Conv. Plasma
Nigella Sativa
Peg.. Lambda

All spironolactone studies
Meta analysis
Home COVID-19 treatment researchSpironolactoneSpironolactone (more..)
Melatonin Meta
Bromhexine Meta Metformin Meta
Budesonide Meta
Cannabidiol Meta Molnupiravir Meta
Colchicine Meta
Conv. Plasma Meta
Curcumin Meta Nigella Sativa Meta
Ensovibep Meta Nitazoxanide Meta
Famotidine Meta Paxlovid Meta
Favipiravir Meta Peg.. Lambda Meta
Fluvoxamine Meta Quercetin Meta
Hydroxychlor.. Meta Remdesivir Meta
Ivermectin Meta
Lactoferrin Meta

All Studies   Meta Analysis   Recent:  
0 0.5 1 1.5 2+ Hospitalization 78% Improvement Relative Risk Recovery time 64% Spironolactone  Davarpanah et al.  LATE TREATMENT Is late treatment with spironolactone + sitagliptin beneficial for COVID-19? Prospective study of 206 patients in Iran (July - September 2021) Lower hospitalization (p=0.0008) and faster recovery (p=0.0001) Davarpanah et al., medRxiv, January 2022 Favors spironolactone Favors control

Combination of Spironolactone and Sitagliptin Improves Clinical Outcomes of Outpatients with COVID-19: An Observational Study

Davarpanah et al., medRxiv, doi:10.1101/2022.01.21.22269322
Jan 2022  
  Source   PDF   All Studies   Meta AnalysisMeta
Prospective study of 206 outpatients in Iran, 103 treated with spironolactone and sitagliptin, showing lower hospitalization and faster recovery with treatment. spironolactone 100mg and sitagliptin 100mg daily.
risk of hospitalization, 78.3% lower, RR 0.22, p < 0.001, treatment 6 of 103 (5.8%), control 23 of 103 (22.3%), NNT 6.1, odds ratio converted to relative risk.
recovery time, 64.4% lower, relative time 0.36, p < 0.001, treatment 103, control 103.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Davarpanah et al., 21 Jan 2022, prospective, Iran, preprint, 9 authors, study period July 2021 - September 2021, average treatment delay 5.74 days, this trial uses multiple treatments in the treatment arm (combined with sitagliptin) - results of individual treatments may vary.
All Studies   Meta Analysis   Submit Updates or Corrections
This PaperSpironolactoneAll
Combination of Spironolactone and Sitagliptin Improves Clinical Outcomes of Outpatients with COVID-19: A Prospective Cohort Study
Mohammad Ali Davarpanah, Reuben Adatorwovor, Yasaman Mansoori, Fatemeh Sadat Rajaie Ramsheh, Amir Parsa, Mehdi Hajiani, Hossein Faramarzi, Ramakanth Kavuluru, MD Kamyar Asadipooya
Background: Coronavirus disease 2019 (COVID-19) leads to hospitalization and death, especially in elderly and those with comorbidities. There are evidences showing that sitagliptin and spironolactone can potentially improve the clinical outcomes of COVID-19 cases. In this observational study on acutely symptomatic outpatient COVID-19 cases, we investigated the effects of spironolactone and sitagliptin on the outcomes of the disease. Methods: This prospective cohort study was conducted at Shiraz University of Medical Sciences Clinics during the fifth wave of the COVID-19 pandemic between July 2021 and September 2021. We followed mild to moderate symptomatic COVID-19 patients, who were treated with either combination (spironolactone 100 mg daily and sitagliptin 100 mg daily) or standard (steroid, antiviral and/or supportive care) therapy up to 30 days. Our primary outcome was hospitalization rate. The secondary outcomes included ER visit, duration of disease, and complications, such as hypoglycemia, low blood pressure or altered mental status. Results: Of the 206 patients referred to clinics, 103 received standard therapy and 103 treated with combination therapy. There were no significant differences in baseline characteristics, except for slightly higher clinical score in control group (6.92 ± 4.01 control, 4.87 ± 2.92 combination; P <0.0001). Treatment with combination therapy was associated with lower admission rate (5.8% combination, 22.3% control; P = 0.0011), ER visits (7.8% combination, 23.3% control; P = 0.0021) and average duration of symptoms (6.67 ± 2.30 days combination, 18.71 ± 6.49 days control; P =<0.0001). Conclusion: In this prospective cohort study of acutely ill outpatients with COVID-19, the combination of sitagliptin and spironolactone reduced duration of COVID infection and hospital visits better than standard therapeutic approaches. The effects of combination of sitagliptin and spironolactone in COVID-19 patients should be further verified in a double blind, randomized, placebocontrolled trial.
