Comparison of losartan and amlodipine effects on the outcomes of patient with COVID-19 and primary hypertension: A randomised clinical trial

Background 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. Methods 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. Results 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). Conclusions 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.

Automated summary

There was no clear advantage in using losartan or amlodipine for treating primary hypertension in COVID-19 patients, as both drugs showed similar effects on mortality rate, hospital stay, and ICU admission length. Further research is needed to determine the best first-line anti-hypertensive medications for COVID-19 patients.