Prospective feasibility study with the use of losartan in COVID-19

Background: The risks of administering Angiotensin II Receptor Blockers for hypertension in hospitalized patients infected with SARS-CoV-2 remains debated To date, there are no prospective studies evaluating outcomes with the use of ARBs in patients with hypertension and COVID 19 Methods: We conducted a single-center prospective feasibility study to ascertain the safety and efficacy of losartan in patients with COVID-19 and HTN Inclusion criteria are patients with age ≥ 18yr, PCR confirmed SARS-CoV-2, BP>130/80, and required FiO2 ≥ 0 25 to maintain SpO2 > 92% These patients were started and titrated on losartan 25mg daily to reach BP goal of <130/80 The vital signs, FiO2 requirements, LFTs, inflammatory markers, serum creatinine and K+ were monitored until discharge, with weekly evaluation of symptoms post-discharge Results: 250 patients were screened from April 22 to May 18, 2020, and 16 patients enrolled Average time to enrollment was 5 5 days, with varying degrees of acuity 6 patients were removed from the study (see Table 1) Eight patients completed the minimum 7 days of losartan while in the hospital 6/8 patients demonstrated no deterioration of SaO2/FiO2 ratio, SaO2/FiO2 compared on day 1 (201 1 ± 108 1) and day 7 (252 3 ± 148 4), and 2/8 patients improved to room air on day 7 Among all patients, inflammatory markers were not significantly changed from admission to peak values (Table 1) Conclusions: This study has demonstrated that patients admitted with COVID 19 and hypertension who completed 7 days of Losartan showed no significant deterioration in oxygenation/worsening of inflammatory markers, thereby providing the rationale for a RCT with the use of losartan versus nonRAAS blockade in COVID-19