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Abstract: PO0847

Prospective Feasibility Study with the Use of Losartan in COVID-19

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Yoo, Jeanwoo, Stony Brook University Hospital, Stony Brook, New York, United States
  • Bolotova, Olena, Stony Brook University Hospital, Stony Brook, New York, United States
  • Chaudhri, Imran, Stony Brook University Hospital, Stony Brook, New York, United States
  • Nataraj, Nisha, Stony Brook University Hospital, Stony Brook, New York, United States
  • Sahib, Haseena, Stony Brook University Hospital, Stony Brook, New York, United States
  • Koraishy, Farrukh M., Stony Brook University Hospital, Stony Brook, New York, United States
  • Ahmad, Sahar, Stony Brook University Hospital, Stony Brook, New York, United States
  • Bloom, Michelle E., Stony Brook University Hospital, Stony Brook, New York, United States
  • Mallipattu, Sandeep K., Stony Brook University Hospital, Stony Brook, New York, United States
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).

Conclusion

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.

Table 1.Clinical characteristics of patients (N16)