Host Response Mediators in Coronavirus (COVID-19) Infection [Added supplement: Sex as a biological variable supplement]

The coronavirus (COVID-19) epidemic continues to grow exponentially affecting over 71,429 individuals with 1775 deaths (February 17, 2020), mostly in China but also in other countries. WHO and others are launching clinical trials of novel anti-virals. We have a unique opportunity to complement trials of anti-virals with investigation of modulation of the human host response to improve outcomes of COVID-19. We are proposing to "repurpose" a class of drugs (ARBs) for hypertension (high blood pressure) that have been shown to prevent lung injury in influenza and could work on corona because influenza and coronavirus bind to the same cell receptor in the lung. ARBs are commonly prescribed for high blood pressure (50-70% of patients). To date, there have been no clinical studies of ARBs in COVID-19. We call our study ARBs CORONA. We believe that ARBs can decrease the severity of COVID-19 and mortality of hospitalized COVID-19 infected adults. We will evaluate safety and effectiveness of available ARBs in COVID-19 in a multicentre study of 497 hospitalized adult patients who are or are not already on ARBs. Key personnel are in place to expedite this study. If this study is successful, ARBs can potentially limit complications and mortality of COVID-19. Potential results: ARBs are inexpensive clinically available cardiovascular drugs. If this study is successful, ARBs can potentially be used globally to limit complications and death due to COVID-19.