Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Int J Clin Pract. 2021 Jun;75(6):e14124. doi: 10.1111/ijcp.14124. Epub 2021 Mar 13.
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.
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.
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).
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.
在伴有 COVID-19 的高血压（HTN）管理中，药物选择存在争议。本研究旨在比较氯沙坦和氨氯地平在原发性 HTN 合并 COVID-19 患者中的疗效。
在这项随机临床试验中，将 COVID-19 合并原发性 HTN 的住院患者纳入研究。一组接受氯沙坦，25mg，每日两次；另一组接受氨氯地平，每日 5mg，治疗 2 周。主要结局为比较 30 天死亡率和住院时间。
接受氯沙坦（N=41）和氨氯地平（N=39）治疗的患者平均年龄分别为 67.3±14.8 岁和 60.1±17.3 岁（P 值=0.068）。氯沙坦和氨氯地平组的住院时间分别为 4.57±2.59 天和 7.30±8.70 天（P 值=0.085）。此外，氯沙坦和氨氯地平组 ICU 入住时间分别为 7.13±5.99 天和 7.15±9.95 天（P 值=0.994）。氯沙坦和氨氯地平组的 30 天死亡率分别为 2 例和 5 例（P 值=0.241）。
在降低死亡率、住院时间和 ICU 入住时间方面，氯沙坦或氨氯地平在 COVID-19 合并原发性 HTN 患者中的应用没有优先级。需要进一步的研究来阐明 COVID-19 中一线抗 HTN 药物。
