Living meta-analysis and evidence synthesis of therapies for COVID-19

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University of Minnesota, 2020 NCT04312009

losartan (n=101) vs. placebo (n=104)

randomized controlled trial   some concerns about risk of bias

Studied treatment

losartan for 7 days or hospital discharge
Losartan 50 mg PO twice daily (100 mg daily total) administered for 10 days.

Control treatment

placebo for 7 days or hospital discharge
placebo (microcrystalline methylcellulose, gelatin capsule); oral administration

Patients

COVID 19 all comers

18 years and older with presumptive positive laboratory test for SARS-coV-2 or upper respiratory infection with recent exposure to laboratory-proven SARS-coV-2-infected person�negative influenza and respiratory virus panel�new or worsening hypoxia (spO2 <95%) compared to baseline or increasing oxygen requirement�randomization within 24 hours of initial presentation to a hospital (inclusive of transfer)exclusion criteria:�currently taking an angiotensin converting enzyme inhibitor (ACei) or angiotensin receptor blocker (ARB)�prior reaction or intolerance to an ARB or ACei

Method

Double-blind.

Multi-center: 13 hospitals in the United States.

Participants discharged prior to day 7 were provided a home pulse oximeter and contacted via phone.

Remark

Nouri-Vaskeh, 2021 IRCT20180802040678N4

angiotensin receptor blockers (ARBs) (n=41) vs. calcium channel blocker (n=41)

randomized controlled trial   some concerns about risk of bias

Studied treatment

Losartan
Losartan 25mg twice a day for two weeks before breakfast and after dinner.

Control treatment

Amlodipine
Amlodipine 5mg per day for two weeks.

Standard treatment, supportive and symptomatic therapy in both groups. In intubated patients, the drugs were continued using nasogastric tube.

Patients

COVID 19 hospitalized

Age 18 years and older, patients with primary HTN with systolicblood pressure (SBP) level of 130-140 mmHg and diastolic blood pressure (DBP) of 85-90 mmHgwho were managed by non-pharmacological strategies or were newly diagnosed.

Method

Open-label.

Single center, Imam Reza Hospital, Tabriz, Iran.

Remark

Duarte, 2020 NCT04355936

angiotensin receptor blockers (ARBs) (n=41) vs. standard of care (n=41)

randomized controlled trial   high risk of bias

Studied treatment

Telmisartan
Telmisartan 80 mg bid during 14 days plus standard care.

Control treatment

Standard care
Standard of care alone.

Patients

COVID 19 hospitalized

Patients admitted in ICU prior to randomization were excluded.

Method

Open-label.

Multicenter, 2 academic hospitals, Buenos Aires, Argentina.

Remark

unplanned interim anakysis