Kotfis Katarzyna, Karolak Igor, Lechowicz Kacper, Zegan-Barańska Małgorzata, Pikulska Agnieszka, Niedźwiedzka-Rystwej Paulina, Kawa Miłosz, Sieńko Jerzy, Szylińska Aleksandra, Wiśniewska Magda
Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, 70-111 Szczecin, Poland.
Institute of Biology, University of Szczecin, 71-412 Szczecin, Poland.
Pharmaceuticals (Basel). 2022 Feb 5;15(2):200. doi: 10.3390/ph15020200.
In December 2019 the SARS-CoV-2 virus appeared in the world, mainly presenting as an acute infection of the lower respiratory tract, namely pneumonia. Nearly 10% of all patients show significant pulmonary fibrotic changes after the infection. The aim of this study was to evaluate the effectiveness and safety of potassium canrenoate in the treatment of COVID-19-associated pneumonia and pulmonary fibrosis. We performed a randomized clinical trial (RCT) of potassium canrenoate vs placebo. A total of 55 patients were randomized and 49 were included in the final analysis (24 allocated to the intervention group and 25 allocated to the control group). Patients were assessed by physical examination, lung ultrasound, CT imaging and blood samples that underwent biochemical analysis. This RCT has shown that the administration of potassium canrenoate to patients with COVID-19 induced pneumonia was not associated with shorter mechanical ventilation time, shorter passive oxygenation, shorter length of hospitalization or less fibrotic changes on CT imaging. The overall mortality rate was not significantly different between the two groups. Adverse events recorded in this study were not significantly increased by the administration of potassium canrenoate. The negative outcome of the study may be associated with the relatively small number of patients included. Any possible benefits from the use of potassium canrenoate as an antifibrotic drug in COVID-19 patients require further investigation.
2019年12月，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒在全球出现，主要表现为下呼吸道急性感染，即肺炎。在所有患者中，近10%在感染后出现明显的肺纤维化改变。本研究的目的是评估坎利酸钾治疗新型冠状病毒肺炎（COVID-19）相关肺炎和肺纤维化的有效性和安全性。我们进行了一项坎利酸钾与安慰剂对比的随机临床试验（RCT）。共有55例患者被随机分组，49例纳入最终分析（24例分配至干预组，25例分配至对照组）。通过体格检查、肺部超声、CT成像以及接受生化分析的血样对患者进行评估。该随机对照试验表明，对COVID-19所致肺炎患者给予坎利酸钾治疗与机械通气时间缩短、被动氧合时间缩短、住院时间缩短或CT成像上纤维化改变减少无关。两组的总死亡率无显著差异。本研究记录的不良事件在给予坎利酸钾治疗后未显著增加。该研究的阴性结果可能与纳入患者数量相对较少有关。在COVID-19患者中使用坎利酸钾作为抗纤维化药物的任何潜在益处都需要进一步研究。
