Another Study Supports The Safety Of Common BP Medications For COVID-19 Patients

Angiotensin-converting-enzyme inhibitors (ACEIs) or angiotensin II-receptor blockers (ARBs) can be safely continued in patients hospitalized with mild to moderate COVID-19, according to results of a multicenter, randomized controlled trial conducted in Brazil.

Findings from the BRACE CORONA trial, released today in JAMA, are in line with the REPLACE COVID randomized controlled trial, published earlier this month in The Lancet Respiratory Medicine.

BRACE CORONA included 659 adults hospitalized with mild to moderate COVID-19 at 29 centers in Brazil between April 9 and June 26. Their mean age was 55 years, 15% were aged 70 or older and 40% were women. The median time from onset of COVID symptoms to hospital admission was six days.

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All patients were on ACEI or ARB therapy prior to hospital admission; at admission, 334 stopped the medication for 30 days and 325 continued the medication. Follow-up ended July 26.

Through 30 days, there was no statistically significant difference in the number of days alive and out of the hospital (the primary outcome) in patients who stopped versus continued the medication (mean, 21.9 days vs. 22.9 days).

There also was no statistically significant difference in death (2.7% for the discontinuation group vs. 2.8% for the continuation group), cardiovascular death (0.6% vs. 0.3%, respectively) or COVID-19 progression (38.3% vs. 32.3%).

The results were "generally consistent" across major subgroups, report Dr. Renato Lopes of Duke Clinical Research Institute in Durham, North Carolina, and colleagues.

"The interplay between SARS-CoV-2 and the renin-angiotensin-aldosterone system (RAAS) has led to competing speculation about the effect of RAAS inhibitors on the course of COVID-19," the authors say.

The BRACE CORONA findings "do not support routinely discontinuing ACEIs or ARBs among patients hospitalized with mild to moderate COVID-19 if there is an indication for treatment," they conclude.

—Reuters Staff

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