The COVID-RASi Trial (COVID-19)

NCT ID: NCT04591210

Last Updated: 2024-02-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

1155 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-27

Study Completion Date

2025-12-31

Brief Summary

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The COVID-RASi study is an international randomized clinical trial that will evaluate the potential benefit of angiotensin modulators on clinical outcomes, in COVID-19 patients. The purpose of this study is to determine if renin-angiotensin system inhibitors (RASi), with angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARB), has a beneficial effect in patients with COVID-19 infections, by reducing ICU admission, ventilator requirement or death. We would also like to determine if there are differences between ACEi and ARB therapeutic treatments. With the increasing potential of long COVID symptoms, at the 1 year follow up, a primary endpoint will be the quality of life of study participants, as assessed by ongoing symptoms and/or the standardized questionnaires.

Detailed Description

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The goal is to determine if RASi with ACEi or ARB, has a beneficial effect in patients with COVID-19 infections, by reducing hospitalizations, ICU admission, ventilator requirement or death.

This is a multi-centre study, conducted in major centres treating COVID-19 patients in-hospital and in various outpatient settings.

Patients admitted to hospital or outpatients that test positive for COVID-19 and meet the inclusion/exclusion criteria will be eligible to participate in this study. All study participants will not be on RASi (ACEi/ARB) treatment at the time of consent. Participants will be randomized to initiation of ACEi vs ARB treatment vs no RASi treatment as part of care for COVID-19 in a 1:1:1 ratio.

The patient will be followed by their physician according to usual clinical care. Sites will complete research-related follow-ups at 24 hours, 7 and 28 days to asssess patient's clinical status, side effects and the achievement of clinical endpoints by telephone interviews. Phone call follow ups will also be conducted at 6 months and 12 months after enrollment in the study.

Conditions

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COVID-19 Cardiovascular Diseases

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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No Treatment (Standard of Care)

Participants will be treated as per standardized care pathway according to province/state and institutional guidelines. Physicians will be reminded not to start ACEi or ARB throughout admission or to outpatients until active study participation is complete at 28 days post symptoms.

Group Type NO_INTERVENTION

No interventions assigned to this group

ACEi treatment

The physician will initiate any ACE inhibitor and dose at their discretion.

Group Type EXPERIMENTAL

Angiotensin converting enzyme inhibitor

Intervention Type DRUG

The study recommends physicians to select an ACEi with proven benefit in cardiovascular diseases such as perindopril, ramipril or enalapril. Lab values will be obtained during baseline. The patient will be followed by the physician clinically, with recommended laboratory testing in one week, including renal function, potassium assessment, and dose adjustments as appropriate.

ARB treatment

The physician will initiate any ARB and dose at their discretion.

Group Type EXPERIMENTAL

Angiotensin II Receptor Blockers

Intervention Type DRUG

The study recommends physicians to select evidence-based ARBs such as candesartan or valsartan or losartan. Lab values will be obtained during baseline. The patient will be followed by the physician clinically, with recommended laboratory testing in one week, and dose adjustments as appropriate.

Interventions

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Angiotensin converting enzyme inhibitor

The study recommends physicians to select an ACEi with proven benefit in cardiovascular diseases such as perindopril, ramipril or enalapril. Lab values will be obtained during baseline. The patient will be followed by the physician clinically, with recommended laboratory testing in one week, including renal function, potassium assessment, and dose adjustments as appropriate.

