Positives

• In the PARACOR-19 randomized trial of patients recovering from acute COVID, sacubitril/valsartan produced a 46% greater reduction in NT-proBNP and 51% greater reduction in collagen telopeptide CITP versus placebo, suggesting reduced cardiac wall stress and fibrosis PubMed.
  
  

Negatives

• PARACOR-19 did not meet its co-primary endpoints of high-sensitivity troponin T or soluble ST2 reduction, so the cardiac benefit was limited to exploratory biomarkers PubMed.
  
  

Hurdles & Side Effects

• Entresto retails for roughly $700 per month and per StatPearls cannot be combined with an ACE inhibitor due to angioedema risk; cautious dose titration is required to avoid symptomatic hypotension in dysautonomic patients NIH.