Comparison of Losartan and Amlodipine Effects on the Outcomes of Patient with COVID-19 and Primary Hypertension: A Randomized Clinical Trial.

BACKGROUND: Controversy exists regarding the drug selection in hypertension (HTN) management in patients with COVID-19. This study aimed to compare the effects of losartan and amlodipine in patients with primary HTN and COVID-19. METHODS: In this randomized clinical trial, hospitalized patients with COVID-19 and primary HTN were enrolled in the study. One arm received losartan, 25 mg, twice a day and the other arm received amlodipine, 5 mg per day for two weeks. The main outcomes were compare 30-day mortality rate and length of hospital stay. RESULTS: The mean age of patients treated with losartan (N=41) and amlodipine (N=39) was 67.3±14.8 and 60.1±17.3 years, respectively (P value=0.068). The length of hospital stay in losartan and amlodipine groups was 4.57±2.59 and 7.30±8.70 days, respectively (P value=0.085). Also, the length of ICU admission in losartan and amlodipines group was 7.13±5.99 and 7.15±9.95 days, respectively (P value=0.994). The 30-day mortality was two and five patients in losartan and amlodipine groups, respectively (P value=0.241). CONCLUSIONS: There was no priority in losartan or amlodipine administration in COVID-19 patients with primary HTN in decreasing mortality rate, hospital and ICU length stay. Further studies need to clarify the first-line anti-HTN medications in COVID-19.