Candesartan as a tentative treatment for COVID-19: a prospective non-randomized open-label study

Lukito, Antonia Anna; Widysanto, Allen; Lemuel, Theo Audi Yanto; Prasetya, Ignatius Bima; Massie, Billy; Yuniarti, Mira; Lumbuun, Nicolaski; Pranata, Raymond; Meidy, Cindy; Wahjoepramono, Eka Julianta; Yusuf, Irawan

Background This study aimed to investigate whether the addition of candesartan to the standard care regimen improved the outcome in patients with coronavirus 2019 (COVID-19). Methods A prospective non-randomized open-label study was undertaken from May to August 2020 on 75 subjects (aged 18–70 years) hospitalized in Siloam Kelapa Dua Hospital. Uni- and multi-variable Cox regression analyses were performed to obtain hazard ratios (HRs). The primary outcomes were: (1) length of hospital stay; (2) time to negative swab; and (3) radiological outcome (time to improvement on chest x ray). Results None of the 75 patients with COVID-19 required intensive care. All patients were angiotensin-receptor-blocker naïve. In comparison with the control group, the candesartan group had a significantly shorter hospital stay [adjusted HR 2.47, 95% confidence interval (CI) 1.16–5.29] after adjusting for a wide range of confounders, and no increased risk of intensive care. In the non-obese subgroup, the candesartan group had a shorter time to negative swab (unadjusted HR 2.11, 95% CI 1.02–4.36; adjusted HR 2.40, 95% CI 1.08–5.09) and shorter time to improvement in chest x ray (adjusted HR 2.82, 95% CI 1.13–7.03) compared with the control group. Conclusion Candesartan significantly reduces the length of hospital stay after adjustment for covariates. All primary outcomes improved significantly in the non-obese subgroup receiving candesartan.