洛萨坦对急性COVID-19住院患者的影响:一项随机对照试验
Karen C Tran1, Pierre Asfar2, Matthew Cheng3
1Division of General Internal Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, Canada.
概括
洛萨坦在住院COVID-19患者中没有降低28天死亡率,并且增加了低血压等严重不良事件. 研究人员建议在住院肺炎患者使用血管激素受体抑制剂 (ARB) 时谨慎使用.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 严重急性呼吸道综合征冠状病毒2 (SARS-CoV-2) 可能会改变氨酸-氨酸系统,可能会增加氨酸II水平.
- 这种改变促使人们调查血管激素受体抑制剂 (ARB) 是否可以减轻COVID-19的严重程度.
研究的目的:
- 评估洛萨坦与常规护理相比的疗效和安全性,以减少2019年冠状病毒病 (COVID-19) 的住院患者28天死亡率.
主要方法:
- 一项随机对照试验涉及341名因急性COVID-19而入院的成年患者,在加拿大和法国的29家医院进行.
- 参与者被分配接受洛萨坦 (25-100毫克/天) 或常规护理,以28天死亡率为主要结局.
- 排除标准包括低血压,高血,急性损伤以及最近使用ARB或ACE抑制剂.
主要成果:
- 该试验因与洛萨坦相关的安全问题而提前结束.
- 洛沙坦组的严重不良事件 (39.8% vs 27.2%) 和低血压 (30.4% vs 15.3%) 与常规护理组相比,洛沙坦组的严重不良事件显著增加.
- 洛萨坦与常规护理组之间在28天死亡率 (6.5%与5.9%) 中没有显著差异.
结论:
- 洛萨坦不应添加到急性COVID-19住院患者的护理中.
- 建议在住院肺炎患者使用ARB时谨慎使用,因为低血压和其他不良影响的风险.
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