DPP-4 Inhibitors as a Savior for COVID-19 Patients with Diabetes

Nag, Snehasish; Mandal, Samanwita; Mukherjee, Oindrila; Mukherjee, Suprabhat; Kundu, Rakesh

doi:10.2217/fvl-2022-0112

Cited by 12 publications

(8 citation statements)

References 91 publications

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“…Further studies are needed to investigate the effects of NMV‐r on these specific COVID‐19‐related outcomes. Furthermore, a previous study suggested the potential benefit of oral antidiabetic drugs, such as DPP4i in treating COVID‐19 37 . Despite the analysis matching the use of different types of antidiabetic agents between the study and control groups and performing subgroup analysis accordingly, their residual confounding effects could not be excluded.…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of nirmatrelvir and ritonavir combination for treating diabetic patients with COVID‐19

Liu

et al. 2023

Journal of Medical Virology

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The aim of this study was to investigate the clinical efficacy of a combination of nirmatrelvir and ritonavir (NMV‐r) for treating COVID‐19 in patients with diabetes mellitus (DM). This retrospective cohort study used the TriNetX research network to identify adult diabetic patients with COVID‐19 between January 1, 2020, and December 31, 2022. Propensity score matching was used to match patients who received NMV‐r (NMV‐r group) with those who did not receive NMV‐r (control group). The primary outcome was all‐cause hospitalization or death during the 30‐day follow‐up period. Two cohorts comprising 13 822 patients with balanced baseline characteristics were created using propensity score matching. During the follow‐up period, the NMV‐r group had a lower risk of all‐cause hospitalization or death than the control group (1.4% [n = 193] vs. 3.1% [n = 434]; hazard ratio [HR], 0.497; 95% confidence interval [CI], 0.420–0.589). Compared with the control group, the NMV‐r group also had a lower risk of all‐cause hospitalization (HR, 0.606; 95% CI, 0.508–0.723) and all‐cause mortality (HR, 0.076; 95% CI, 0.033–0.175). This lower risk was consistently observed in almost all subgroup analyses, which examined sex (male: 0.520 [0.401–0.675]; female: 0.586 [0.465–0.739]), age (age 18–64 years: 0.767 [0.601–0.980]; ≥65 years: 0.394 [0.308–0.505]), level of HbA1c (<7.5%: 0.490 [0.401–0.599]; ≥7.5%: 0.655 [0.441–0.972]), unvaccinated (0.466 [0.362–0.599]), type 1 DM (0.453 [0.286–0.718]) and type 2 DM (0.430 [0.361–0.511]). NMV‐r can help reduce the risk of all‐cause hospitalization or death in nonhospitalized patients with DM and COVID‐19.

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Section: Discussionmentioning

confidence: 99%

Clinical efficacy of nirmatrelvir and ritonavir combination for treating diabetic patients with COVID‐19

Liu

et al. 2023

Journal of Medical Virology

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“…They can alleviate SARS-CoV-2 cytokine storm and injury to the organs. The use of DPP-4 inhibitors in patients with SARS-CoV-2 infection was associated with the improvement of glucose levels in diabetic patients and clinical improvement and reduction of inflammatory markers in diabetic and non-diabetic patients ( 71 , 77 , 78 ).…”

