Table 1.

Study objectives.

Primary objective

To examine the efficacy of ramipril 2.5 mg orally daily over 14 days versus placebo in patients with SARS-CoV-2 infection in improving survival and reduction in need for admission to an intensive care unit (ICU) or to receive invasive mechanical ventilation.

Secondary objectives

Proportion of patients needing continued hospitalization at day 14

Proportion of patients needing ICU admission

Proportion of patients needing invasive mechanical ventilation

Time to mortality

Time to ICU admission

Time to discharge from the hospital

Need for hospitalization among outpatients or rehospitalization among those discharged

Proportion of patients developing hypotension and needing pressor support

Proportion of patients developing septic shock, defined as sepsis with hypotension requiring vasopressors to maintain MAP ≥65 and serum lactate >2 mmol/L after fluid resuscitation (Sepsis-3 JAMA 2016)

Acute kidney injury defined by KDIGO guidelines, increase in serum creatinine by ≥0.3 mg/dL within 48 h or increase in serum creatinine ≥1.5 times baseline within 7 days.

Exploratory objectives

To examine the efficacy of ramipril in improving biomarkers of the renin-angiotensin-aldosterone axis

To examine racial differences in response to treatment with ramipril in patients with SARS-Cov-2 infection