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The Efficacy of the Mineralcorticoid Receptor Antagonist Canrenone in COVID-19 Patients

Background: In COVID-19 patients, aldosterone via angiotensin-converting enzyme-2 deregulation may be responsible for systemic and pulmonary vasoconstriction, inflammation, and oxidative organ damage. Aim: To verify retrospectively the impact of the mineralcorticoid receptor antagonist canrenone i.v...

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Autores principales: Vicenzi, Marco, Ruscica, Massimiliano, Iodice, Simona, Rota, Irene, Ratti, Angelo, Di Cosola, Roberta, Corsini, Alberto, Bollati, Valentina, Aliberti, Stefano, Blasi, Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564548/
https://www.ncbi.nlm.nih.gov/pubmed/32933039
http://dx.doi.org/10.3390/jcm9092943
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author Vicenzi, Marco
Ruscica, Massimiliano
Iodice, Simona
Rota, Irene
Ratti, Angelo
Di Cosola, Roberta
Corsini, Alberto
Bollati, Valentina
Aliberti, Stefano
Blasi, Francesco
author_facet Vicenzi, Marco
Ruscica, Massimiliano
Iodice, Simona
Rota, Irene
Ratti, Angelo
Di Cosola, Roberta
Corsini, Alberto
Bollati, Valentina
Aliberti, Stefano
Blasi, Francesco
author_sort Vicenzi, Marco
collection PubMed
description Background: In COVID-19 patients, aldosterone via angiotensin-converting enzyme-2 deregulation may be responsible for systemic and pulmonary vasoconstriction, inflammation, and oxidative organ damage. Aim: To verify retrospectively the impact of the mineralcorticoid receptor antagonist canrenone i.v. on the need of invasive ventilatory support and/or all-cause in-hospital mortality. Methods: Sixty-nine consecutive COVID-19 patients, hospitalized for moderate to severe respiratory failure at Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca’ Granda Ospedale Maggiore Policlinico of Milan, received two different therapeutic approaches in usual care according to the personal skills and pharmacological management experience of the referral medical team. Group A (n = 39) were given vasodilator agents or renin–angiotensin–aldosterone system (RAAS) inhibitors and group B (n = 30) were given canrenone i.v. Results: Among the 69 consecutive COVID-19 patients, those not receiving canrenone i.v. (group A) had an event-free rate of 51% and a survival rate of 64%. Group B (given a mean dose of 200 mg/q.d. of canrenone for at least two days of continuous administration) showed an event-free rate of 80% with a survival rate of 87%. Kaplan–Meier analysis for composite outcomes and mortality showed log rank statistics of 0.0004 and 0.0052, respectively. Conclusions: The novelty of our observation relies on the independent positive impact of canrenone on the all-cause mortality and clinical improvement of COVID-19 patients ranging from moderate to severe diseases.
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spelling pubmed-75645482020-10-29 The Efficacy of the Mineralcorticoid Receptor Antagonist Canrenone in COVID-19 Patients Vicenzi, Marco Ruscica, Massimiliano Iodice, Simona Rota, Irene Ratti, Angelo Di Cosola, Roberta Corsini, Alberto Bollati, Valentina Aliberti, Stefano Blasi, Francesco J Clin Med Article Background: In COVID-19 patients, aldosterone via angiotensin-converting enzyme-2 deregulation may be responsible for systemic and pulmonary vasoconstriction, inflammation, and oxidative organ damage. Aim: To verify retrospectively the impact of the mineralcorticoid receptor antagonist canrenone i.v. on the need of invasive ventilatory support and/or all-cause in-hospital mortality. Methods: Sixty-nine consecutive COVID-19 patients, hospitalized for moderate to severe respiratory failure at Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca’ Granda Ospedale Maggiore Policlinico of Milan, received two different therapeutic approaches in usual care according to the personal skills and pharmacological management experience of the referral medical team. Group A (n = 39) were given vasodilator agents or renin–angiotensin–aldosterone system (RAAS) inhibitors and group B (n = 30) were given canrenone i.v. Results: Among the 69 consecutive COVID-19 patients, those not receiving canrenone i.v. (group A) had an event-free rate of 51% and a survival rate of 64%. Group B (given a mean dose of 200 mg/q.d. of canrenone for at least two days of continuous administration) showed an event-free rate of 80% with a survival rate of 87%. Kaplan–Meier analysis for composite outcomes and mortality showed log rank statistics of 0.0004 and 0.0052, respectively. Conclusions: The novelty of our observation relies on the independent positive impact of canrenone on the all-cause mortality and clinical improvement of COVID-19 patients ranging from moderate to severe diseases. MDPI 2020-09-11 /pmc/articles/PMC7564548/ /pubmed/32933039 http://dx.doi.org/10.3390/jcm9092943 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Vicenzi, Marco
Ruscica, Massimiliano
Iodice, Simona
Rota, Irene
Ratti, Angelo
Di Cosola, Roberta
Corsini, Alberto
Bollati, Valentina
Aliberti, Stefano
Blasi, Francesco
The Efficacy of the Mineralcorticoid Receptor Antagonist Canrenone in COVID-19 Patients
title The Efficacy of the Mineralcorticoid Receptor Antagonist Canrenone in COVID-19 Patients
title_full The Efficacy of the Mineralcorticoid Receptor Antagonist Canrenone in COVID-19 Patients
title_fullStr The Efficacy of the Mineralcorticoid Receptor Antagonist Canrenone in COVID-19 Patients
title_full_unstemmed The Efficacy of the Mineralcorticoid Receptor Antagonist Canrenone in COVID-19 Patients
title_short The Efficacy of the Mineralcorticoid Receptor Antagonist Canrenone in COVID-19 Patients
title_sort efficacy of the mineralcorticoid receptor antagonist canrenone in covid-19 patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564548/
https://www.ncbi.nlm.nih.gov/pubmed/32933039
http://dx.doi.org/10.3390/jcm9092943
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