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Effects of Renin-Angiotensin-Aldosterone Inhibitors on Early Outcomes of Hypertensive Covid-19 Patients: A Randomized Triple-Blind Clinical Trial Publisher Pubmed



Najmeddin F1 ; Solhjoo M2 ; Ashraf H3, 4, 5 ; Salehi M6 ; Rasooli F7 ; Ghoghaei M8 ; Soleimani A3 ; Bahreini M7, 9
Authors
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Authors Affiliations
  1. 1. Department of Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Cardiac Primary Prevention Research Center (CPPRC), Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Infectious Disease, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Department of Internal Medicine, Sina Hospital, Tehran, Iran
  9. 9. Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran

Source: American Journal of Hypertension Published:2021


Abstract

Background: The role of angiotensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) has been addressed in some studies related to the current coronavirus disease-2019 (COVID-19) pandemic with possible higher severity and mortality in patients with hypertension. A triple-blind randomized controlled trial was designed to evaluate the effects of these medications on the COVID-19 progression. Methods: Patients were enrolled in this trial between April and September 2020. They were randomized in 2 groups. The former dosage of ACEis/ARBs was continued in one group while in another group, the ACEis/ARBs were replaced by amlodipine ± carvedilol according to the dose equivalents. The primary outcomes were length of stay in hospitals and intensive care units (ICUs). Other outcomes include mechanical ventilation, noninvasive ventilation, readmission, and COVID-19 symptoms after discharge. Results: We randomized 64 patients with COVID-19 into 2 groups. Most patients were aged 66-80 and 46-65 years-old, 33 (51.6%) and 27 (42.2%), respectively. The study groups were nearly similar in baseline vital signs and characteristics. In addition, there was no significant difference in terms of recorded systolic and diastolic blood pressure measurements between groups. Furthermore, we did not find a significant difference between the days of ICU or ward admission, the discharge rate, or readmission rates between the 2 groups. Conclusions: This randomized triple-blind multicentric clinical trial did not show any deleterious effects of ACEi/ARB medications in hypertensive COVID-19 patients. Clinical trials registration: The trial acquired the ethical code, IR.TUMS.VCR.REC.1399.028 and was registered in the Iranian randomized controlled trial system (registration no. IRCT20151113025025N3), https://en.irct.ir/trial/46531. © 2021 The Author(s). Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. All rights reserved.
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