Spironolactone as an adjuvant treatment for COVID-19: a systematic review and meta-analysis

BackgroundA systematic review and meta-analysis have been conducted to evaluate the efficacy of spironolactone as an adjuvant treatment for COVID-19 patients based on current evidence.MethodsWe searched MEDLINE (PubMed), medRvix, Web of Science, Cochrane Library, Google Scholar, Clinicaltrials.gov, Collabovid, Research Square, ScienceDirect, and Oxford University Press for studies evaluating the efficacy of spironolactone as an adjuvant therapy for COVID-19 patients up to 30 April 2023. Based on the PRISMA 2020 statement criteria a systematic review and meta-analysis of studies were performed.ResultsThe results of our meta-analysis showed a significant reduction in primary composite outcome (combined rate of mortality or severe disease occurrence) (OR = 0.28, 95% CI: 0.18 to 0.44), mortality (OR = 0.24, 95% CI: 0.12 to 0.47), and progression to severe disease (OR = 0.44, 95% CI: 0.26 to 0.75) in the spironolactone group compared to controls. Spironolactone therapy did not significantly improve the time to recovery (MD = -1.09, 95% CI: -2.63 to 1.46; I2 = 98%).ConclusionSpironolactone can be an efficient and safe adjuvant treatment for COVID-19 patients alongside concomitant medications. Future randomized controlled trials are needed to strengthen the available evidence.