Comparison of losartan and amlodipine effects on the outcomes of patient with COVID-19 and primary hypertension: A randomised clinical trial

Int J Clin Pract. 2021 Jun;75(6):e14124. doi: 10.1111/ijcp.14124. Epub 2021 Mar 13.

Abstract

Background: Controversy exists regarding the drug selection in hypertension (HTN) management in patients with COVID-19. This study aimed to compare the effects of losartan and amlodipine in patients with primary HTN and COVID-19.

Methods: In this randomised clinical trial, hospitalised patients with COVID-19 and primary HTN were enrolled in the study. One arm received losartan, 25 mg, twice a day and the other arm received amlodipine, 5 mg per day for 2 weeks. The main outcomes were compare 30-day mortality rate and length of hospital stay.

Results: The mean age of patients treated with losartan (N = 41) and amlodipine (N = 39) was 67.3 ± 14.8 and 60.1 ± 17.3 years, respectively (P value = .068). The length of hospital stay in losartan and amlodipine groups was 4.57 ± 2.59 and 7.30 ± 8.70 days, respectively (P value = .085). Also, the length of ICU admission in losartan and amlodipine group was 7.13 ± 5.99 and 7.15 ± 9.95 days, respectively (P value = .994). The 30-day mortality was two and five patients in losartan and amlodipine groups, respectively (P value = .241).

Conclusions: There was no priority in losartan or amlodipine administration in COVID-19 patients with primary HTN in decreasing mortality rate, hospital and ICU length stay. Further studies need to clarify the first-line anti-HTN medications in COVID-19.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amlodipine / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure
  • COVID-19*
  • Double-Blind Method
  • Humans
  • Hypertension* / drug therapy
  • Losartan / pharmacology
  • Losartan / therapeutic use
  • Middle Aged
  • SARS-CoV-2
  • Treatment Outcome

Substances

  • Antihypertensive Agents
  • Amlodipine
  • Losartan