There is no clinical data supporting any prophylactic treatment for COVID19. The pandemic or coronavirus presents an unprecedented challenge to identify effective drugs for prevention and treatment. Given the rapid pace of scientific discovery, all researchers and healthcare professionals are trying their level best to help treat this coronavirus. A large number of people are rapidly infected by the coronavirus. Clinicians need to ensure to help the patients provide the COVID19 treatment with efficacy for maximum recovery. But, are antiviral medicines enough to help treat coronavirus?. The question remains unanswered and still unclear. It needs further research in terms of proving efficacious treatment to COVID positive patients.
No preventative therapy has come into existence to treat coronavirus infection
No proven effective therapy has come into existence yet for coronavirus treatment. The COVID19 pandemic represents the greatest global public health crisis of the generation. The speed and volume of clinical trials launched to investigate potential therapies for COVID19 highlights the need for high-quality evidence for coronavirus. Many authors and researchers have worked on various case reports and review articles.
Severe forms of COVID19 are the most responsible for the isolated respiratory failure in the form of Acute Respiratory Distress Syndrome, which accounts for most of the mortality.
Clinical course and symptoms of COVID19
The World Health Organization (WHO) declared coronavirus 2019 caused by SARS CoV2 infection as a global pandemic. The clinical course and symptoms mimic as follows: Upper Respiratory tract Infection (URTI), Acute Respiratory Distress Syndrome (ARDS) and Pneumonia. The major complication of the coronavirus infection is Pulmonary fibrosis. Based on these symptoms, spironolactone has shown proven positive effects for Covid 19 affected patients.
How can Sprirolactone help?
Spironolactone is FDA approved drug and is proven to show a positive effect in treating pulmonary fibrosis. Based on research and randomized clinical trials (RCT), Spironolactone has shown proven effects in the treatment of Covid 19 which are as follows:
(1) Mineralocorticoid receptor antagonist action: MRAs have great efficacy in the treatment of pulmonary oedema as it has antihypertensive effect by helping in diuresis, potassium retention and preserving ejection fraction thus being beneficial for patients affected by heart failure. MRAs have a positive effect on collagen metabolism which can help a great deal in preventing pulmonary fibrosis from affecting the lung. Spironolactone along with its metabolites which are canerenon and eplerenone belongs to a group of MRAs that works by blocking the action of the aldosterone receptor. This further helps in the blockage of sodium reabsorption with water retention and increased potassium retention. This helps in diuretic effect especially with patients with Congestive Cardiac Failure (CCF) and pulmonary oedema
(2)Anti Hyper-Inflammatory action: The development of a higher inflammatory state may trigger ARDS. This is particularly classified as an increase in the level of cytokines, interleukin factor, and Tumour necrosis factors which are inflammatory parameters causing covid infection. Spironolactone has a positive effect in reducing these inflammatory markers
(3)Impact on apoptosis of immune cells: Spironolactone helps in reducing the cell death (apoptosis) of immune cells thus helping in preserving the immune system which can help you fight against covid 19.
(4)Oxidative stress: SARS CoV2 has more potential to trigger oxidative stress where the free radicals cause oxidative damage to the stress. Spironolactone helps in the prevention of oxidative stress. Other effects of spironolactone are the Antiandrogenic effect and Antifibrolytic effect.