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COVID-19-The Potential Beneficial Therapeutic Effects of Spironolactone during SARS-CoV-2 Infection.
Kotfis, Katarzyna; Lechowicz, Kacper; Drozdzal, Sylwester; Niedzwiedzka-Rystwej, Paulina; Wojdacz, Tomasz K; Grywalska, Ewelina; Biernawska, Jowita; Wisniewska, Magda; Parczewski, Milosz.
  • Kotfis K; Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland.
  • Lechowicz K; Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland.
  • Drozdzal S; Department of Pharmacokinetics and Monitored Therapy, Pomeranian Medical University, 70-111 Szczecin, Poland.
  • Niedzwiedzka-Rystwej P; Institute of Biology, University of Szczecin, 71-412 Szczecin, Poland.
  • Wojdacz TK; Independent Clinical Epigenetics Laboratory, Pomeranian Medical University, 71-252 Szczecin, Poland.
  • Grywalska E; Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, 20-093 Lublin, Poland.
  • Biernawska J; Department of Anesthesiology and Intensive Therapy, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland.
  • Wisniewska M; Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland.
  • Parczewski M; Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University in Szczecin, 71-455 Szczecin, Poland.
Pharmaceuticals (Basel) ; 14(1)2021 Jan 17.
Article in English | MEDLINE | ID: covidwho-1031152
Semantic information from SemMedBD (by NLM)
1. 2019 novel coronavirus CAUSES COVID-19
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
COVID-19
2. Disease CAUSES Pneumonia
Subject
Disease
Predicate
CAUSES
Object
Pneumonia
3. Disease CAUSES Severe acute respiratory infection
Subject
Disease
Predicate
CAUSES
Object
Severe acute respiratory infection
4. Pneumonia CAUSES Respiratory Distress Syndrom
Subject
Pneumonia
Predicate
CAUSES
Object
Respiratory Distress Syndrom
5. Severe acute respiratory infection CAUSES Respiratory Distress Syndrom
Subject
Severe acute respiratory infection
Predicate
CAUSES
Object
Respiratory Distress Syndrom
6. Pharmaceutical Preparations PREVENTS Pulmonary Fibrosis
Subject
Pharmaceutical Preparations
Predicate
PREVENTS
Object
Pulmonary Fibrosis
7. spironolactone AFFECTS Pulmonary Edema
Subject
spironolactone
Predicate
AFFECTS
Object
Pulmonary Edema
8. Mineralocorticoid Receptor INTERACTS_WITH Potassium Sparing Diuretics
Subject
Mineralocorticoid Receptor
Predicate
INTERACTS_WITH
Object
Potassium Sparing Diuretics
9. Pneumonia PROCESS_OF Patients
Subject
Pneumonia
Predicate
PROCESS_OF
Object
Patients
10. spironolactone PREVENTS Acute Lung Injury
Subject
spironolactone
Predicate
PREVENTS
Object
Acute Lung Injury
11. ACE2 gene|ACE2 INHIBITS TMPRSS2 gene|TMPRSS2
Subject
ACE2 gene|ACE2
Predicate
INHIBITS
Object
TMPRSS2 gene|TMPRSS2
12. 2019 novel coronavirus CAUSES COVID-19
Subject
2019 novel coronavirus
Predicate
CAUSES
Object
COVID-19
13. Disease CAUSES Pneumonia
Subject
Disease
Predicate
CAUSES
Object
Pneumonia
14. Disease CAUSES Severe acute respiratory infection
Subject
Disease
Predicate
CAUSES
Object
Severe acute respiratory infection
15. Pneumonia CAUSES Respiratory Distress Syndrome, Adult
Subject
Pneumonia
Predicate
CAUSES
Object
Respiratory Distress Syndrome, Adult
16. Severe acute respiratory infection CAUSES Respiratory Distress Syndrome, Adult
Subject
Severe acute respiratory infection
Predicate
CAUSES
Object
Respiratory Distress Syndrome, Adult
17. Pharmaceutical Preparations PREVENTS Pulmonary Fibrosis
Subject
Pharmaceutical Preparations
Predicate
PREVENTS
Object
Pulmonary Fibrosis
18. spironolactone AFFECTS Pulmonary Edema
Subject
spironolactone
Predicate
AFFECTS
Object
Pulmonary Edema
19. Mineralocorticoid Receptor INTERACTS_WITH Potassium Sparing Diuretics
Subject
Mineralocorticoid Receptor
Predicate
INTERACTS_WITH
Object
Potassium Sparing Diuretics
20. Pneumonia PROCESS_OF Patients
Subject
Pneumonia
Predicate
PROCESS_OF
Object
Patients
21. spironolactone PREVENTS Acute Lung Injury
Subject
spironolactone
Predicate
PREVENTS
Object
Acute Lung Injury
22. ACE2 gene|ACE2 INHIBITS TMPRSS2 gene|TMPRSS2
Subject
ACE2 gene|ACE2
Predicate
INHIBITS
Object
TMPRSS2 gene|TMPRSS2
ABSTRACT
In March 2020, coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 was declared a global pandemic by the World Health Organization (WHO). The clinical course of the disease is unpredictable but may lead to severe acute respiratory infection (SARI) and pneumonia leading to acute respiratory distress syndrome (ARDS). It has been shown that pulmonary fibrosis may be one of the major long-term complications of COVID-19. In animal models, the use of spironolactone was proven to be an important drug in the prevention of pulmonary fibrosis. Through its dual action as a mineralocorticoid receptor (MR) antagonist and an androgenic inhibitor, spironolactone can provide significant benefits concerning COVID-19 infection. The primary effect of spironolactone in reducing pulmonary edema may also be beneficial in COVID-19 ARDS. Spironolactone is a well-known, widely used and safe anti-hypertensive and antiandrogenic medication. It has potassium-sparing diuretic action by antagonizing mineralocorticoid receptors (MRs). Spironolactone and potassium canrenoate, exerting combined pleiotropic action, may provide a therapeutic benefit to patients with COVID-19 pneumonia through antiandrogen, MR blocking, antifibrotic and anti-hyperinflammatory action. It has been proposed that spironolactone may prevent acute lung injury in COVID-19 infection due to its pleiotropic effects with favorable renin-angiotensin-aldosterone system (RAAS) and ACE2 expression, reduction in transmembrane serine protease 2 (TMPRSS2) activity and antiandrogenic action, and therefore it may prove to act as additional protection for patients at highest risk of severe pneumonia. Future prospective clinical trials are warranted to evaluate its therapeutic potential.
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Full text: Available Collection: International databases Database: MEDLINE Topics: Long Covid Language: English Year: 2021 Document Type: Article Affiliation country: Ph14010071

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Full text: Available Collection: International databases Database: MEDLINE Topics: Long Covid Language: English Year: 2021 Document Type: Article Affiliation country: Ph14010071