ABSTRACT
Purpose: Despite the spread of SARS-CoV-2 global pandemic and the volume of clinical trials launched, no specific therapeutic drug approaches improving outcomes have been so far approved. In COVID-19 patients, aldosterone via ACE2 deregulation may be responsible for systemic and pulmonary vasoconstriction, inflammation and oxidative organ damage.Aim: To verify retrospectively the impact of the mineral corticoid receptor antagonist canrerone i.v. on the need of invasive ventilatory support and/or all-cause in-hospital mortality.Study design: In this retrospective study (CARDIOVID-19, ID-107162), COVID-19 patients hospitalized for severe respiratory failure were taken care by pneumologists or cardiologists and received two different therapeutic approaches according to personal skill of referral medical team on pharmacological management. Group 1 (n=39) were given vasodilator agents or RAAS-inhibitors and group 2 (n=30) were given canrenone i.v.Results: Among 69 consecutive COVID-19 patients, enrolled in COVID-19 NETWORK registry, the group given canrenone (200 mg/q.d. for a median of 14±11) showed a free event rate of 83% with a survival percentage of 90%. In group 1, not receiving canrenone, free event rate was 51% and survival 64%. Kaplan-Meier analysis for composite outcomes showed a Log Rank of 0.0004 and for mortality, Log Rank was 0.005.Conclusions: The novelty of our observation relies on the independent positive impact of the canrenone, a mineral corticoid receptor antagonist, on all-cause mortality and clinical improvement in COVID-19 patients.