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
Janet Diaz-Martinez,
Wayne Kotzker,
Martha A. Mendoza-Hernandez,
Rajdeep S. Gadh,
Gustavo A. Hernandez-Fuentes,
Andrew Bañuelos,
José Guzmán-Esquivel,
Angelina Hong,
Osiris G. Delgado-Enciso,
Elizabeth Geyer-Roberts,
Margarita L. Martinez-Fierro,
Iram P. Rodriguez-Sanchez,
Idalia Garza-Veloz,
Luis M. Canseco-Ávila,
Ivan Delgado-Enciso
Affiliations
Janet Diaz-Martinez
Research Center in Minority Institutions, Robert Stempel College of Public Health, Florida International University, Miami, FL 33199, USA
Wayne Kotzker
Florida Kidney Physicians, Panoramic Health Practice, Boca Raton, FL 33431, USA
Martha A. Mendoza-Hernandez
Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico
Rajdeep S. Gadh
Florida Kidney Physicians, Panoramic Health Practice, Coral Springs, FL 33071, USA
Gustavo A. Hernandez-Fuentes
Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico
Andrew Bañuelos
Department GME (General Medicine Education), Hospital Corporation of America Westside, Westside, FL 33324, USA
José Guzmán-Esquivel
Clinical Epidemiology Research Unit, Mexican Institute of Social Security, Villa de Alvarez, Colima 29883, Mexico
Angelina Hong
Department GME (General Medicine Education), Hospital Corporation of America Westside, Westside, FL 33324, USA
Osiris G. Delgado-Enciso
Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico
Elizabeth Geyer-Roberts
Department of Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova University, Fort Lauderdale, FL 33328, USA
Margarita L. Martinez-Fierro
Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Autonomous University of Zacatecas, Zacatecas 98160, Mexico
Iram P. Rodriguez-Sanchez
Molecular and Structural Physiology Laboratory, School of Biological Sciences, Autonomous University of Nuevo Leon, San Nicolas de los Garza 66455, Mexico
Idalia Garza-Veloz
Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences, Autonomous University of Zacatecas, Zacatecas 98160, Mexico
Luis M. Canseco-Ávila
Diagnostic and Molecular Biomedicine Laboratory, Faculty of Chemistry Sciences, Campus IV, Autonomous University of Chiapas, Tapachula 30700, Mexico
Ivan Delgado-Enciso
Department of Molecular Medicine, School of Medicine, University of Colima, Colima 28040, Mexico
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 p p p p 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.
