Angiotensin II (Giapreza) has not been used in any clinical trials, but according to the ATHOS-III clinical trial it was shown to be beneficial in the setting of vasodilatory shock with renal dysfunction. COVID-19 is known to recognize the ACE2 receptor on the host cell and utilizes the ACE2 receptor to enter the cell. Angiotensin II is thought to competitively inhibit COVID-19 from binding to the ACE2 receptor. Angiotensin II is also known for binding to the angiotensin-1 (AT-1) receptor, which leads to internalization, degradation, and downregulation of the ACE2 receptor. Both of these mechanisms are believed to decrease/prevent COVID-19 from entering the host cell and continuing to replicate.
Currently, there is insufficient evidence to recommend Angiotensin II as a treatment for COVID-19.