Telmisartan in Respiratory Failure Due to COVID-19

Inclusion Criteria: * Age greater than or equal to 18 years of age. * Admitted to the Hospital Regional de Alta Especialidad de Zumpango. * Confirmed SARS-CoV-2 infection with either: positive laboratory test for SARS-CoV-2; or positive CT thorax diagnostic for SARS-CoV-2 infection according to the prevailing criteria. * Hypoxic respiratory failure: SpO2 ≤94% on room OR tachypnea (respiratory rate ≥22 breaths/min). Randomization: * Within 24 hours of confirmed in-hospital SARS-CoV-2 infection diagnosis OR * within 24 hours of hospital admission in case of pre-hospital confirmed SARS-CoV-2 infection. * In case there is a lack of laboratory tests for SARS-CoV-2 in a potentially eligible patient, a positive laboratory test for SARS-CoV-2 will be no longer required. In that case, the potentially eligible patient needs to meet the prevailing criteria for the diagnosis of SARS-CoV-2 infection, such as typical abnormalities on pulmonary CT in the setting of high clinical suspicion of SARS-CoV-2 infection. Exclusion Criteria: * Admitted to ICU prior to randomization. * Currently taking an an angiotensin converting enzyme inhibitor (ACEi) or Angiotensin receptor blocker (ARB). * Use of other investigational drugs at the time of enrollment * Prior reaction or intolerance to an ARB; or severe intolerance to an ACEi, defined as angio-oedema requiring medical intervention. * Systolic blood pressure \< 105 mmHg or diastolic blood pressure \<65mmHg. * Potassium greater than 5.5 mEq/L within 4 weeks of study enrollment. * Estimated Glomerular Filtration Rate (eGFR) of \< 30ml/min/1.73 m2 within 4 weeks of study initiation. * A known history of renal artery stenosis. * AST and/or ALT \> 3 times the upper limit of normal within 4 weeks of study enrollment. * Severe liver dysfunction (Child-Pugh score C), biliary cirrhosis or cholestasis. * Severe volume depletion or severe acute kidney injury. * Inability to obtain informed consent. * Pregnancy or breastfeeding.