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- Title
Can the treatment of polycystic ovary syndrome with spironolactone prevent severe COVID infection?
- Authors
Armanini, Decio; Sabbadin, Chiara; De Marco, Luigi; Bordin, Luciana
- Abstract
In a recent paper, Subramanian and collaborators reported a 52% increased risk of COVID-19 infection in women with polycystic ovary syndrome (PCOS) and an incidence nearly twice that of women without PCOS. The authors focused, as important factors of the increased prevalence of infection, both the inflammatory characteristic of PCOS and the increase in androgens that facilitate the entry of the virus into the cells of the target organs. We asked 200 consecutive, unvaccinated women with PCOS who had been followed with spirono lactone for more than 4 months, about COVID-19 infection and found only four patients who were infected. No ne of the infected patients were hospitalized and only one had fever and other manifestations of the syndrome, but the se symptoms resolved in a few days. The other three reported only mild or minimal symptoms. This observation needs confirmation with specific studies, considering the possibility that many other patients may have been infected by being asymptomatic and not swabbing for COVID-19. Spironolactone can increase the circulating angiotensin-converting enzyme 2 and antagonize the androgen receptor, preventing activation of transmembrane protease serine 2 in cel ls of the respiratory tract and other tissues. Drug also has potent anti-inflammatory and antithrombotic actions by antag onizing the mineralocorticoid receptor in target tissues and inflammatory cells. From Subramanian's study and rep orted observations, a proper evaluation of the use of spironolactone in COVID-19 in both PCOS and the general popu lation is urged.
- Subjects
POLYCYSTIC ovary syndrome; ANDROGEN receptors; MINERALOCORTICOID receptors; ANGIOTENSIN converting enzyme; PROSTATE cancer; SPIRONOLACTONE
- Publication
European Journal of Endocrinology, 2022, Vol 186, Issue 5, pL11
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-21-0759