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Impact of Glucose-Lowering Drugs on Mortality and Other Adverse Outcomes in Patients with Type 2 Diabetes Admitted for COVID-19
37 Pages Posted: 3 Sep 2020
More...Abstract
Background: Limited evidence exists on the role of glucose-lowering drugs in patients with COVID-19. This work examines the impact of each at-home glucose-lowering drugs individually or in combination with metformin on mortality and other adverse outcomes in patients with type 2 diabetes hospitalized for COVID-19.
Methods: We selected all patients with type 2 diabetes in the Spanish Society of Internal Medicine’s SEMI-COVID-19 Registry, an observational, multicenter, nationwide registry of patients admitted for COVID-19 in Spain from March 1, 2020. Each glucose-lowering drug user was matched with a user of other glucose-lowering drugs by propensity scores. To evaluate treatment effect on study outcomes, both conditional logit and mixed effect logistic regression were used when simple size ≥100.
Findings: A total of 2,666 patients were found in the SEMI-COVID-19 Registry, 1297 on glucose-lowering drugs in monotherapy and 465 in combination with metformin. After propensity matching, 249 patients on metformin, 105 on dipeptidyl peptidase-4 inhibitors, 129 on insulin, 127 on metformin/dipeptidyl peptidase-4 inhibitors, 34 on metformin/sodium-glucose cotransporter 2 inhibitor, and 67 on metformin/insulin were selected. No at-home glucose-lowering drugs showed a significant association with in-hospital death; the composite outcome of need of intensive care unit admission, mechanical ventilation, or in-hospital death; in-hospital complications; or long-time hospital stays.
Interpretation: In patients with type 2 diabetes admitted for COVID-19, at-home glucose-lowering drugs had a neutral effects on mortality and adverse outcomes. Given the close relationship between diabetes and COVID-19 and the limited evidence on the role of glucose-lowering drugs, prospective studies are needed.
Funding Statement: None.
Declaration of Interests: None
Ethics Approval Statement: This study was also carried out in accordance with the Declaration of Helsinki and was approved by the Institutional Research Ethics Committees of each participating hospital.
Keywords: Type 2 diabetes, Glucose-lowering drug, Coronavirus disease-2019
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