Efficacy of Blood Pressure Drug in Treating Covid-19 Cases
A recent study based on ‘real world’ data from India suggests that a commonly used high blood pressure medication, angiotensin receptor blockers (ARBs), is ineffective in treating even mild cases of COVID-19. Researchers from the London School of Hygiene, University of Oxford, and TPP House, UK, conducted two studies to provide valuable insights into the effectiveness of COVID-19 treatments and their ability to prevent severe illness.
Study on Angiotensin Receptor Blockers (ARBs)
Published in the British Medical Journal, one study focused on ARBs, such as telmisartan, commonly prescribed for high blood pressure and heart disease. The randomized controlled trial involved 787 patients, predominantly from India, admitted to hospitals between May 2020 and November 2021. Participants, with an average age of 49, received either ARBs or a placebo for 28 days. Despite hopes of mitigating severe COVID-19 effects, researchers observed no significant difference in illness severity between the two groups after 14 days of treatment.
Observational Study on Antibody Treatments
Another study conducted in England from December 2021 to February 2022 compared the effectiveness of the antibody treatment sotrovimab with the antiviral drug molnupiravir. High-risk adults with COVID-19, averaging 52 years of age, were analyzed using hospital records and death certificates. The findings revealed a 46% lower risk of severe COVID-19 outcomes among those receiving sotrovimab compared to molnupiravir within 28 days of treatment.
Limitations and Strengths
While both studies provide valuable insights, they have limitations. The observational study may suffer from misclassification regarding the cause of death or hospital admission. Additionally, differences in initial COVID-19 severity or other unmeasured factors could influence results. In the randomized controlled trial, the absence of a placebo in Australia and the use of relatively low drug doses pose limitations. However, the studies boast substantial strengths, including detailed and comprehensive data in the observational study and good adherence to treatment protocols in the randomized trial.
Implications and Ongoing Discussions
These findings hold implications for clinical practice, suggesting the ineffectiveness of ARBs in treating mild COVID-19 cases and the superiority of sotrovimab over molnupiravir in preventing severe outcomes. Despite ongoing discussions regarding the effectiveness of different treatments, both ARBs and sotrovimab remain available for use in England, providing clinicians with valuable options in managing COVID-19 cases.
