Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact email@example.com.
Glucose-Lowering Drugs and Outcomes in COVID-19 Patients with Diabetes
30 Pages Posted: 7 May 2022More...
Aims: To evaluate the mortality of eight antihyperglycemics for COVID-19 patients with diabetes prior to diagnosis of COVID-19.
Materials and Methods: We searched PubMed, Embase, Cochrane Central Register, Web of Science, and ClinicalTrials. gov through 21 March 2022. COVID-19 patients with diabetes while receiving glucose-lowering therapies for at least 14 days prior to COVID-19 confirmed were included. The Newcastle Ottawa scale was used to assess the risk of bias in nonrandomized studies. Bayesian network meta-analyses were performed.
Results: Twenty nine distinct observational studies (3,665,644 COVID-19 patients with diabetes mellitus) were included. Compared with insulin, DPP4i, secretagogues, and glucosidase inhibitors, the incidence of adverse outcomes in patients with diabetes who took SGLT2i was relatively lower: OR 2.7 (95% CrI 1.9-3.9); 2,0 (1.4-2.8); 1.6 (1.1-2.4); 1.8 (1.1-3.0); 0.32 (0.16-0.70); 0.47 (0.23-0.95). The SUCRA value of SGLT2i was the lowest (7%), followed by GLPIRA (13%) and biguanides (35%).
Conclusion: The limitation of this study is that the differences in basic characteristics among therapies arms were not analyzed. SGLT2I may be an optimal choice for patients with diabetes before COVID-19 infection. GLP1RA and guanidine can also be a good choice for the protection of patients with diabetes during COVID-19 pandemic times.
Funding: None to declare.
Declaration of Interest: None to declare.
Keywords: COVID-19, diabetes, glucose-lowering therapies
Suggested Citation: Suggested Citation