Key result
Losartan fails to improve 7-day PaO2:FiO2 ratio vs placebo in hospitalized COVID-19 patients.
Why the study?
SARS-CoV-2 viral entry may disrupt angiotensin II homeostasis contributing to COVID-19 lung injury, but data on angiotensin II type 1 receptor blockade in humans are mixed.
Does losartan improve the Pao2:Fio2 ratio at 7 days in hospitalized patients with COVID-19 and acute lung injury?
RCT (n=205)
blinded
randomized
Yes
Does losartan improve the Pao2:Fio2 ratio at 7 days in hospitalized patients with COVID-19 and acute lung injury?
Mean Difference: -24.8 (95% CI -55.6–6.1)
p-value: p=.12
Initiation of losartan in hospitalized COVID-19 patients with acute lung injury does not improve oxygenation and may reduce vasopressor-free days.
No takes yet. Share an insight, caveat, or question.
Losartan should not be used to improve oxygenation in hospitalized COVID-19 with acute lung injury; challenges prior expectations for renin-angiotensin blockade benefit.
Puskarich et al. (2022) conducted an RCT in COVID-19-induced lung injury (n=205). Losartan vs. placebo was evaluated on imputed arterial partial pressure of oxygen to fraction of inspired oxygen (Pao2:Fio2) ratio at 7 days (difference -24.8, 95% CI -55.6 to 6.1, p=.12). Losartan 50 mg twice daily did not significantly improve the PaO2:FiO2 ratio at 7 days compared with placebo in hospitalized patients with COVID-19 (difference, -24.8; 95% CI, -55.6 to 6.1; P=0.12).
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