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COVIDMED – An early pandemic randomized clinical trial of losartan treatment for hospitalized COVID-19 patients

Freilich et al., Contemporary Clinical Trials Communications, doi:10.1016/j.conctc.2022.100968, COVIDMED, NCT04340557
Oct 2022  
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Mortality -533% Improvement Relative Risk Hospitalization time -160% Losartan  COVIDMED  LATE TREATMENT  RCT Is late treatment with losartan beneficial for COVID-19? RCT 12 patients in the USA Higher mortality (p=0.49) and longer hospitalization (p=0.3), not sig. c19early.org Freilich et al., Contemporary Clinical.., Oct 2022 Favorslosartan Favorscontrol 0 0.5 1 1.5 2+
RCT 15 hospitalized COVID-19 patients showing no significant differences with losartan treatment. The study was terminated early due to low enrollment.
risk of death, 533.3% higher, RR 6.33, p = 0.49, treatment 4 of 9 (44.4%), control 0 of 3 (0.0%), continuity correction due to zero event (with reciprocal of the contrasting arm).
hospitalization time, 160.3% higher, relative time 2.60, p = 0.30, treatment 9, control 3.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Freilich et al., 31 Oct 2022, Randomized Controlled Trial, placebo-controlled, USA, peer-reviewed, mean age 69.8, 4 authors, trial NCT04340557 (history) (COVIDMED). Contact: daniel.freilich@bassett.org, jennifer.victory@bassett.org, paul.jenkins@bassett.org.
This PaperLosartanAll
COVIDMED – An early pandemic randomized clinical trial of losartan treatment for hospitalized COVID-19 patients
Daniel Freilich, Jennifer Victory, Paul Jenkins, Anne Gadomski
Contemporary Clinical Trials Communications, doi:10.1016/j.conctc.2022.100968
Losartan Angiotensin converting enzyme inhibitor (ACEi) Angiotensin II receptor Blocker (ARB) COVID
Source of funding This work was supported by a Bassett Research Institute ED Thomas Grant (which included funds to purchase study drugs) and salary support from the Bassett Research Institute and Bassett Medical Center's Department of Internal Medicine. Funders had no role in the design, execution, data analysis, or manuscript preparation or publication of this study. Authors' contributions All authors contributed to refinement of and approved the manuscript. Authorship role All authors collaborated in the writing/editing of the manuscript. Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Appendix A. Supplementary data Supplementary data to this article can be found online at https://doi. org/10.1016/j.conctc.2022.100968.
References
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Bengtson, Montgomery, Nazir, Satterwhite, Kim et al., An open label trial to assess safety of losartan for treating worsening respiratory illness in COVID-19, Front. Med, doi:10.3389/fmed.2021.630209
Cao, Wang, Wen, Liu, Wang et al., A trial of lopinavir-ritonavir in adults hospitalized with severe covid-19, N. Engl. J. Med
Cohen, Hanff, William, Sweitzer, Rosado-Santander et al., Continuation versus discontinuation of renin-angiotensin system inhibitors in patients admitted to hospital with COVID-19: a prospective, randomised, open-label trial, Lancet Respir. Med
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Fosbol, Butt, Østergaard, Andersson, Selmer et al., Association of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use with COVID-19 diagnosis and mortality, JAMA
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Mehta, Kalra, Nowacki, Anjewierden, Han et al., Association of use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers with testing positive for coronavirus disease 2019 (COVID-19), JAMA Cardiol
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Late treatment
is less effective
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