Additional Information Correspondence: Kamyar Asadipooya, MD, Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, Barnstable Brown Diabetes and Obesity Center, University of Kentucky, Lexington, KY 40504, USA. Email: Disclosure Summary: The authors have no conflicts of interest to report. Authors' contributions: KA proposed the idea and designed the study. KA, RA, YM and RK wrote the manuscript. MAD, YM, HF, FSRR, AP, and MH collected the data. RA provided statistical analysis and wrote statistical part. All authors approved the final version of the manuscript. .
Al-Kuraishy, Gareeb, Qusty, Alexiou, Batiha, Impact of Sitagliptin in Non-Diabetic Covid-19 Patients, Current molecular pharmacology
Bardaweel, Hajjo, Sabbah, Sitagliptin: a potential drug for the treatment of COVID-19?, Acta pharmaceutica
Blair, Gotimukul, Wang, Mina, Bartels et al., Mild to moderate COVID-19 illness in adult outpatients: Characteristics, symptoms, and outcomes in the first 4 weeks of illness, Medicine
Cantuti-Castelvetri, Ojha, Pedro, Djannatian, Franz et al., Neuropilin-1 facilitates SARS-CoV-2 cell entry and infectivity, Science
Cases, Emergency Department Visits, Hospital Admissions, and Deaths Among Older Adults Following the Introduction of COVID-19
Chen, Zhang, Case, Winkler, Liu et al., Resistance of SARS-CoV-2 variants to neutralization by monoclonal and serum-derived polyclonal antibodies, Nature medicine
Christie, Henley, Mattocks, Fernando, Lansky et al., Decreases in COVID-19
Deacon, Dipeptidyl peptidase 4 inhibitors in the treatment of type 2 diabetes mellitus, Nature reviews Endocrinology
Dong, Fan, Ji, Yu, Wu et al., Spironolactone alleviates diabetic nephropathy through promoting autophagy in podocytes, Int Urol Nephrol
Edwards, New Horizons: Does Mineralocorticoid Receptor Activation by Cortisol Cause ATP Release and COVID-19 Complications?, The Journal of clinical endocrinology and metabolism
Gao, Ding, Dong, Zhang, Azkur et al., Risk factors for severe and critically ill COVID-19 patients: A review, Allergy
Garcia, Lipskiy, Tyson, Watkins, Esser et al., Centers for Disease Control and Prevention 2019 novel coronavirus disease (COVID-19) information management: addressing national health-care and public health needs for standardized data definitions and codified vocabulary for data exchange, Journal of the American Medical Informatics Association
Goodacre, Thomas, Sutton, Burnsall, Lee et al., Derivation and validation of a clinical severity score for acutely ill adults with suspected COVID-19: The PRIEST observational cohort study, PloS one
Gupta, Gonzalez-Rojas, Juarez, Casal, Moya et al., Early Treatment for Covid-19 with SARS-CoV-2 Neutralizing Antibody Sotrovimab, The New England journal of medicine
Haga, Yamamoto, Nakai-Murakami, Osawa, Tokunaga et al., Modulation of TNF-alphaconverting enzyme by the spike protein of SARS-CoV and ACE2 induces TNF-alpha production and facilitates viral entry, Proceedings of the National Academy of Sciences of the United States of America
Harvey, Carabelli, Jackson, Gupta, Thomson et al., SARS-CoV-2 variants, spike mutations and immune escape, Nature reviews Microbiology
Heurich, Hofmann-Winkler, Gierer, Liepold, Jahn et al., TMPRSS2 and ADAM17 cleave ACE2 differentially and only proteolysis by TMPRSS2 augments entry driven by the severe acute respiratory syndrome coronavirus spike protein, Journal of virology
