Can the commonly prescribed drug Valsartan prevent serious accumulation of fluid in the lungs in COVID-19? To answer this question, the Dutch Cardiovascular Alliance started the Praetorian COVID study. Initiators and research leaders Niels van Royen and Roland van Kimmenade (Radboudumc) are urging colleagues from other hospitals to participate.
The researchers hope that Valsartan will reduce the number of ICU admissions, and overall mortality. The first COVID-19 patient for this placebo controlled randomized trial was included last Saturday at the Jeroen Bosch Hospital. The Radboud university medical center itself, the Noordwest Ziekenhuisgroep, Rijnstate and Amsterdam UMC have also joined the study. In total, more than 600 patients will be included. The researchers want to be able to draw initial conclusions within six months. For this, more hospitals need to participate so inclusion of patients can be swift.
Mechanism of the drug
Valsartan lowers blood pressure by blocking the receptor for Angiotensin II. Activation of this receptor increases blood pressure, allowing fluid to leak to surrounding tissue. Because the corona virus uses ACE2, an enzyme that breaks down Angiotensin II, to enter cells, patients with COVID-19 have less of this protein. As a result, less Angiotensin-II is broken down and fluid can leak through the blood vessels into the lungs. The Praetorian study should show whether Valsartan indeed has a beneficial effect on this imbalance and thus on the course of the disease.
Implications
If so, this drug could make a significant contribution to treatment of complications of COVID-19. Not only by reducing the symptoms, but also by reducing the number of ICU admissions. The relatively cheap medicine could also play a major role in combating COVID-19 in less prosperous countries.
Involved DCVA partners
The Netherlands Heart Institute (NL-HI) and the Dutch Heart Foundation are closely involved in the financing and coordination of the Praetorian COVID study. NVVC and WCN use their network to involve cardiologists, internists and hospitals.
More hospitals needed
For swift inclusion of patients, we need to include more hospitals in this study. Hospitals willing to participate in Praetorean COVID can register with Roland van Kimmenade, cardiologist at Radboudumc
Send an email to Roland.vanKimmenade@radboudumc.nl