Administration of losartan to hospitalized patients with COVID-19 and acute lung injury is not efficacious for reducing lung injury, according to a study published in JAMA Network Open. Michael A. Puskarich, MD, and colleagues examined the efficacy of losartan for reducing lung injury in hospitalized patients with COVID-19 in a blinded, placebo-controlled trial conducted at 13 US hospitals. A total of 205 hospitalized patients with COVID-19 and a respiratory sequential organ failure assessment score of at least 1 who were not already using a renin-angiotensin-aldosterone system inhibitor were randomly assigned to either losartan or placebo (101 and 104 participants, respectively). Losartan did not significantly affect the imputed arterial partial pressure of oxygen to fraction of inspired oxygen ratio at 7 days compared with placebo (difference, −24.8; 95% CI, −55.6 to 6.1). Losartan also did not improve any secondary outcomes compared with placebo and resulted in fewer vasopressor-free days than placebo (median, 9.4 vs 8.7).
