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Does Losartan reduce the severity of COVID-19 in hypertensive patients?

Mirjalili et al., BMC Cardiovascular Disorders, doi:10.1186/s12872-022-02548-2
Mar 2022  
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Mortality 81% Improvement Relative Risk Case 3% Losartan for COVID-19  Mirjalili et al.  Prophylaxis Is prophylaxis with losartan beneficial for COVID-19? Retrospective 280 patients in Iran Lower mortality with losartan (p=0.003) c19early.org Mirjalili et al., BMC Cardiovascular D.., Mar 2022 Favorslosartan Favorscontrol 0 0.5 1 1.5 2+
Retrospective study of 280 hypertensive patients in Iran showing lower mortality with losartan use in COVID-19 patients, however data is contradictory and unclear. The text and Figure 1 indicate that 179 of 280 patients were PCR+, however Table 1 shows 101 patients were PCR+. Table 1 shows 11% of PCR- patients died, authors do not provide an explanation for the very high mortality of PCR- patients. The followup period for the outcomes is not specified. The reported exclusions in Figure 1 does not match the description of the resulting 280 patients as hypertensive. Authors indicate that the patients "presented to COVID-19 laboratory and diagnostic centers", it is unclear why almost all were hospitalized, including the PCR- patients.
risk of death, 81.2% lower, RR 0.19, p = 0.003, treatment 161, control 119, odds ratio converted to relative risk, control prevalance approximated with overall prevalence.
risk of case, 3.3% lower, RR 0.97, p = 0.86, treatment 161, control 119, odds ratio converted to relative risk, control prevalance approximated with overall prevalence.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Mirjalili et al., 19 Mar 2022, retrospective, Iran, peer-reviewed, mean age 64.6, 5 authors. Contact: adehghani42@yahoo.com (corresponding author).
This PaperLosartanAll
Does Losartan reduce the severity of COVID-19 in hypertensive patients?
Mohammadreza Mirjalili, Moslem Taheri Soodejani, Mehdi Raadabadi, Ali Dehghani, Fateme Salemi
BMC Cardiovascular Disorders, doi:10.1186/s12872-022-02548-2
Background: One of the global problems is to control the coronavirus epidemic, and the role of different medicines is still unknown to policymakers. This study was conducted to evaluate the effects of losartan on the mortality rate of COVID-19 in hypertensive patients. Methods: The research sample of analytical study included 1458 patients presenting to COVID-19 diagnostic centers in Yazd that were examined in the first six months of 2020. Data were analyzed using descriptive statistics as well as chi-square, Fisher's exact test, t test, and logistic regression. Results: Of 1458 subjects that were studied, 280 were hypertensive of whom 179 tested positive for SARS-CoV-2 PCR. The results showed a lower chance of death by more than 5 times in hypertensive patients who used losartan (P = 0.003). Moreover, regarding the effect of losartan on the prevention of COVID-19 in hypertensive patients, it was found that this medicine played a protective role although this relationship was not statistically significant (P = 0.86). Conclusions: The results showed that losartan reduced the chance of mortality in hypertensive patients. It is recommended that the effect of losartan and other blood pressure medicines on COVID-19 patients be investigated in larger studies as well as laboratory investigations.
Authors' contributions MM and AD have designed the study and supervised the thesis. MR collected the data and analyzed it. They also prepared the first draft of the manuscript. MTS has edited and finalized the manuscript. All authors read the manuscript and approved it. Declarations Ethics approval and consent to participate The article's proposal was approved by the ethics committee of Shahid Sadoughi University of Medical Sciences with the ID of IR.SSU.REC.1399.101. Due to the retrospective nature of the study, no study specific consent form was used. However, patients admitted to our hospital are asked to sign a general consent upon admission, which covers the collection of patient data and publication of these results. Therefore, the individual's informed consent was waived by the above ethics committee. We received administrative permission from (Secretary of University/Regional Research Ethics Committee Shahid Sadoughi University of Medical Sciences) to access and use the data. Data used in the study were anonymized. The ethics committee approved this procedure with the above ethical code. The present study was conducted in terms of the principles of the revised Declaration of Helsinki, which waived requirement for informed consent. Consent for publication Not applicable. Competing interests All authors declare that they have no conflict of interest regarding this study. • fast, convenient online submission • thorough peer review by experienced researchers in..