Hoffmann, Kleine-Weber, Schroeder, Krüger, Herrler et al., SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor, Cell
Hopkins, Coronavirus resource center
Jackson, Farzan, Chen, Choe, Mechanisms of SARS-CoV-2 entry into cells, Nature reviews Molecular cell biology
Jeffers, Tusell, Gillim-Ross, Hemmila, Achenbach et al., CD209L (L-SIGN) is a receptor for severe acute respiratory syndrome coronavirus, Proceedings of the National Academy of Sciences of the United States of America
Jeon, Son, Choi, Effect of Spironolactone on COVID-19 in Patients With Underlying Liver Cirrhosis: A Nationwide Case-Control Study in South Korea, Frontiers in medicine
Keidar, Gamliel-Lazarovich, Kaplan, Pavlotzky, Hamoud et al., Mineralocorticoid receptor blocker increases angiotensin-converting enzyme 2 activity in congestive heart failure patients, Circ Res
Kuba, Imai, Rao, Gao, Guo et al., A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus-induced lung injury, Nat Med
Kustin, Harel, Finkel, Perchik, Harari et al., Evidence for increased breakthrough rates of SARS-CoV-2 variants of concern in BNT162b2-mRNA-vaccinated individuals, Nature medicine
Li, Liu, Zhou, Wang, On resistance to virus entry into host cells, Biophys J
Li, Zhang, Yang, Lian, Xie et al., The MERS-CoV Receptor DPP4 as a Candidate Binding Target of the SARS-CoV-2
Mareev, Orlova, Plisyk, Pavlikova, Matskeplishvili et al., Results of Open-Label non-Randomized Comparative Clinical Trial: "BromhexIne and Spironolactone for CoronаvirUs Infection requiring hospiTalization (BISCUIT), Kardiologiia
Martin, Anderson, Chang, Ehrmann, Lobo et al., Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline, The Journal of clinical endocrinology and metabolism
Mccullough, Kelly, Ruocco, Lerma, Tumlin et al., Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection, The American journal of medicine
Montastruc, Romano, Montastruc, Silva, Seguin et al., Pharmacological characteristics of patients infected with SARS-Cov-2 admitted to Intensive Care Unit in South of France, Therapie
Monteil, Kwon, Prado, Hagelkrüys, Wimmer et al., Inhibition of SARS-CoV-2 Infections in Engineered Human Tissues Using Clinical-Grade Soluble Human ACE2, Cell
Patoulias, Doumas, Dipeptidyl Peptidase-4 Inhibitors and COVID-19-Related Deaths among Patients with Type 2 Diabetes Mellitus: A Meta-Analysis of Observational Studies, Endocrinology and metabolism
Peacocke, Heupink, Frønsdal, Dahl, Chola, Global access to COVID-19 vaccines: a scoping review of factors that may influence equitable access for low and middle-income countries, BMJ open
Qi, Qian, Zhang, Zhang, Single cell RNA sequencing of 13 human tissues identify cell types and receptors of human coronaviruses, Biochemical and biophysical research communications
Rahimi, Bezmin Abadi, Emergence of the Delta Plus variant of SARS-CoV-2 in Iran, Gene reports
Rahmanzade, Rahmanzadeh, Hashemian, Tabarsi, Iran's Approach to COVID-19: Evolving Treatment Protocols and Ongoing Clinical Trials, Frontiers in public health
Rakhmat, Kusmala, Handayani, Juliastuti, Nawangsih et al., Dipeptidyl peptidase-4 (DPP-4) inhibitor and mortality in coronavirus disease 2019 (COVID-19) -A systematic review, meta-analysis, and meta-regression, Diabetes & metabolic syndrome