Intervention Type DRUG

Angiotensin II Receptor Blockers

The study recommends physicians to select evidence-based ARBs such as candesartan or valsartan or losartan. Lab values will be obtained during baseline. The patient will be followed by the physician clinically, with recommended laboratory testing in one week, and dose adjustments as appropriate.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patient with COVID-19 diagnosis with laboratory confirmation within the last 30 days AND
* Age 40 years old or greater if outpatient OR age 18 years old or greater if inpatient (admitted to the hospital) at time of recruitment

Exclusion Criteria

* Contraindication to ARB or ACEi, including severe aortic stenosis and angioedema
* Patients who are currently on active treatment with ARB/ACEi
* Known bilateral renal artery stenosis
* Systolic BP ≤90 mmHg
* eGFR\<30 ml/min, if not receiving dialysis treatment
* K\>5.5 mmol/L on screening laboratory testing
* Recent history of dizziness, vertigo, related to hypotension or orthostatic hypotension, that can lead to contraindication to ACEI/ARBs
* Acute respiratory distress syndrome requiring invasive ventilation
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ottawa Heart Institute Research Corporation

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Peter Liu, MD

Role: PRINCIPAL_INVESTIGATOR

Ottawa Heart Institute Research Corporation

Locations

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Centro de Pesquisa Clinicas Dr Marco Mota

Maceió, Alagoas, Brazil

Site Status

Centro de Pesquisas em Diabetes e Doencas Endocrino-Metabolicas

Fortaleza, Ceará, Brazil

Site Status

Santa Casa de Itabuna

Itabuna, Estado de Bahia, Brazil

Site Status

Hospital Felicio Rocho

Belo Horizonte, Minas Gerais, Brazil

Site Status

Centro de Pesquisa Clinica da Unimed Campo Grande

Campo Grande, Minas Gerais, Brazil

Site Status

Clinica de Campo Grande

Campo Grande, Minas Gerais, Brazil

Site Status

Nucleo de Pesquisa Clinica SS

Curitiba, Paraná, Brazil

Site Status

Hospital Agamenom Magalhaes

Recife, Pernambuco, Brazil

Site Status

Pronto Socorro Cardiologico de Pernambuco Recife

Recife, Pernambuco, Brazil

Site Status

Hospital Eduardo Campos da Pessoa Idosa

Estância, Recife, Brazil

Site Status

Instituto Atena de Pesquisa Clinica

Natal, Rio Grande do Norte, Brazil

Site Status

Hospital Universitar Canoas

Canoas, Rio Grande do Sul, Brazil

Site Status

Hospital Sao Vicente de Paulo

Passo Fundo, Rio Grande do Sul, Brazil

Site Status

Hospital Sao Lucas da PUCRS

Porto Alegre, Rio Grande do Sul, Brazil

Site Status

Hospital Universitario Sao Francisco na Providencia de Deus

Bragança Paulista, São Paulo, Brazil

Site Status

Instituto de Pesquisa Clinica de Campinas

Campinas, São Paulo, Brazil

Site Status

Hospital Bela Vista

Consolação, São Paulo, Brazil

Site Status

Hospital de Julho

São Paulo, São Paulo, Brazil

Site Status

Instituto de Coracao

São Paulo, São Paulo, Brazil

Site Status

Instituto Prevent Senior

São Paulo, São Paulo, Brazil

Site Status

Instituto Goiano de Oncologia e Hematologia

Goiânia, , Brazil

Site Status

Alberta Health Services

Edmonton, Alberta, Canada

Site Status

University of Ottawa Heart Institute

Ottawa, Ontario, Canada

Site Status

Hospital de Infectologia Dr Daniel Mendez Fernandez

Azcapotzalco, Mexico City, Mexico

Site Status

Hospital General de Zona 20

La Margarita, Puebla, Mexico

Site Status

Hospital General Regional No 2

El Marqués, Querétaro, Mexico

Site Status

Unidad de Medicina Familiar No 77

Ecatepec de Morelos, State of Mexico, Mexico

Site Status

Hospital General zona 11

Xalapa, Veracruz, Mexico

Site Status

Unidad de Medicina Familiar No 10

Xalapa, Veracruz, Mexico

Site Status

Hospital General 1, IMSS

Mexico City, , Mexico

Site Status

Hospital General de zona 27- IMSS

Mexico City, , Mexico

Site Status

Countries

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Brazil Canada Mexico

Other Identifiers

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CTO-3212

Identifier Type: -

Identifier Source: org_study_id

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