Angiotensin II Receptor Antagonist Adverse Reaction, Covid19
Conditions
Keywords
covid19, ace inhibitors, ace2
Brief summary
The SWITCH-COVID trial will randomize patients with COVID-19 that are currently using renin-angiotensin system inhibitors for treating hypertension to maintain the therapy during in-hospital stay or switch the therapy to other antihypertensive classes.
Detailed description
Patients eligible for the study, after signing informed consent will be randomized 1:1 for maintenance of renin-angiotensin system inhibitors or switching the antihypertensive therapy for other classes according to a pre-specified protocol. Patients are going to be followed during hospital stay for evaluation of clinical endpoints. Also blood and urine samples will be acquired for evaluation of renin-angiotensin system activation.
Interventions
DRUGRenin-angiotensin system inhibitors
switch anti-hypertensive class
Sponsors
University of Sao Paulo
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Hypertension in use of renin-angiotensin system inhibitors * Confirmed COVID-19 infection by rt-PCR, serology tests or typical clinical presentation and chest CT. * Symptoms onset \< 96h * Need for hospitalization
Exclusion criteria
* Heart failure * Previous cerebrovascular disease * Previous myocardial infarction * Blood pressure \> 180 x 100 mmHg * Need for 3 or more anti-hypertensive classes * Use os spironolactone * Severe pulmonary disease * Contraindication for using other anti-hypertensive classes (calcium channel blockers, hydralazine, diuretics or nitrates)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Need for ICU or mortality | 30 days | Combined of need for ICU or mortality |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| High sensitivity troponin levels and covid-19 severity | 30 days | Evaluate correlation between hs-TnT and covid-19 severity |
| ACE-2 activity and disease severity | 30 days | Evaluate correlation of ACE-2 activity and disease severity |
| ACE-2 activity with different Renin-angiotensin system inhibitors | 30 days | Evaluate correlation of ACE-2 activity and Renin-angiotensin system inhibitors |
| Blood control and acute renal failure | 30 days | Evaluate blood pressure control and acute renal failure in each arm (safety) |
Countries
Brazil
Outcome results
None listed