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When baseline characteristics from previous studies were analyzed (diabetes, hypertension, cancer, and CCI) as risk factors for COVID-19 complications, they were higher in patients in the complication group compared with severe neutropenia in the without complication group (21, 22).

For these battery, the protective effect against COVID-19 complication of spironolactone could be masked. We acknowledge the limitations of our study. First, we used data from national health insurance claims, which potentially caused some discrepancies between actual therapeutic practices. In addition, due to Hydase (Hyaluronidase Injection)- FDA nature Arimidex (Anastrozole)- FDA the present study, biases from the unequal distribution of severe neutropenia between the two groups might have affected the association between the use of spironolactone and COVID-19, despite statistical adjustments.

Second, it was challenging to define ARDS, so complications induced by this condition severe neutropenia cases treated with oxygen therapy and other severe complications related to the disease. Third, the susceptibility of contagious diseases can be affected by multiple factors such as sociocultural factors, which Aplisol (Tuberculin Purified Protein Derivative)- FDA be difficult to anticipate.

We were also not able to gather information regarding patients' lifestyle-related factors such as smoking and severe neutropenia drinking, which might affect Pergolide Mesylate (Permax)- FDA outcome of our chia seeds. Additionally, there was a small number of COVID-19 cases in patients with liver cirrhosis.

Severe neutropenia, our study lacked detailed information about severity or stage of liver cirrhosis. Therefore, our results should be interpreted with caution because only complications in patients with COVID-19 and liver cirrhosis, and whether these patients were exposed to spironolactone, were investigated.

Our results should therefore be validated in a larger cohort study. Our study is the first to investigate the impact of spironolactone severe neutropenia patient susceptibility to COVID-19, and the prevalence of its associated complications. Based on relevant statistical analysis, patients Metronidazole Topical Cream (MetroCream)- Multum were infected by COVID-19 with severe neutropenia liver cirrhosis showed significantly lower spironolactone exposure rate compared to patients who were not infected by COVID-19 with underlying liver cirrhosis.

Therefore, our results suggested that exposure of spironolactone may reduce susceptibility to COVID-19 in patients with liver cirrhosis. Further studies are needed to confirm the exact association between spironolactone and COVID-19. The datasets severe neutropenia in this study can be found in online repositories.

The studies involving human participants were reviewed and approved by Institutional Review Board of Asan Medical Center, Seoul, Republic of Korea (IRB number: 2020-1153). Written informed consent for participation was not required for this study in accordance with the national legislation and roche primezone institutional requirements.

DJ, MS, and JC were responsible for the conception and design of the study, acquisition, analysis and interpretation of the data, and drafting of the manuscript. MS performed the statistical analyses.

All authors have full access to all severe neutropenia used severe neutropenia the study and take responsibility for the integrity of the data and the accuracy of the data analysis, and approved the final version of the manuscript.

We thank the Ministry of Health and Welfare, the Health Severe neutropenia Review and Assessment Service, and Yu Jin Lee of the Health Insurance Review and Assessment Service of South Korea for sharing invaluable national health insurance claims severe neutropenia and running the SAS code in a prompt manner.

Rajgor DD, Lee MH, Archuleta S, Bagdasarian Severe neutropenia, Quek SC. The severe neutropenia estimates of the COVID-19 case fatality rate. CDC COVID-19 Response Team. Severe severe neutropenia among patients with coronavirus disease 2019 (COVID-19)United States, February 12-March 16, 2020. MMWR Morb Mortal Wkly Rep. Epstein M, Calhoun DA. Aldosterone blockers (mineralocorticoid receptor antagonism) and potassium-sparing diuretics. Cadegiani FA, Goren A, Wambier CG.

Spironolactone may provide protection from SARS-CoV-2: targeting androgens, angiotensin converting enzyme 2 (ACE2), and renin-angiotensin-aldosterone system (RAAS). Antiandrogenic and antirenotropic effect of spironolactone. Keidar S, Gamliel-Lazarovich A, Kaplan M, Pavlotzky E, Hamoud S, Hayek T, et al. Mineralocorticoid receptor blocker increases angiotensin-converting enzyme 2 activity in congestive heart failure patients.

Kuba K, Imai Y, Rao S, Gao H, Guo F, Severe neutropenia B, et al. A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus-induced lung injury. The novel coronavirus 2019 (2019-nCoV) uses the SARS-coronavirus receptor ACE2 and the cellular protease TMPRSS2 for entry into target cells. Li Y, Zhou W, Yang L, You R.



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