Dataset Information

Losartan in hospitalized patients with COVID-19 in North America: An individual participant data meta-analysis.

ABSTRACT:

Background

Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers (ARBs) have been hypothesized to benefit patients with COVID-19 via the inhibition of viral entry and other mechanisms. We conducted an individual participant data (IPD) meta-analysis assessing the effect of starting the ARB losartan in recently hospitalized COVID-19 patients.

Methods

We searched ClinicalTrials.gov in January 2021 for U.S./Canada-based trials where an angiotensin-converting enzyme inhibitors/ARB was a treatment arm, targeted outcomes could be extrapolated, and data sharing was allowed. Our primary outcome was a 7-point COVID-19 ordinal score measured 13 to 16 days post-enrollment. We analyzed data by fitting multilevel Bayesian ordinal regression models and standardizing the resulting predictions.

Results

325 participants (156 losartan vs 169 control) from 4 studies contributed IPD. Three were randomized trials; one used non-randomized concurrent and historical controls. Baseline covariates were reasonably balanced for the randomized trials. All studies evaluated losartan. We found equivocal evidence of a difference in ordinal scores 13-16 days post-enrollment (model-standardized odds ratio [OR] 1.10, 95% credible interval [CrI] 0.76-1.71; adjusted OR 1.15, 95% CrI 0.15-3.59) and no compelling evidence of treatment effect heterogeneity among prespecified subgroups. Losartan had worse effects for those taking corticosteroids at baseline after adjusting for covariates (ratio of adjusted ORs 0.29, 95% CrI 0.08-0.99). Hypotension serious adverse event rates were numerically higher with losartan.

Conclusions

In this IPD meta-analysis of hospitalized COVID-19 patients, we found no convincing evidence for the benefit of losartan versus control treatment, but a higher rate of hypotension adverse events with losartan.

SUBMITTER: Di Stefano L

PROVIDER: S-EPMC10256351 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Publications

Losartan in hospitalized patients with COVID-19 in North America: An individual participant data meta-analysis.

Di Stefano Leon L Ram Malathi M Scharfstein Daniel O DO Li Tianjing T Khanal Preeti P Baksh Sheriza N SN McBee Nichol N Bengtson Charles D CD Gadomski Anne A Geriak Matthew M Puskarich Michael A MA Salathe Matthias A MA Schutte Aletta E AE Tignanelli Christopher J CJ Victory Jennifer J Bierer Barbara E BE Hanley Daniel F DF Freilich Daniel A DA

Medicine 20230601 23

<h4>Background</h4>Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers (ARBs) have been hypothesized to benefit patients with COVID-19 via the inhibition of viral entry and other mechanisms. We conducted an individual participant data (IPD) meta-analysis assessing the effect of starting the ARB losartan in recently hospitalized COVID-19 patients.<h4>Methods</h4>We searched ClinicalTrials.gov in January 2021 for U.S./Canada-based trials where an angiotensin-converting en ...[more]

PMID: 37335665

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Dataset Information

Losartan in hospitalized patients with COVID-19 in North America: An individual participant data meta-analysis.

Background

Methods

Results

Conclusions

Publications

Losartan in hospitalized patients with COVID-19 in North America: An individual participant data meta-analysis.

Similar Datasets

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