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. 2021 Jul:108:159-166.
doi: 10.1016/j.ijid.2021.05.019. Epub 2021 May 24.

Candesartan as a tentative treatment for COVID-19: A prospective non-randomized open-label study

Antonia Anna Lukito  1 , Allen Widysanto  2 , Theo Audi Yanto Lemuel  2 , Ignatius Bima Prasetya  2 , Billy Massie  2 , Mira Yuniarti  2 , Nicolaski Lumbuun  3 , Raymond Pranata  4 , Cindy Meidy  3 , Eka Julianta Wahjoepramono  2 , Irawan Yusuf  5
Affiliations

Candesartan as a tentative treatment for COVID-19: A prospective non-randomized open-label study

Antonia Anna Lukito et al. Int J Infect Dis. 2021 Jul.

Abstract

Background: This study aimed to investigate whether the addition of candesartan to the standard care regimen improved the outcome in patients with coronavirus 2019 (COVID-19).

Methods: A prospective non-randomized open-label study was undertaken from May to August 2020 on 75 subjects (aged 18-70 years) hospitalized in Siloam Kelapa Dua Hospital. Uni- and multi-variable Cox regression analyses were performed to obtain hazard ratios (HRs). The primary outcomes were: (1) length of hospital stay; (2) time to negative swab; and (3) radiological outcome (time to improvement on chest X ray).

Results: None of the 75 patients with COVID-19 required intensive care. All patients were angiotensin-receptor-blocker naïve. In comparison with the control group, the candesartan group had a significantly shorter hospital stay [adjusted HR 2.47, 95% confidence interval (CI) 1.16-5.29] after adjusting for a wide range of confounders, and no increased risk of intensive care. In the non-obese subgroup, the candesartan group had a shorter time to negative swab (unadjusted HR 2.11, 95% CI 1.02-4.36; adjusted HR 2.40, 95% CI 1.08-5.09) and shorter time to improvement in chest x ray (adjusted HR 2.82, 95% CI 1.13-7.03) compared with the control group.

Conclusion: Candesartan significantly reduces the length of hospital stay after adjustment for covariates. All primary outcomes improved significantly in the non-obese subgroup receiving candesartan.

Keywords: Angiotensin; Candesartan; Coronavirus; SARS-CoV-2; Severity.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Research flowchart.
Figure 2
Figure 2
Use of candesartan and primary outcomes (unadjusted model). (A) Length of hospital stay, (B) time to negative swab, and (C) time to improvement on chest X ray. SOC, standard care; HR, hazard ratio; CI, confidence interval.
Figure 3
Figure 3
Use of candesartan and primary outcomes (adjusted model). (A) Length of hospital stay, (B) time to negative swab, and (C) time to improvement on chest X ray. SOC, standard care; HR, hazard ratio; CI, confidence interval.
Figure 4
Figure 4
Use of candesartan and primary outcomes in non-obese patients (unadjusted model). (A) Length of hospital stay, (B) time to negative swab, and (C) time to improvement on chest X ray. SOC, standard care; HR, hazard ratio; CI, confidence interval.
Figure 5
Figure 5
Use of candesartan and primary outcomes in obese patients (adjusted model). (A) Length of hospital stay, (B) time to negative swab, and (C) time to improvement on chest X ray. SOC, standard care; HR, hazard ratio; CI, confidence interval.
Figure 6
Figure 6
Central illustration: The possible mechanism of angiotensin receptor blockers in mitigating cardiovascular and lung injury in patients with coronavirus disease 2019. SARS-CoV-2, severe acute respiratory syndrome coronavirus-2; ACE2, angiotensin-converting enzyme 2.
See this image and copyright information in PMC

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