J Clin Hypertens (Greenwich) . Randomized elimination and prolongation of ACE inhibitors and ARBs in coronavirus 2019 (REPLACE COVID) Trial Protocol

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J Clin Hypertens (Greenwich)


. 2020 Sep 16.
doi: 10.1111/jch.14011. Online ahead of print.
Randomized elimination and prolongation of ACE inhibitors and ARBs in coronavirus 2019 (REPLACE COVID) Trial Protocol


Jordana B Cohen ^{1 2} , Thomas C Hanff ^{2 3} , Vicente Corrales-Medina ⁴ , Preethi William ⁵ , Nicolas Renna ⁶ , Nelson R Rosado-Santander ⁷ , Juan E Rodriguez-Mori ⁸ , Jonas Spaak ⁹ , Jaime Andrade-Villanueva ¹⁰ , Tara I Chang ¹¹ , Alejandro Barbagelata ^{12 13} , Carlos E Alfonso ¹⁴ , Eduardo Bernales-Salas ⁷ , Johanna Coacalla ⁷ , Carlos Augusto Castro-Callirgos ⁸ , Karen E Tupayachi-Venero ⁸ , Carola Medina ¹⁵ , Renzo Valdivia ¹⁵ , Mirko Villavicencio ¹⁵ , Charles R Vasquez ^{2 16} , Michael O Harhay ^{2 17} , Jesse Chittams ² , Tiffany Sharkoski ³ , James Brian Byrd ¹⁸ , Daniel L Edmonston ¹⁹ , Nancy Sweitzer ⁵ , Julio A Chirinos ³



Affiliations

• PMID: 32937008
• DOI: 10.1111/jch.14011

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19), is associated with high incidence of multiorgan dysfunction and death. Angiotensin-converting enzyme 2 (ACE2), which facilitates SARS-CoV-2 host cell entry, may be impacted by angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), two commonly used antihypertensive classes. In a multicenter, international randomized controlled trial that began enrollment on March 31, 2020, participants are randomized to continuation vs withdrawal of their long-term outpatient ACEI or ARB upon hospitalization with COVID-19. The primary outcome is a hierarchical global rank score incorporating time to death, duration of mechanical ventilation, duration of renal replacement or vasopressor therapy, and multiorgan dysfunction severity. Approval for the study has been obtained from the Institutional Review Board of each participating institution, and all participants will provide informed consent. A data safety monitoring board has been assembled to provide independent oversight of the project.

Keywords: COVID-19; angiotensin receptor blocker; angiotensin-converting enzyme inhibitor; angiotensin-converting enzyme inhibitor 2; clinical trial; coronavirus; hypertension.