The association of hypertension and diabetes pharmacotherapy with COVID-19 severity and immune signatures: an observational study

Diabetes, obesity, metabolism, and SARS-CoV-2 infection: the end of the beginning

“…carried out a retrospective analysis of 717 COVID-19 hospitalizations in Singapore, including 76 individuals with T2D, the majority (88%) treated with metformin. The cohort of 27 subjects treated with DPP-4 inhibitors exhibited a greater need for supplemental oxygen and had higher rates of ICU admission, associations that persisted after multivariate correction for other risk factors ( Dalan et al., 2020 ). Furthermore, no association between clinical outcomes, including mortality, was observed in a retrospective analysis of hospitalized individuals with COVID-19 and T2D, including 142 people on DPP-4 inhibitors and 1,115 individuals on other glucose-lowering agents ( Zhou et al., 2020 ).…”

Non-insulin anti-diabetic agents in patients with type 2 diabetes and COVID-19: A Critical Appraisal of Literature

“…Dalan et al. [ 40 ] found no difference in intensive care unit (ICU) admissions (Adjusted RR 1.35; 95% CI, 0.50–3.68; p = 0.56) or mechanical ventilation (Adjusted RR 3.55; 95% CI, 0.46–27.33; p = 0.22) in SUs users (n = 33) vs. non-users, in a multi-variate analysis. In a multi-variate analysis of 1:1 propensity-matched cohorts, Kim et al.…”

“…Notably, Dalan et al. [ 40 ] reported a 4-fold increased risk of ICU admission in DPP-4i users (27/76) compared to the non-users, in a multivariate analysis (RR 4.07; 95% CI 1.42–11.66, p = 0.009). On the contrary, in a French case series of 27 patients with diabetes (10 receiving DPP-4i), Montastruc et al.…”

Sodium–Glucose Cotransporter 2 Inhibitors and Major COVID-19 Outcomes: Promising Mechanisms, Conflicting Data, and Intriguing Clinical Decisions

“…In their anecdotal report, Bossi and colleagues demonstrate that ''off-label'' use of sodium-glucose cotransporter 2 (SGLT2) inhibitors in three subjects with severe or critical severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia without diabetes did not have a significant impact on surrogate clinical outcomes, such as length of hospital stay [1]. In another recent retrospective analysis, Dalan et al provide significant evidence regarding the impact of different antihypertensive and antihyperglycemic drug classes on coronavirus disease 2019 (COVID-19) ''hard'' outcomes [2]. Of note, the researchers demonstrated that among infected subjects with concomitant type 2 diabetes mellitus (T2DM), those prior treated with SGLT2 inhibitors (n = 16) featured a significantly lower risk of mechanical ventilation, after adjustment for baseline characteristics and other established cardiovascular risk factors [2].…”

“…In another recent retrospective analysis, Dalan et al provide significant evidence regarding the impact of different antihypertensive and antihyperglycemic drug classes on coronavirus disease 2019 (COVID-19) ''hard'' outcomes [2]. Of note, the researchers demonstrated that among infected subjects with concomitant type 2 diabetes mellitus (T2DM), those prior treated with SGLT2 inhibitors (n = 16) featured a significantly lower risk of mechanical ventilation, after adjustment for baseline characteristics and other established cardiovascular risk factors [2]. The latter might have significant prognostic implications, based on the high mortality rates observed among patients that develop acute respiratory distress syndrome (ARDS) and are managed with mechanical ventilation [3].…”