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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

See all articles by Luis Miguel Pérez-Belmonte

Luis Miguel Pérez-Belmonte

Hospital Regional Universitario de Málaga

José David Torres-Peña

Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA)

María D. López-Carmona

Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA)

M. Mar Ayala-Gutiérrez

Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA)

Francisco Fuentes-Jiménez

Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba

Lucía Jorge Huerta

Internal Medicine Department, 12 de Octubre University Hospital

Jaime Alonso Muñoz

Internal Medicine Department, Gregorio Marañon University Hospital

Manuel Rubio-Rivas

Internal Medicine Department, Bellvitge University Hospital, L'Hospitalet de Llobregat (Barcelona)

Manel Madrazo

Internal Medicine Department, Dr. Peset University Hospital

Marcos Guzmán Garcia

Internal Medicine Department, San Juan de la Cruz Hospital

Beatriz Vicente Montes

Internal Medicine Department, León University Hospital Complex

Joaquim Fernández Sola

Internal Medicine Department, Clinic Barcelona Hospital

Javier Ena

Internal Medicine Department, Marina Baixa Hospital

Ruth Gonzalez Ferrer

Internal Medicine Department, Tajo Hospital

Carmen Mella Pérez

Internal Medicine Department, Ferrol University Hospital Complex

Carlos J. Ripper

Internal Medicine Department, Insular de Gran Canaria Hospital

Jose Javier Napal Lecumberri

Internal Medicine Department, Marqués de Valdecilla University Hospital

Iris El Attar Acedo

Internal Medicine Department, Torrecárdenas Hospital

Susana Plaza Canteli

Internal Medicine Department, Severo Ochoa University Hospital

Sara Fuente Cosío

Internal Medicine Department, Valle del Nalón Hospital

Francisco Amorós Martínez

Internal Medicine Department, Vinalopó University Hospital

Begoña Cortés Rodríguez

Internal Medicine Department, Alto Guadalquivir Hospital

Pablo Pérez-Martínez

Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital

José M. Ramos-Rincón

Universidad de Alicante - Department of Internal Medicine

Ricardo Gómez-Huelgas

University of Málaga (UMA) - Internal Medicine Department

SEMI-COVID-19 Network Group

Independent

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

Suggested Citation

Pérez-Belmonte, Luis Miguel and Torres-Peña, José David and López-Carmona, María D. and Ayala-Gutiérrez, M. Mar and Fuentes-Jiménez, Francisco and Jorge Huerta, Lucía and Alonso Muñoz, Jaime and Rubio-Rivas, Manuel and Madrazo, Manel and Guzmán Garcia, Marcos and Vicente Montes, Beatriz and Fernández Sola, Joaquim and Ena, Javier and Gonzalez Ferrer, Ruth and Mella Pérez, Carmen and Ripper, Carlos J. and Napal Lecumberri, Jose Javier and El Attar Acedo, Iris and Plaza Canteli, Susana and Fuente Cosío, Sara and Amorós Martínez, Francisco and Cortés Rodríguez, Begoña and Pérez-Martínez, Pablo and Ramos-Rincón, José M. and Gómez-Huelgas, Ricardo and Group, SEMI-COVID-19 Network, Impact of Glucose-Lowering Drugs on Mortality and Other Adverse Outcomes in Patients with Type 2 Diabetes Admitted for COVID-19. Available at SSRN: https://ssrn.com/abstract=3666251 or http://dx.doi.org/10.2139/ssrn.3666251

Luis Miguel Pérez-Belmonte (Contact Author)

Hospital Regional Universitario de Málaga ( email )

Carlos de Haya Av., s/n, 29001
Málaga
Spain

José David Torres-Peña

Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA) ( email )

María D. López-Carmona

Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA) ( email )

M. Mar Ayala-Gutiérrez

Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA) ( email )

Francisco Fuentes-Jiménez

Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba ( email )

Lucía Jorge Huerta

Internal Medicine Department, 12 de Octubre University Hospital ( email )

Jaime Alonso Muñoz

Internal Medicine Department, Gregorio Marañon University Hospital ( email )

Manuel Rubio-Rivas

Internal Medicine Department, Bellvitge University Hospital, L'Hospitalet de Llobregat (Barcelona) ( email )

Manel Madrazo

Internal Medicine Department, Dr. Peset University Hospital ( email )

Marcos Guzmán Garcia

Internal Medicine Department, San Juan de la Cruz Hospital ( email )

Beatriz Vicente Montes

Internal Medicine Department, León University Hospital Complex ( email )

Joaquim Fernández Sola

Internal Medicine Department, Clinic Barcelona Hospital ( email )

Javier Ena

Internal Medicine Department, Marina Baixa Hospital ( email )

Ruth Gonzalez Ferrer

Internal Medicine Department, Tajo Hospital ( email )

Carmen Mella Pérez

Internal Medicine Department, Ferrol University Hospital Complex ( email )

Carlos J. Ripper

Internal Medicine Department, Insular de Gran Canaria Hospital ( email )

Jose Javier Napal Lecumberri

Internal Medicine Department, Marqués de Valdecilla University Hospital ( email )

Iris El Attar Acedo

Internal Medicine Department, Torrecárdenas Hospital ( email )

Susana Plaza Canteli

Internal Medicine Department, Severo Ochoa University Hospital ( email )

Sara Fuente Cosío

Internal Medicine Department, Valle del Nalón Hospital ( email )

Francisco Amorós Martínez

Internal Medicine Department, Vinalopó University Hospital ( email )

Begoña Cortés Rodríguez

Internal Medicine Department, Alto Guadalquivir Hospital ( email )

Pablo Pérez-Martínez

Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital ( email )

José M. Ramos-Rincón

Universidad de Alicante - Department of Internal Medicine ( email )

Pintor Baeza, 11
03010 Alicante
Spain

Ricardo Gómez-Huelgas

University of Málaga (UMA) - Internal Medicine Department ( email )

Málaga
Spain

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