan TREATS Adverse event
Subject
losartan
Predicate
TREATS
Object
Adverse event
ABSTRACT
Rationale Coronavirus disease 2019 (COVID-19) can cause disruption of the renin-angiotensin system in the lungs, possibly contributing to pulmonary capillary leakage. Thus, angiotensin receptor blockers (ARBs) may improve respiratory failure.

Objective:

Assess safety of losartan for use in respiratory failure related to COVID-19 (NCT04335123).

Methods:

Single arm, open label trial of losartan in those hospitalized with respiratory failure related to COVID-19. Oral losartan (25 mg daily for 3 days, then 50 mg) was administered from enrollment until day 14 or hospital discharge. A post-hoc external control group with patients who met all inclusion criteria was matched 11 to the treatment group using propensity scores for comparison.

Measures:

Primary outcome was cumulative incidence of any adverse events. Secondary, explorative endpoints included measures of respiratory failure, length of stay and vital status.

Results:

Of the 34 participants enrolled in the trial, 30 completed the study with a mean age SD of 53.8 ± 17.7 years and 17 males (57%). On losartan, 24/30 (80%) experienced an adverse event as opposed to 29/30 (97%) of controls, with a lower average number of adverse events on losartan relative to control (2.2 vs. 3.3). Using Poisson regression and controlling for age, sex, race, date of enrollment, disease severity at enrollment, and history of high-risk comorbidities, the incidence rate ratio of adverse events on losartan relative to control was 0.69 (95% CI 0.49-0.97)

Conclusions:

Losartan appeared safe for COVID-19-related acute respiratory compromise. To assess true efficacy, randomized trials are needed.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Controlled clinical trial / Observational study / Randomized controlled trials Topics: Long Covid Language: English Journal: Front Med (Lausanne) Year: 2021 Document Type: Article Affiliation country: Fmed.2021.630209

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Controlled clinical trial / Observational study / Randomized controlled trials Topics: Long Covid Language: English Journal: Front Med (Lausanne) Year: 2021 Document Type: Article Affiliation country: Fmed.2021.630209