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c19early.org
Spironolactone for COVID-19
12 studies with >20,000 patients
Serious outcome risk
Spironolactone
Control
Significantly lower risk for mortality, progression, and recovery.
11 studies from 10 independent teams in 8 countries show significant benefit.
COVID-19 Spironolactone studies · October 2026
Covid Analysis Spironolactone reduces COVID-19 risk: real-time meta-analysis of 12 studies (Version 13)
Significantly lower risk is seen for mortality, progression, and recovery. 11 studies from 10 independent teams in 8 countries show significant benefit. Meta-analysis using the most serious outcome reported shows 31% [15‑44%] l..
Dec 18
2023
 Mehrizi et al., Frontiers in Public Health, doi:10.3389/fpubh.2023.1280434 Drug prescription patterns and their association with mortality and hospitalization duration in COVID-19 patients: insights from big data
32% lower mortality (p<0.0001). Retrospective study of 917,198 hospitalized COVID-19 cases covered by the Iran Health Insurance Organization over 26 months showing that antithrombotics, corticosteroids, and antivirals reduced mortality while diuretics, antibiotics, and..
Mar 2
2023
 Cousins et al., medRxiv, doi:10.1101/2023.02.28.23286515 Association between spironolactone use and COVID-19 outcomes in population-scale claims data: a retrospective cohort study
18% lower mortality (p=0.004) and 17% lower ventilation (p<0.0001). PSM retrospective 898,303 hospitalized COVID-19 patients in the USA, 16,324 on spironolactone, showing lower mortality and ventilation with spironolactone use.
Jul 6
2022
 Cousins et al., Cell Reports Methods, doi:10.1016/j.crmeth.2023.100503 (date from preprint) Integrative analysis of functional genomic screening and clinical data identifies a protective role for spironolactone in severe COVID-19
81% lower ventilation (p=0.006) and 66% lower ICU admission (p=0.002). PSM retrospective 64,349 COVID-19 patients in the USA, showing spironolactone associated with lower ICU admission. Authors also present in vitro research showing dose-dependent inhibition in a human lung epithelial cell line.
Jul 2
2022
 Wadhwa et al., medRxiv, doi:10.1101/2022.07.01.22277163 Phase 2 randomised placebo-controlled trial of spironolactone and dexamethasone versus dexamethasone in COVID-19 hospitalised patients in Delhi
72% lower progression (p=0.03), 49% higher hospital discharge (p=0.05), and 18% faster recovery (p=0.06). RCT 120 hospitalized patients in India, 74 treated with spironolactone and dexamethasone, and 46 with dexamethasone, showing lower progression with treatment. Spironolactone 50mg once daily day 1, 25mg once daily until day 21.
Mar 29
2022
 MacFadden et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofac156 Screening Large Population Health Databases for Potential COVID-19 Therapeutics: A Pharmacopeia-Wide Association Study (PWAS) of Commonly Prescribed Medications
7% fewer cases (p=0.008). Retrospective 26,121 cases and 2,369,020 controls ≥65yo in Canada, showing lower cases with chronic use of spironolactone.
Feb 7
2022
 Abbasi et al., Journal of the Endocrine Society, doi:10.1210/jendso/bvac017 A Randomized Trial of Sitagliptin and Spironolactone With Combination Therapy in Hospitalized Adults With COVID-19
55% lower mortality (p=0.1), 34% lower ventilation (p=0.36), 19% lower ICU admission (p=0.67), and 47% improved recovery (p<0.0001). RCT including 51 spironolactone patients and 87 control patients in Iran, showing improved recovery with spironolactone, sitagliptin, and the combination of both.
Jan 21
2022
 Davarpanah et al., Journal of Endocrinological Investigation, doi:10.1007/s40618-023-02141-0 (date from preprint) Combination of spironolactone and sitagliptin improves clinical outcomes of outpatients with COVID-19: a prospective cohort study
78% lower hospitalization (p=0.0008), 67% lower progression (p=0.003), and 64% faster recovery (p=0.0001). 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.
Oct 13
2021
 Ersoy et al., Aydin Sağlik Dergi̇si̇, doi:10.17932/IAU.ASD.2015.007/asd_v07i3002 Assessment Of The Efficacy Of Spironolactone For COVID-19 ARDS Patients
46% lower mortality (p=0.002). Retrospective 30 COVID-19 ARDS ICU patients and 30 control patients, showing lower mortality with treatment.
Feb 23
2021
 Jeon et al., Frontiers in Medicine, doi:10.3389/fmed.2021.629176 Effect of Spironolactone on COVID-19 in Patients With Underlying Liver Cirrhosis: A Nationwide Case-Control Study in South Korea
77% fewer cases (p=0.005). Retrospective 6,462 liver cirrhosis patients in South Korea, with 67 COVID+ cases, showing significantly lower cases with spironolactone treatment. Death and ICU results per group are not provided.
Dec 3
2020
 Mareev et al., Кардиология, doi:10.18087/cardio.2020.11.n1440 Results of Open-Label non-Randomized Comparative Clinical Trial: “BromhexIne and Spironolactone for CoronаvirUs Infection requiring hospiTalization (BISCUIT)
11% improved recovery (p=0.47), 8% shorter hospitalization (p=0.35), and 87% improved viral clearance (p=0.08). Prospective 103 PCR+ patients in Russia, 33 treated with bromexhine+spironolactone, showing lower PCR+ at day 10 or hospitalization >10 days with treatment. Bromhexine 8mg 4 times daily, spironolactone 25-50 mg/day for 10 days.
Oct 6
2020
 Cadegiani et al., medRxiv, doi:10.1101/2020.10.05.20206870 An open-label prospective observational study of antiandrogen and non-antiandrogen early pharmacological approaches in females with mild-to-moderate COVID-19. The Pre-AndroCoV Female Trial
77% faster recovery (p=0.006) and 38% faster viral clearance (p=0.02). Prospective study of 270 female COVID-19 patients in Brazil, 75 with hyperandrogenism, of which 8 were on spironolactone. Results suggest that HA patients may be at increased risk, and that spironolactone use may reduce the risk compared ..
May 7
2020
 Holt et al., Journal of Hypertension, doi:10.1097/hjh.0000000000002515 Influence of inhibitors of the renin–angiotensin system on risk of acute respiratory distress syndrome in Danish hospitalized COVID-19 patients
129% higher combined mortality/ICU admission (p=0.0007). Retrospective 689 hospitalized COVID-19 patients in Denmark, showing higher risk of ICU/death with spironolactone use in unadjusted results subject to confounding by indication.