Use of Finasteride and Spironolactone in Hospitalized COVID-19 Patients and Their Effect on Severity Outcomes
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Rational Spironolactone (SPN) and Finasteride (FIN) allegedly provide benefits in patients with coronavirus disease 2019(COVID-19) due to their anti-androgenic effects. This study aimed to analyze if the use of SPN and FIN in hospitalized COVID-19patients, modified their outcome. METHODS: Retrospective study of patients admitted to our hospital with COVID-19 infectionbetween March 2020 and February 2022. Patients were divided into four groups according to medications received: Group 1received FIN SPN, group 2 received FIN, group 3 received SPN, and group 4 received neither, the latter was randomly selected.Primary outcomes included mortality, and length of stay (LOS). Secondary assessments were acute severity scores, andinflammatory markers (interleukin 6 [IL6] and interleukin 10 [IL10]). Descriptive statistics, Chi-square, Multiple LogisticRegression, and Mann-Whitney tests were utilized to ascertain statistical significance. RESULTS: 318 patients were included inthe study. Table 1 summarizes the comparison analysis of the cohort. Adjusted odds ratio (ORa) by gender for mortality in group 2was 2.66 (1.40-5.08; p=0.003). ORa by sex for mortality in group 4 was 0.37 (0.22-0.64; p<0.001). When comparing groups 1and 4, there is a significant difference in highest APACHE score (p<0.01), highest SOFA score (p<0.01), and Ichikado score(p<0.01). When comparing groups 3 and 4, there was a significant difference in the highest APACHE score (p<0.05) andIchikado score (p<0.05). When comparing groups 2 and 4, there was a significant difference in LOS (p<0.01), highest APACHEscore (p<0.01), highest SOFA score (p<0.01), Ichikado score (p<0.01), and highest IL10 (p<0.05). Group 1 and 2 comparisonsrevealed a significant difference in highest IL6 (p<0.05), and highest IL10 (p<0.05). Groups 2 and 3 comparisons showed asignificant difference in LOS (p<0.01), Ichikado score (p<0.05), and highest IL6 (p<0.05). CONCLUSION: Patients that receivedanti-androgenic medications demonstrated to be sicker on hospital admission. The Finasteride treatment group had higherseverity scores, higher inflammatory markers and lower CD4 and CD8 cell counts thus, stayed longer at the hospital, and hadworse outcomes than its counterparts. We were unable to address mortality difference as the patients that received these drugswere sicker on admission than their counterparts.
