While not a trial of ARBs as therapy, BRACE CORONA was a randomized controlled trial exploring stopping-versus-continuing ACE inhibitors/ARBs in patients with hypertension. It showed no harm in continuation of ACE inhibitors and ARBs with COVID-19. There was a non-statistically significant hint of a benefit in the ACEi/ARB group but the trial was not powered to detect this.The first randomized controlled trial of an ARB for treatment of COVID-19 returned preliminary results showing possible improvements in time to discharge, need for supplementary oxygen and CRP. See "Telmisartan for treatment of Covid-19 patients: an open randomized clinical trial. Preliminary report." See independent critical appraisal of trial.
Results: "14 of 51 patients (27%) on a twice-daily dose of the drug (n=51) plus standard of care required oxygen therapy at the end of the treatment period vs. 22 of 55 patients (45%) in the control arm. That corresponds to a 40% relative risk reduction, an effect, the company said, that was “statistically significant (p=0.057) at the 10% level as predefined in the statistical analysis plan." - Press release on C21 results.
Updated results: "At the end of the trial, about a week after the last dose of C21, the effect was even more pronounced, with only one patient in the C21 group still needing oxygen supplementation compared to 11 patients in the placebo group - a reduction by >90% (p<0.002)." - Press release on updated C21 results.
C21, an AT2R agonist, has shown benefit in animal lung injury models, similar to ARBs. In a recent randomized, placebo-controlled clinical trial, C21 showed promise as COVID-19 treatment. Photo CC-BY Rathinasabapathy, et al.While not a trial of ARBs as therapy, BRACE CORONA was a randomized controlled trial exploring stopping-versus-continuing ACE inhibitors/ARBs in patients with hypertension. It showed no harm in continuation of ACE inhibitors and ARBs with COVID-19. There was a non-statistically significant hint of a benefit in the ACEi/ARB group but the trial was not powered to detect this.
Results: "14 of 51 patients (27%) on a twice-daily dose of the drug (n=51) plus standard of care required oxygen therapy at the end of the treatment period vs. 22 of 55 patients (45%) in the control arm. That corresponds to a 40% relative risk reduction, an effect, the company said, that was “statistically significant (p=0.057) at the 10% level as predefined in the statistical analysis plan." - Press release on C21 results.
Updated results: "At the end of the trial, about a week after the last dose of C21, the effect was even more pronounced, with only one patient in the C21 group still needing oxygen supplementation compared to 11 patients in the placebo group - a reduction by >90% (p<0.002)." - Press release on updated C21 results.
philipn authored on Dec. 31, 2020, 4 p.m. 
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