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Effect of Spironolactone on COVID-19 in Patients With Underlying Liver Cirrhosis: A Nationwide Case-Control Study in South Korea

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Abstract
Purpose: On the basis that spironolactone is involved in ACE2 expression and TMPRSS2 activity, previous studies have suggested that spironolactone may influence the infectivity of COVID-19. Research has suggested that cell entry of SARS-CoV-2, the virus that induces COVID-19, is associated with the ACE2 receptor and TMPRSS2. The purpose of this study was to investigate whether spironolactone has a protective effect against COVID-19 and the development of associated complications in patients with liver cirrhosis.

Methods: We conducted a nationwide case-control study on liver cirrhosis patients with or without COVID-19 from the population-based data acquired from the National Health Insurance Systems of Republic of Korea. After 1:5 case-control matching, multivariable adjusted conditional logistic regression analysis was performed.

Results: Among the patients with liver cirrhosis, the case group with COVID-19 was found to be significantly less exposed to spironolactone compared with the control group without COVID-19. The adjusted odds ratio (OR) and 95% confidence interval (CI) between the two groups was 0.20 (0.07-0.54). In addition, regardless of cumulative dose of spironolactone, exposure to spironolactone was associated with lower COVID-19 infection. In terms of the development of complications due to COVID-19, spironolactone did not show any significant association between the patients with and without complications (P = 0.43). The adjusted OR and 95% CI between the two groups was 1.714 (0.246-11.938).

Conclusion: We conclude that spironolactone may reduce susceptibility to COVID-19 but does not affect the development of its associated complications; however, further studies are needed to confirm the exact association between spironolactone and COVID-19 infection.
Author(s)
손민국전동섭최종기
Issued Date
2021
Type
Article
Keyword
Care and treatmentcoronavirus disease 2019infectivityLiver cirrhosisMedical researchMedicineExperimentalResearchSpironolactonesusceptibility
DOI
10.3389/fmed.2021.629176
URI
https://oak.ulsan.ac.kr/handle/2021.oak/6990
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_f2f87eea2e3c49cab3f730e8847b55e0&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Effect%20of%20Spironolactone%20on%20COVID-19%20in%20Patients%20With%20Underlying%20Liver%20Cirrhosis:%20A%20Nationwide%20Case-Control%20Study%20in%20South%20Korea&offset=0&pcAvailability=true
Publisher
FRONTIERS IN MEDICINE
Location
스위스
Language
영어
ISSN
2296-858X
Citation Volume
8
Citation Number
629176
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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