A Randomized Trial of Sitagliptin and Spironolactone with Combination Therapy in Hospitalized Adults with COVID-19

Farhad Abbasi, Reuben Adatorwovor, Mohammad Ali Davarpanah, Yasaman Mansoori, Mehdi Hajiani, Farzan Azodi, Sepideh Sefidbakht, Shayesteh Davoudi, Farzana Rezaei, Shayan Mohammadmoradi, Kamyar Asadipooya

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Context: COVID-19 may cause respiratory distress syndrome and death. Treatment of COVID-19 to prevent complications remains a priority. Objective: Our investigation sought to determine whether combination of spironolactone and sitagliptin could reduce mortality for inpatients with SARS-CoV-2 infection. Methods: This single-blind, 4-arm, prospective randomized clinical trial was conducted at Shiraz and Bushehr University of Medical Sciences hospitals between December 2020 and April 2021. We randomized hospitalized adult patients with COVID-19 pneumonia into 4 groups: control, combination therapy, sitagliptin add-on, or spironolactone add-on. The primary outcome was the clinical improvement of the patients in the hospital as measured on an 8-point numerical scale. The secondary outcomes included intubation, ICU admission, end organ damages, CT findings, and paraclinical information. Results: A total of 263 admitted patients were randomly assigned to control group (87 patients), combination group (60 patients), sitagliptin group (66 patients), and spironolactone group (50 patients). There were no significant differences in baseline characteristics, except for higher age in control group. The intervention groups, especially combination therapy, had better clinical outcomes (clinical score on fifth day of admission: 3.11 ± 2.45 for controls, 1.33 ± 0.50 for combination, 1.68 ± 1.02 for sitagliptin, and 1.64 ± 0.81 for spironolactone; P = 0.004). However, the mortality rate was lower in patients who received spironolactone (21.84% control, 13.33% combination, 13.64% sitagliptin, 10.00% spironolactone; P = 0.275). Our intervention reduced lung infiltration but not the area of involvement in lungs. Conclusion: Sitagliptin and spironolactone can potentially improve clinical outcomes of hospitalized COVID-19 patients.

Original languageEnglish
Article numberbvac017
JournalJournal of the Endocrine Society
Issue number4
StatePublished - Apr 1 2022

Bibliographical note

Publisher Copyright:
© 2022 Crown copyright 2022.


  • ACE2
  • COVID-19
  • DPP4 inhibitor
  • spironolactone

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism


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