Hospitalized COVID-19 patients may safely continue taking angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), suggests the REPLACE COVID trial.

The studys primary hierarchical endpoint - a global rank score in which patients were ranked by the severity of COVID disease course based on various biomarkers and clinical events, with a lower rank score suggesting more severe COVID-19 hospitalization - was about the same, whether patients were randomized to continue or discontinue these blood pressure drugs (median rank 73 vs 81, β-coefficient 8, 95% CI –13 to 29). Continuation and discontinuation arms also exhibited no differences in the secondary endpoints of all-cause death [15% vs 13% (P=0.99)]; at least one adverse event [39% vs 36% (P=0.77)]; length of hospitalization [6 vs 5 days (P=0.56)]. The findings are published online in The Lancet Respiratory Medicine… (Medpage Today)