SGLT-2 inhibitors for COVID-19 — A miracle waiting to happen or just another beat around the bush?

Chatterjee, Subhankar

doi:10.1016/j.pcd.2020.05.013

Cited by 12 publications

(13 citation statements)

References 17 publications

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“…Another retrospective analysis (n = 283 patients with COVID-19 and diabetes type 2) identified lower mortality rates in patients with vs. without metformin intake (p = 0.01) [82]. Further high-quality data regarding outcome of COVID-19 in patients with intake of antidiabetic drugs are yet lacking [83].…”

Section: Diabetes Mellitusmentioning

confidence: 99%

Vascular Events, Vascular Disease and Vascular Risk Factors—Strongly Intertwined with COVID-19

Scutelnic

Heldner

2020

Curr Treat Options Neurol

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Purpose of review To elucidate the intertwining of vascular events, vascular disease and vascular risk factors and COVID-19. Recent findings Strokes are a leading cause of disability and death worldwide. Vascular risk factors are important drivers of strokes. There are unmodifiable vascular risk factors such as age and ethnicity and modifiable vascular risk factors. According to the INTERSTROKE study, the 10 most frequent modifiable vascular risk factors are arterial hypertension, physical inactivity, overweight, dyslipidaemia, smoking, unhealthy diet, cardiac pathologies, diabetes mellitus, stress/depression and overconsumption of alcohol. Also, infection and inflammation have been shown to increase the risk of stroke. There is high-quality evidence for the clinical benefits of optimal primary and secondary stroke prevention. The COVID-19 pandemic brought a new perspective to this field. Vascular events, vascular disease and vascular risk factors—and COVID-19—are strongly intertwined. An increased risk of vascular events—by multifactorial mechanisms—has been observed in COVID-19 patients. Also, a higher rate of infection with COVID-19, severe COVID-19 and bad outcome has been demonstrated in patients with pre-existing vascular disease and vascular risk factors. Summary At present, we suggest that regular interactions between healthcare professionals and patients should include education on COVID-19 and on primary and secondary vascular prevention in order to reduce the burden of disease in our ageing populations.

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Section: Diabetes Mellitusmentioning

confidence: 99%

Vascular Events, Vascular Disease and Vascular Risk Factors—Strongly Intertwined with COVID-19

Scutelnic

Heldner

2020

Curr Treat Options Neurol

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“…Thus, efforts should be made to provide adjuvant organ protection therapies. Despite a potential higher risk for SGLT2 inhibitors adverse effects in the context of acute illness and the resulting current advise against using them in COVID-19 patients, as recently emphasized [ 112 ], they have a favorable efficacy profile in preserving renal function, decreasing the impact of heart failure and increasing the survival of patients with risk factors for severe COVID-19. In preclinical studies, SGLT2 inhibitors had lung protective effects by decreasing oxidative stress, tissue hypoxia and inflammation [ 81 , 113 , 114 , 115 ].…”

Section: Clinical Trials Of Sglt2 Inhibitors In Covid-19mentioning

confidence: 99%

Exploring Sodium Glucose Co-Transporter-2 (SGLT2) Inhibitors for Organ Protection in COVID-19

Fernández-Fernández

D’Marco

Górriz

et al. 2020

JCM

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Hospital admissions and mortality from the Coronavirus disease 2019 (COVID-19) pandemic are spreading throughout the world, and second and third waves are thought to be likely. Risk factors for severe COVID-19 include diabetes, chronic kidney disease and cardiovascular disease. Currently, there is no vaccine and no approved therapy. Therapeutic approaches are aimed at preventing viral replication and spread, limiting the impact of the inflammatory overdrive (cytokine storm), preventing thromboembolic complications and replacing or supporting organ function. However, despite organ support, mortality is currently 65% for those receiving advanced respiratory support and 78% for those requiring renal replacement therapies. Thus, efforts should be made to provide adjuvant organ protection therapy. This may imply novel therapies in clinical development (e.g., the Fas ligand trap asunercept), but uptake of repurposed drugs already in clinical use may be faster. In this regard, sodium glucose co-transporter-2 (SGLT2) inhibitors were recently shown to protect the heart and kidney both within and outside of a diabetic milieu context. Further, preclinical data support a beneficial effect for the lung. We now discuss the potential benefits and risks of SGLT2 inhibitors in COVID-19 and an ongoing clinical trial testing the impact of dapagliflozin on outcomes in COVID-19 patients with respiratory failure.

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“…5 Dapagliflozin is known to cause a reduction in lactate levels by decreasing its release from epicardial adipose tissue and causing a lowering in oxygen consumption in tissues and promoting glucose utilisation in the aerobic pathway. 6 Decreased lactate levels reduces the activation of lactate/H + symporter and thus maintaining an adequate cytosolic pH. This leads to a decreased entry of SARS-CoV-2 into cells due to an increase in the cytosolic pH.…”

Section: Sglt2 Inhibitors: a New Ray Of Hopementioning

confidence: 99%

“… 7 Increased ACE-2 levels were initially thought to increase viral entry however recent evidence stands contrary to the same as there is a limited availability of a serine protease transmembrane protease serine 2 (TMPRSS2) which is required for binding to ACE2 receptors. 6 , 7 …”

Section: Sglt2 Inhibitors: a New Ray Of Hopementioning

confidence: 99%

SGLT-2 inhibitors as cardioprotective agents in COVID-19

Gupta

Kunal

2020

Heart & Lung

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SGLT-2 inhibitors for COVID-19 — A miracle waiting to happen or just another beat around the bush?

Cited by 12 publications

References 17 publications

Vascular Events, Vascular Disease and Vascular Risk Factors—Strongly Intertwined with COVID-19

Vascular Events, Vascular Disease and Vascular Risk Factors—Strongly Intertwined with COVID-19

Exploring Sodium Glucose Co-Transporter-2 (SGLT2) Inhibitors for Organ Protection in COVID-19

SGLT-2 inhibitors as cardioprotective agents in COVID-19

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