Angiotensin II Infusion in COVID-19: An International, Multicenter, Registry-based Study.

Abstract

In order to expand our understanding of the role of angiotensin II (ANGII) in COVID-19, we conducted an international, multicenter registry study to assess the use of ANGII in patients with COVID-19 compared to patients not receiving ANGII. Critically ill adult patients who were diagnosed with COVID-19 and received ANGII were matched with COVID-19 patients not receiving ANGII according to age, respiratory support, history of hypertension, use of angiotensin converting enzyme inhibitors and/or angiotensin II receptor blocker, and date of admission. All outcomes were exploratory in nature and included improvement in oxygenation, duration of organ support and mortality. In one year, 132 patients were included (65 in ANGII group and 67 in the control group), and patients were comparable in baseline characteristics. During the first 12 hours of infusion, patients in the ANGII had a faster decrease in FiO2 and maintained similar mean arterial pressure levels. Hospital mortality was not statistically significantly different between the groups (53.8% vs. 40.3%; p = 0.226). Within the limitations of such a study design, our findings confirm previous observations of a potentially positive effect of ANGII on blood pressure and FiO2 but no effect on patient-centered outcomes. This article is protected by copyright. All rights reserved.