1. Introduction
acute infection, pneumonia, chronic kidney disease, cardiovascular diseases, inflammation, long-term sequelae, fibrosis, liver disease, COVID-19-associated pneumonia, MR, coronavirus disease 2019
ACUTE INFECTION, VIRUS, CORONAVIRUS DISEASE 2019, PNEUMONIA, LUNG FIBROSIS, ISCHEMIC HEART DISEASE, CARDIOVASCULAR DISEASES, COVID-19 PNEUMONIA, DISEASE, INFLAMMATION, FIBROSIS, LIVER DISEASE, SECONDARY, CONGESTIVE HEART FAILURE, HYPERTENSION, PATHOGENESIS
In March 2020, the World Health Organization (WHO) announced a global pandemic of coronavirus disease 2019 (COVID-19) that presented mainly as an acute infection of the lower respiratory tract (pneumonia), with multiple long-term consequences, including lung fibrosis. The aim of this study was to evaluate the influence of potassium canrenoate on inflammatory markers in the treatment of COVID-19 pneumonia. A randomized clinical trial (RCT) of intravenous potassium canrenoate vs. placebo was performed between December 2020 and November 2021. This study is a secondary analysis of that RCT. In the final analysis, a total of 49 hospitalized patients were included (24 allocated to the potassium canrenoate group and 25 to the placebo group). Patients were assessed by serum testing and blood cell cytometry on day 1 and day 7 of the intervention. Age, sex, and body mass index were not significantly different between the placebo group and intervention group. Although there was a significantly higher rate of ischemic heart disease in the placebo group, rates of other preexisting comorbidities were not significantly different. There were no significant differences in the inflammatory parameters between the potassium canrenoate and placebo groups on day 1 and day 7. However, the intragroup comparisons using Wilcoxon’s test showed significant differences between day 1 and day 7. The CD3% for potassium canrenoate increased significantly between day 1 and day 7 (12.85 ± 9.46; 11.55 vs. 20.50 ± 14.40; 17.80; In March 2020, following the emergence of the SARS-CoV-2 virus initially identified in December 2019, the World Health Organization (WHO) declared a worldwide pandemic of coronavirus disease 2019 (COVID-19). This disease predominantly manifested as an acute infection affecting the lower respiratory tract, often presenting as pneumonia [It has been shown that severe COVID-19 is associated with a significant derangement in proinflammatory cytokines, namely, IL-1β, IL-2, IL-6, IL-8, or TNF-α, often referred to as the “cytokine storm” [A prolonged increase in the level of IL-6 contributes to long COVID symptoms, so reducing IL-6 levels is particularly important during early COVID to prevent long-term sequelae [The renin–angiotensin–aldosterone (RAA) system is a major player in the pathogenesis of COVID-19. The entry of SARS-CoV-2 virus into the cells is possible only as a result of the expression of the angiotensin-converting enzyme 2 (ACE2) receptor and the transmembrane serine protease 2 (TMPRSS2) [Under physiological conditions, the activator of the mineralocorticoid receptor (MR) is aldosterone. Its higher concentration can lead to hypertension, aggravation of cardiovascular diseases and also increased inflammation and tissue fibrosis [There are studies suggesting a beneficial effect of mineralocorticoid receptor antagonists (MRAs) in the treatment of COVID-19 [Potassium canrenoate is a mineralocorticoid receptor (MR) antagonist and a diuretic frequently used in practice for patients with chronic kidney disease, congestive heart failure or liver disease [Therefore, the purpose of the current study was to assess the influence of potassium canrenoate, an intravenous formula of mineralocorticoid receptor antagonist, on the change in inflammatory markers in patients with severe COVID-19-associated pneumonia.