Related Experiment Video

Updated: Sep 26, 2025

Live Imaging and Quantification of Viral Infection in K18 hACE2 Transgenic Mice Using Reporter-Expressing Recombinant SARS-CoV-2
08:41

Live Imaging and Quantification of Viral Infection in K18 hACE2 Transgenic Mice Using Reporter-Expressing Recombinant SARS-CoV-2

Published on: November 5, 2021

2.9K

Association between Mineralocorticoid Receptor Antagonist and Mortality in SARS-CoV-2 Patients: A Systematic Review

Jean Kim1, Kyle Miyazaki1, Parthav Shah1

  • 1Department of Internal Medicine, University of Hawaii, Honolulu, HI 96813, USA.

Healthcare (Basel, Switzerland)
|April 23, 2022
PubMed

Insights

Mineralocorticoid receptor antagonists (MRA) may not reduce mortality in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This systematic review and meta-analysis found no significant association between MRA therapy and SARS-CoV-2 patient mortality.

Area of Science:

  • Cardiovascular Pharmacology
  • Infectious Diseases
  • Translational Medicine

Background:

  • Mineralocorticoid receptor antagonists (MRA) exhibit anti-fibrotic, anti-vasoconstrictive, and anti-inflammatory properties, suggesting potential benefits in mitigating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection severity.
  • Spironolactone, a specific MRA, may improve SARS-CoV-2 outcomes due to its dual MRA and antiandrogen actions, potentially reducing viral entry via TMPRSS2.

Purpose of the Study:

  • To investigate the association between mineralocorticoid receptor antagonist (MRA) therapy and mortality in patients diagnosed with SARS-CoV-2 infection.
  • To conduct a systematic review and meta-analysis adhering to PRISMA guidelines to evaluate existing evidence.

Main Methods:

  • A systematic literature search was conducted on MEDLINE and EMBASE databases for studies reporting mortality incidence in SARS-CoV-2 patients on MRA therapy.
  • Meta-analysis employed a random-effects model to calculate the pooled odds ratio (OR) and 95% confidence interval (CI).
  • Included studies encompassed all MRA types, including spironolactone and canrenone.

Main Results:

  • Five studies comprising 1,388,178 subjects (80,903 on MRA therapy) met the inclusion criteria.
  • The meta-analysis revealed no statistically significant association between MRA therapy and mortality in SARS-CoV-2 infected patients (OR = 0.387, 95% CI: 0.134-1.117, p = 0.079).

Conclusions:

  • Mineralocorticoid receptor antagonist therapy does not appear to be associated with reduced mortality in patients with SARS-CoV-2 infection.
  • Further research may be warranted to fully elucidate the role of MRAs in the context of viral infections.
Keywords:
COVID-19SARS-CoV-2aldosterone antagonistcoronavirusmeta-analysismineralocorticoid receptor antagonistspironolactone

More Related Videos

Author Spotlight: Developing a Rat Model for Weight-Bearing Intervention to Investigate Osteonecrosis of the Femoral Head05:55

Author Spotlight: Developing a Rat Model for Weight-Bearing Intervention to Investigate Osteonecrosis of the Femoral Head

Published on: September 27, 2024

689
Induction of Atherosclerotic Plaques Through Activation of Mineralocorticoid Receptors in Apolipoprotein E-deficient Mice07:36

Induction of Atherosclerotic Plaques Through Activation of Mineralocorticoid Receptors in Apolipoprotein E-deficient Mice

Published on: September 26, 2018

10.2K

Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
539
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
36
Antihypertensive Drugs: Angiotensin II Receptor Blockers01:30

Antihypertensive Drugs: Angiotensin II Receptor Blockers

In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
981
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
516
Antihypertensive Drugs: Direct Renin Inhibitors01:25

Antihypertensive Drugs: Direct Renin Inhibitors

The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
862
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists01:18

Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists

Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
236