Section: Discussionmentioning

confidence: 99%

Type 1 Diabetes and COVID-19: A Literature Review and Possible Management

Kashfi,

Anbardar,

Asadipooya

et al. 2023

Int J Endocrinol Metab

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Context: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection normally damages the respiratory system but might likewise impair endocrine organs’ function. Thyroid dysfunction and hyperglycemia are common endocrine complications of SARS-CoV-2 infection. The onset of type 1 diabetes (T1D) and associated complications, including diabetic ketoacidosis (DKA), hospitalization, and death, are thought to have increased during the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to review the available data about the incidence rate of T1D and accompanying complications since the beginning of the COVID-19 pandemic. Evidence Acquisition: A literature review was conducted using the electronic databases PubMed and Google Scholar. The keywords “T1D, T1DM, Type 1 DM or Type 1 Diabetes”, “Coronavirus, SARS-CoV-2 or COVID-19” were used to search these databases. Titles and abstracts were screened for selection, and then relevant studies were reviewed in full text. Results: A total of 25 manuscripts out of 304 identified studies were selected. There were 15 (60%) multicenter or nationwide studies. The data about the incidence rate of T1D, hospitalization, and death are not consistent across countries; however, DKA incidence and severity seem to be higher during the COVID-19 pandemic. The present study’s data collection demonstrated that COVID-19 might or might not increase the incidence of T1D. Nevertheless, it is associated with the higher incidence and severity of DKA in T1D patients. This finding might indicate that antivirals are not fully protective against the endocrine complications of SARS-CoV-2 infection, which promotes the application of an alternative approach. Conclusions: Combining medications that reduce SARS-CoV-2 entry into the cells and modulate the immune response to infection is an alternative practical approach to treating COVID-19.

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“…It is predicted that PCS may affect millions of people worldwide [ 1 ], mainly people with comorbidities [ 3 ], e.g., type 2 diabetes mellitus (2TDM). The symptoms of PCS are difficulty with concentration, cognitive dysfunction, amnesia, depression, fatigue and anxiety [ 3 ], and the risk factors for the persistence of neuropsychiatric symptoms in PCS are older age, female sex and the severity of comorbidities, e.g., diabetes [ 4 ], which is often associated with tachycardia, sarcopenia, microcirculatory dysfunction or organ damage [ 5 ]. PCS is therefore a phenomenon that affects life expectancy.…”

Section: Introductionmentioning

confidence: 99%

“…Diabetes is estimated to be associated with approximately 15% of patients suffering from severe COVID-19. The mortality rate in COVID-19-positive diabetic patients was reported to be 2- to 3-fold higher compared to COVID-19-negative diabetic patients [ 5 ]. The literature (studies and meta-analyses) shows higher mortality in the COVID-19-positive diabetic population compared to the COVID-19-positive non-diabetic population [ 6 , 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, optimal diabetic control (in the case of T1DM/T2DM) was associated with better outcomes and fewer comorbidities among COVID-19-positive patients [ 10 ]. Such statistics account for the urge to partake in therapeutic intervention [ 5 ]. However, the information on the COVID-19-associated diabetic cases and their responses to drug treatment are scarce.…”

Section: Introductionmentioning

confidence: 99%

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Insulin and Metformin Administration: Unravelling the Multifaceted Association with Mortality across Various Clinical Settings Considering Type 2 Diabetes Mellitus and COVID-19

Lewandowski,

Bronowicka-Szydełko,

Rabczyński

et al. 2024

Biomedicines

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Due to the molecular mechanisms of action of antidiabetic drugs, they are considered to be effective in the treatment of both COVID-19 and the post-COVID-19 syndromes. The aim of this study was to determine the effect of administering insulin and metformin on the mortality of patients with type 2 diabetes (T2DM) with symptomatic COVID-19 with the use of logistic regression models. The association between death and insulin and metformin was weak and could not be included in the multivariate model. However, the interaction of both drugs with other factors, including remdesivir and low-molecular-weight heparin (metformin), age and hsCRP (insulin), modulated the odds of death. These interactions hint at multifaceted (anti-/pro-) associations of both insulin and metformin with the odds of death, depending on the patient’s characteristics. In the multivariate model, RDW-SD, adjusted with low-molecular-weight heparin treatment, age, sex and K+, was associated with mortality among patients with COVID-19 and T2DM. With a 15% increase in RDW-SD, the risk of death increased by 87.7%. This preliminary study provides the foundations for developing further, more personalized models to assess the risk of death in T2DM patients, as well as for identifying patients at an increased risk of death due to COVID-19.

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DPP-4 Inhibitors as a Savior for COVID-19 Patients with Diabetes

Cited by 12 publications

References 91 publications

Clinical efficacy of nirmatrelvir and ritonavir combination for treating diabetic patients with COVID‐19

Clinical efficacy of nirmatrelvir and ritonavir combination for treating diabetic patients with COVID‐19

Type 1 Diabetes and COVID-19: A Literature Review and Possible Management

Insulin and Metformin Administration: Unravelling the Multifaceted Association with Mortality across Various Clinical Settings Considering Type 2 Diabetes Mellitus and COVID-19

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