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COVID-19—The Potential Beneficial Therapeutic Effects of Spironolactone during SARS-CoV-2 Infection

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Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
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Department of Pharmacokinetics and Monitored Therapy, Pomeranian Medical University, 70-111 Szczecin, Poland
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Institute of Biology, University of Szczecin, 71-412 Szczecin, Poland
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Independent Clinical Epigenetics Laboratory, Pomeranian Medical University, 71-252 Szczecin, Poland
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Department of Clinical Immunology and Immunotherapy, Medical University of Lublin, 20-093 Lublin, Poland
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Department of Anesthesiology and Intensive Therapy, Pomeranian Medical University in Szczecin, 71-252 Szczecin, Poland
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Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland
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Department of Infectious, Tropical Diseases and Immune Deficiency, Pomeranian Medical University in Szczecin, 71-455 Szczecin, Poland
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Author to whom correspondence should be addressed.
Pharmaceuticals 2021, 14(1), 71; https://0-doi-org.brum.beds.ac.uk/10.3390/ph14010071
Received: 1 December 2020 / Revised: 13 January 2021 / Accepted: 14 January 2021 / Published: 17 January 2021
(This article belongs to the Special Issue COVID-19 in Pharmaceuticals)
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. View Full-Text
Keywords: COVID-19; SARS-CoV-2; coronavirus; pandemic; spironolactone; potassium canrenoate; ARDS (acute respiratory distress syndrome); androgen receptor antagonist; TMPRSS2 COVID-19; SARS-CoV-2; coronavirus; pandemic; spironolactone; potassium canrenoate; ARDS (acute respiratory distress syndrome); androgen receptor antagonist; TMPRSS2
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MDPI and ACS Style

Kotfis, K.; Lechowicz, K.; Drożdżal, S.; Niedźwiedzka-Rystwej, P.; Wojdacz, T.K.; Grywalska, E.; Biernawska, J.; Wiśniewska, M.; Parczewski, M. COVID-19—The Potential Beneficial Therapeutic Effects of Spironolactone during SARS-CoV-2 Infection. Pharmaceuticals 2021, 14, 71. https://0-doi-org.brum.beds.ac.uk/10.3390/ph14010071

AMA Style

Kotfis K, Lechowicz K, Drożdżal S, Niedźwiedzka-Rystwej P, Wojdacz TK, Grywalska E, Biernawska J, Wiśniewska M, Parczewski M. COVID-19—The Potential Beneficial Therapeutic Effects of Spironolactone during SARS-CoV-2 Infection. Pharmaceuticals. 2021; 14(1):71. https://0-doi-org.brum.beds.ac.uk/10.3390/ph14010071

Chicago/Turabian Style

Kotfis, Katarzyna, Kacper Lechowicz, Sylwester Drożdżal, Paulina Niedźwiedzka-Rystwej, Tomasz K. Wojdacz, Ewelina Grywalska, Jowita Biernawska, Magda Wiśniewska, and Miłosz Parczewski. 2021. "COVID-19—The Potential Beneficial Therapeutic Effects of Spironolactone during SARS-CoV-2 Infection" Pharmaceuticals 14, no. 1: 71. https://0-doi-org.brum.beds.ac.uk/10.3390/ph14010071

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