Do Angiotensin Receptor Blockers Mitigate Progression to Acute Respiratory Distress Syndrome With SARS-CoV-2 Infection

Phase 4

Completed

Brief Summary: The purpose of this research is to identify whether or not Angiotensin Receptor Blockers (ARB) can halt the progression to respiratory failure requiring transfer into the intensive care unit (ICU), as well as halt mechanical ventilation in subjects with mild to moderate hypoxia due to the corona virus that causes COVID-19. Based on previous animal studies, the researchers hypothesize that the addition of an ARB is beneficial in abating acute lung injury in subjects in early stages of SARS-CoV-2 viral induced hypoxia.

Detailed Description: This is an investigator initiated, open label, multicenter, two arm, randomized study to compare the impact of adding an ARB to the Standard of Care (SOC) to the SOC without an ARB. Randomization ratio will be 1:1. The goal of this study is to identify whether or not ARBs have an impact on inhibiting the progression to respiratory failure requiring mechanical ventilation in patients with mild to moderate hypoxia in the setting of COVID-19. The addition of an ARB to the standard of care treatment for these patients may be beneficial in abating acute lung injury in patients in early stages of SARS-CoV-2 induced hypoxia.

Recruitment & Eligibility

Inclusion Criteria

Confirmed COVID-19 positive test result
Mild to moderate respiratory symptoms of COVID-19.
Systolic blood pressure ≥ 105 mmHg.
Screen within 3 days of a positive COVID-19 test.
Age ≥18 years old.
Access to a phone in the hospital room or an electronic device that is capable of receiving phone or video calls.
Able to read/write/speak English or Spanish fluently.
Subjects must have the capacity to provide consent or an appropriate LAR to provide informed consent.
Negative pregnancy test for women of childbearing potential and subject is randomized to the study arm.

Exclusion Criteria

Severe allergy to any ARB or ACE-inhibitor, including angioedema
In the intensive care unit at screening.
Home meds include any kind of ACE inhibitor or ARB
Acute Kidney Injury (50% reduction in GFR from baseline at admission to any time during treatment in the study treatment arm)
Hyperkalemia >5.0 mmol/L at baseline or any time during treatment in the study treatment arm
Creatinine Clearance < 30 ml/min at baseline or any time during treatment in the study treatment arm

Arm && Interventions

Group	Intervention	Description
Group A (Study drug+SOC)	Losartan	Standard of Care plus an ARB to be taken orally twice daily for up to 10 days or until discharged from the hospital, whichever occurs first. Investigator may increase dose on days 2 - 10 if confident the subject will tolerate.

Primary Outcome Measures

Name	Time	Method
Mechanical Ventilation	from date of patient admission to date of patient discharge or date of death, whichever came first, assessed up to 45 days	Number of subjects requiring transfer into ICU for mechanical ventilation due to respiratory failure

Secondary Outcome Measures

Name	Time	Method
ICU Transfer	from date of patient admission to date of patient discharge or date of death, whichever came first, assessed up to 45 days	Number of subjects transferred from non-ICU bed to an ICU bed
Oxygen Therapy	from date of patient admission to date of patient discharge or date of death, whichever came first, assessed up to 45 days	Mean number of liters of oxygen consumed

Locations (3): Sharp Grossmont Hospital
🇺🇸
La Mesa, California, United States
Sharp Chula Vista Medical Center
🇺🇸
San Diego, California, United States
Sharp Memorial Hospital
🇺🇸
San Diego, California, United States
Sharp Grossmont Hospital
🇺🇸La Mesa, California, United States