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Kouhpayeh, S.; Shariati, L.; Boshtam, ' 'M.; Rahimmanesh, I.; Mirian, M.; Zeinalian, M.; Salari-jazi, A.; ' 'Khanahmad, N.; Damavandi, M.S.; Sadeghi, P.; Khanahmad, H. The Molecular ' 'Story of COVID-19; NAD+ Depletion Addresses All Questions in this ' 'Infection. Preprints 2020, 2020030346 ' 'https://doi.org/10.20944/preprints202003.0346.v1.', 'DOI': '10.20944/preprints202003.0346.v1'}, { 'key': '2548_CR24', 'doi-asserted-by': 'crossref', 'unstructured': 'Covid C, Team R, COVID C, Team R, COVID C, Team R, et al. Severe ' 'outcomes among patients with coronavirus disease 2019 (COVID-19)—United ' 'States, February 12–March 16, 2020. Morbidity and mortality weekly ' 'report. 2020;69(12):343. https://dx.doi.org/10.15585%2Fmmwr.mm6912e2.', 'DOI': '10.15585/mmwr.mm6912e2'}, { 'key': '2548_CR25', 'unstructured': 'TNCPERE T. Vital surveillances: the epidemiological characteristics of ' 'an outbreak of 2019 novel coronavirus disease (COVID-19)-China, 2020. ' '2020.'}, { 'issue': '6', 'key': '2548_CR26', 'doi-asserted-by': 'publisher', 'first-page': '767', 'DOI': '10.1016/j.cmi.2020.04.012', 'volume': '26', 'author': 'J Zhang', 'year': '2020', 'unstructured': 'Zhang J, Wang X, Jia X, Li J, Hu K, Chen G, et al. Risk factors for ' 'disease severity, unimprovement, and mortality in COVID-19 patients in ' 'Wuhan, China. Clin Microbiol Infect. 2020;26(6):767–72. ' 'https://doi.org/10.1016/j.cmi.2020.04.012.', 'journal-title': 'Clin Microbiol Infect'}, { 'issue': '7', 'key': '2548_CR27', 'doi-asserted-by': 'publisher', 'first-page': '811', 'DOI': '10.1001/jamacardio.2020.1017', 'volume': '5', 'author': 'T Guo', 'year': '2020', 'unstructured': 'Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular ' 'implications of fatal outcomes of patients with coronavirus disease 2019 ' '(COVID-19). JAMA Cardiol. 2020;5(7):811–8. 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' 'https://doi.org/10.1080/22221751.2020.1746200.', 'journal-title': 'Emerg Microb Infect'}], 'container-title': 'BMC Cardiovascular Disorders', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1186/s12872-022-02548-2.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1186/s12872-022-02548-2/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1186/s12872-022-02548-2.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2022, 3, 19]], 'date-time': '2022-03-19T12:09:27Z', 'timestamp': 1647691767000}, 'score': 1, 'resource': { 'primary': { 'URL': 'https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-022-02548-2'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2022, 3, 19]]}, 'references-count': 29, 'journal-issue': {'issue': '1', 'published-print': {'date-parts': [[2022, 12]]}}, 'alternative-id': ['2548'], 'URL': 'http://dx.doi.org/10.1186/s12872-022-02548-2', 'relation': {}, 'ISSN': ['1471-2261'], 'subject': [], 'container-title-short': 'BMC Cardiovasc Disord', 'published': {'date-parts': [[2022, 3, 19]]}, 'assertion': [ { 'value': '22 August 2021', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '8 March 2022', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '19 March 2022', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, {'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}}, { 'value': 'The article’s proposal was approved by the ethics committee of Shahid Sadoughi ' 'University of Medical Sciences with the ID of IR.SSU.REC.1399.101. Due to the ' 'retrospective nature of the study, no study specific consent form was used. ' 'However, patients admitted to our hospital are asked to sign a general consent ' 'upon admission, which covers the collection of patient data and publication of ' 'these results. Therefore, the individual’s informed consent was waived by the ' 'above ethics committee. We received administrative permission from (Secretary ' 'of University/Regional Research Ethics Committee Shahid Sadoughi University of ' 'Medical Sciences) to access and use the data. Data used in the study were ' 'anonymized. The ethics committee approved this procedure with the above ' 'ethical code. The present study was conducted in terms of the principles of ' 'the revised Declaration of Helsinki, which waived requirement for informed ' 'consent.', 'order': 2, 'name': 'Ethics', 'group': { 'name': 'EthicsHeading', 'label': "<!--Emphasis Type='Bold' removed-->Ethics approval and consent to " 'participate'}}, { 'value': 'Not applicable.', 'order': 3, 'name': 'Ethics', 'group': { 'name': 'EthicsHeading', 'label': "<!--Emphasis Type='Bold' removed-->Consent for publication"}}, { 'value': 'All authors declare that they have no conflict of interest regarding this ' 'study.', 'order': 4, 'name': 'Ethics', 'group': { 'name': 'EthicsHeading', 'label': "<!--Emphasis Type='Bold' removed-->Competing interests"}}], 'article-number': '116'}
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