Switch of Renin-Angiotensin System Inhibitors in Patients With Covid-19

Switch or Maintenance of Renin-Angiotensin System Inhibitors in Patients With Covid-19: A Randomized Proof of Concept Trial

The SWITCH-COVID trial will randomize patients with COVID-19 that are currently using renin-angiotensin system inhibitors for treating hypertension to maintain the therapy during in-hospital stay or switch the therapy to other antihypertensive classes.

Patients eligible for the study, after signing informed consent will be randomized 1:1 for maintenance of renin-angiotensin system inhibitors or switching the antihypertensive therapy for other classes according to a pre-specified protocol.

Patients are going to be followed during hospital stay for evaluation of clinical endpoints. Also blood and urine samples will be acquired for evaluation of renin-angiotensin system activation.

Inclusion Criteria:

• Hypertension in use of renin-angiotensin system inhibitors
• Confirmed COVID-19 infection by rt-PCR, serology tests or typical clinical presentation and chest CT.
• Symptoms onset < 96h
• Need for hospitalization

Exclusion Criteria:

• Heart failure
• Previous cerebrovascular disease
• Previous myocardial infarction
• Blood pressure > 180 x 100 mmHg
• Need for 3 or more anti-hypertensive classes
• Use os spironolactone
• Severe pulmonary disease
• Contraindication for using other anti-hypertensive classes (calcium channel blockers, hydralazine, diuretics or nitrates)