Satoh, Ishikawa, Minami, Akatsu, Nakamura, Eplerenone inhibits tumour necrosis factor alpha shedding process by tumour necrosis factor alpha converting enzyme in monocytes from patients with congestive heart failure, Heart
Shao, Xu, Yu, Pan, Chen, Dipeptidyl peptidase 4 inhibitors and their potential immune modulatory functions, Pharmacology & therapeutics
Solerte, 'addio, Trevisan, Lovati, Rossi et al., Sitagliptin Treatment at the Time of Hospitalization Was Associated With Reduced Mortality in Patients With Type 2 Diabetes and COVID-19: A Multicenter, Case-Control, Retrospective, Observational Study, Diabetes care
Stoian, Sachinidis, Stoica, Nikolic, Patti et al., The efficacy and safety of dipeptidyl peptidase-4 inhibitors compared to other oral glucose-lowering medications in the treatment of type 2 diabetes, Metabolism: clinical and experimental
Tomlins, Rhodes, Perner, Dhanasekaran, Mehra et al., Recurrent fusion of TMPRSS2 and ETS transcription factor genes in prostate cancer, Science
Tsang, Chan, Cho, Yu, Yim et al., An update on COVID-19 pandemic: the epidemiology, pathogenesis, prevention and treatment strategies, therapy
Vankadari, Wilce, Emerging WuHan (COVID-19) coronavirus: glycan shield and structure prediction of spike glycoprotein and its interaction with human CD26, Emerg Microbes Infect
Verdecchia, Cavallini, Spanevello, Angeli, The pivotal link between ACE2 deficiency and SARS-CoV-2 infection, Eur J Intern Med
Walls, Park, Tortorici, Wall, Mcguire et al., Structure, Function, and Antigenicity of the SARS-CoV-2 Spike Glycoprotein, Cell
Wang, Nair, Liu, Iketani, Luo et al., Antibody resistance of SARS-CoV-2 variants B.1.351 and B.1.1.7, Nature
Wang, Qiu, Hou, Deng, Xu et al., AXL is a candidate receptor for SARS-CoV-2 that promotes infection of pulmonary and bronchial epithelial cells, Cell research
Weinreich, Sivapalasingam, Norton, Ali, Gao et al., REGEN-COV Antibody Combination and Outcomes in Outpatients with Covid-19, The New England journal of medicine
Weisblum, Schmidt, Zhang, Dasilva, Poston et al., Escape from neutralizing antibodies by SARS-CoV-2 spike protein variants, eLife
Wilcox, Pitt, Is Spironolactone the Preferred Renin-Angiotensin-Aldosterone Inhibitor for Protection Against COVID-19?, J Cardiovasc Pharmacol
Wrapp, Wang, Corbett, Goldsmith, Hsieh et al., Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation, Science
Wysocki, Ye, Hassler, Gupta, Wang et al., A Novel Soluble ACE2 Variant with Prolonged Duration of Action Neutralizes SARS-CoV-2 Infection in Human Kidney Organoids, Journal of the American Society of Nephrology
Xie, Wang, Liang, Lin, Yang et al., Critical Review of the Scientific Evidence and Recommendations in COVID-19 Management Guidelines, Open forum infectious diseases
Xu, Xu, Jiang, Dua, Hansbro et al., SARS-CoV-2 induces transcriptional signatures in human lung epithelial cells that promote lung fibrosis, Respir Res
Zhang, Xiang, Huo, Zhou, Jiang et al., Molecular mechanism of interaction between SARS-CoV-2 and host cells and interventional therapy, Signal transduction and targeted therapy
Late treatment
is less effective
Please send us corrections, updates, or comments. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
  or use drag and drop