In a recent study published in the BMJ, researchers conducted a phase 3 multicenter randomized controlled trial to compare the effect of angiotensin receptor blockers disrupting the renin-angiotensin formula on clinical outcomes in other people with coronavirus disease 2019 (COVID-19).
The severe acute respiratory syndrome coronavirus 2 spike protein (SARS-CoV-2) binds to the angiotensin-converting enzyme 2 (ACE-2) receptor on the host cell, triggering a series of reactions that allow the virus to enter the host cell. One of the functions of ACE-2 in the renin-angiotensin formula is to degrade angiotensin II, the accumulation of which can cause adverse effects.
Experiments with mouse models showed that SARS-CoV, a predecessor of SARS-CoV-2, binding to the ACE-2 receptor caused the accumulation of angiotensin II and fibrosis and lung inflammation, which were reversed with the use of angiotensin receptor blockers. Further experiments with angiotensin receptor blockers showed relief in lung damage and pulmonary edema in mouse models of SARS-CoV-induced lung injury. However, there is a lack of effectiveness of angiotensin receptor blockers in relieving severe symptoms of COVID-19 in humans.
In the existing set, researchers conducted a phase 3 controlled, randomized, pragmatic, multicenter, double-blind trial called CLARITY. People aged 18 years and older with laboratory-confirmed SARS-CoV-2 infections requiring hospitalization were recruited at 17 sites in India and Australia.
People previously treated with renin-angiotensin formula inhibitors or whose renal function, serum potassium or glomerular filtration rate were not recorded were excluded from the trial. Participants were randomly assigned to the angiotensin receptor antagonist organization or organization in a 1:1 ratio.
Participants in India gained either a 40 mg dose of telmisartan, an angiotensin receptor blocker, for 28 days or a corresponding placebo. In Australia, doctors selected which angiotensin receptor blocker to use. Follow-up was conducted by telephone with patients after discharge and knowledge of the trial was collected from medical records.
The number one final results of COVID-19 trial severity, measured on an ordinal scale of one to seven, being one “no hospitalization or activity limitations” and seven being “death. “Secondary outcomes included respiratory failure, admission to care unit and mortality. The prespecified protective endpoints at day 28 were hypotension and acute kidney injury, and we also considered the exploratory endpoint for hyperkalemia.
The results reported no significant differences in the number one final outcomes between angiotensin receptor antagonist organization and control organization. seven for the organization of the remedy.
Participants experienced milder symptoms than expected at the start of the study, with approximately 75% of patients discharged within a week and more than 90% after two weeks. The patients in the trial were also younger than those in the other report. trials, which would possibly be the low severity of the disease.
Although most participants were from India and were considered to be at the greatest threat of severe COVID-19, only 28% of patients needed supplemental oxygen, indicating more mild symptoms of the disease. The study was conducted between May 2020 and November 2021. and a total of 787 participants were registered in the trial. The reported mortality rate was 2%.
The effects were consistent with those of 4 previous randomised trials administering angiotensin receptor blockers to patients with COVID-19. These studies also reported that treatment with angiotensin receptor inhibitors had no benefit on number one outcomes, such as mortality, length of hospital stay, and lung injury. and fan requirements. The use of angiotensin receptor blockers did not cause any adverse effects such as hypotension, kidney damage or higher serum potassium levels.
Overall, the randomized, double-blind, phase three controlled trial to compare the efficacy of angiotensin receptor blockers in reducing severe COVID-19 outcomes reported no significant treatment benefit.
Although the remedy was thought to be safe and did not produce any adverse effects, no differences in disease severity scores were observed between angiotensin receptor antagonist organization and control organization.
Written by
Chinta Sidharthan is a Bangalore-based India. Su academic background is in evolutionary biology and genetics, and has extensive experience in clinical studies, teaching, clinical writing and herpetology. Chinta holds a PhD in evolutionary biology from the Indian Institute of Science and is passionate about science education, writing, animals, wildlife and conservation. For his doctoral studies, he explored the origins and diversification of blind snakes in India, where he did extensive fieldwork in the jungles of southern India. He has won the Governor Award General Bronze Medal and Gold Medal for Academic Excellence from the University of Bangalore and has published his studies in high-impact journals.
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