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Analysis of Survival Modification by Furosemide Use in a Cohort of Hospitalized COVID-19 Patients with Severe or Critical Disease in Mexico: Due to Its Chemical Structure, Furosemide Is More than Just a Diuretic.
Diaz-Martinez, Janet; Kotzker, Wayne; Mendoza-Hernandez, Martha A; Gadh, Rajdeep S; Hernandez-Fuentes, Gustavo A; Bañuelos, Andrew; Guzmán-Esquivel, José; Hong, Angelina; Delgado-Enciso, Osiris G; Geyer-Roberts, Elizabeth; Martinez-Fierro, Margarita L; Rodriguez-Sanchez, Iram P; Garza-Veloz, Idalia; Canseco-Ávila, Luis M; Delgado-Enciso, Ivan.
Afiliación
  • Diaz-Martinez J; Research Center in Minority Institutions, Robert Stempel College of Public Health, Florida International University, Miami, FL 33199, USA.
  • Kotzker W; Florida Kidney Physicians, Panoramic Health Practice, Boca Raton, FL 33431, USA.
  • Mendoza-Hernandez MA; Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico.
  • Gadh RS; COVID Unit, General Hospital Number 1, Mexican Institute of Social Security, Villa de Alvarez, Colima 29883, Mexico.
  • Hernandez-Fuentes GA; Florida Kidney Physicians, Panoramic Health Practice, Coral Springs, FL 33071, USA.
  • Bañuelos A; Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico.
  • Guzmán-Esquivel J; Department GME (General Medicine Education), Hospital Corporation of America Westside, Westside, FL 33324, USA.
  • Hong A; Clinical Epidemiology Research Unit, Mexican Institute of Social Security, Villa de Alvarez, Colima 29883, Mexico.
  • Delgado-Enciso OG; Department GME (General Medicine Education), Hospital Corporation of America Westside, Westside, FL 33324, USA.
  • Geyer-Roberts E; Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico.
  • Martinez-Fierro ML; Department of Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova University, Fort Lauderdale, FL 33328, USA.
  • Rodriguez-Sanchez IP; Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Autonomous University of Zacatecas, Zacatecas 98160, Mexico.
  • Garza-Veloz I; Molecular and Structural Physiology Laboratory, School of Biological Sciences, Autonomous University of Nuevo Leon, San Nicolas de los Garza 66455, Mexico.
  • Canseco-Ávila LM; Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Autonomous University of Zacatecas, Zacatecas 98160, Mexico.
  • Delgado-Enciso I; Diagnostic and Molecular Biomedicine Laboratory, Faculty of Chemistry Sciences, Campus IV, Autonomous University of Chiapas, Tapachula 30700, Mexico.
Pharmaceutics ; 16(7)2024 Jul 10.
Article en En | MEDLINE | ID: mdl-39065617
ABSTRACT
In the ongoing fight against Coronavirus Disease 2019 (COVID-19), researchers are exploring potential treatments to improve outcomes, especially in severe cases. This includes investigating the repurposing of existing medications, such as furosemide, which is widely available. This study aimed to evaluate the impact of furosemide on mortality rates among COVID-19 patients with severe or critical illness. We assessed a cohort of 515 hospitalized adults who experienced a high mortality rate of 43.9%. Using a multivariate analysis with adjusted risk ratios (AdRRs), factors like smoking (AdRR 2.48, 95% CI 1.53-4.01, p < 0.001), a high Pneumonia Severity Index (PSI) score (AdRR 7.89, 95% CI 5.82-10.70, p < 0.001), mechanical ventilation (AdRR 23.12, 95% CI 17.28-30.92, p < 0.001), neutrophilia (AdRR 2.12, 95% CI 1.52-2.95, p < 0.001), and an elevated neutrophil-to-lymphocyte ratio (NLR) (AdRR 2.39, 95% CI 1.72-3.32, p < 0.001) were found to increase mortality risk. In contrast, vaccination and furosemide use were associated with reduced mortality risk (AdRR 0.58, p = 0.001 and 0.60, p = 0.008; respectively). Furosemide showed a pronounced survival benefit in patients with less severe disease (PSI < 120) and those not on hemodialysis, with mortality rates significantly lower in furosemide users (3.7% vs. 25.7%). A Kaplan-Meier analysis confirmed longer survival and better oxygenation levels in patients treated with furosemide. Furthermore, a Structure-Activity Relationship analysis revealed that furosemide's sulfonamide groups may interact with cytokine sites such as tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), potentially explaining its beneficial effects in COVID-19 management. These findings suggest that furosemide could be a beneficial treatment option in certain COVID-19 patient groups, enhancing survival and improving oxygenation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE País/Región como asunto: Mexico Idioma: En Revista: Pharmaceutics Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE País/Región como asunto: Mexico Idioma: En Revista: Pharmaceutics Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza