PMID- 34398433 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20211019 IS - 1869-6953 (Print) IS - 1869-6961 (Electronic) IS - 1869-6961 (Linking) VI - 12 IP - 11 DP - 2021 Nov TI - Lower COVID-19 Mortality in Patients with Type 2 Diabetes Mellitus Taking Dipeptidyl Peptidase-4 Inhibitors: Results from a Turkish Nationwide Study. PG - 2857-2870 LID - 10.1007/s13300-021-01133-8 [doi] AB - INTRODUCTION: To investigate the effect of preexisting treatment with dipeptidyl peptidase-4 inhibitors (DPP-4is) on COVID-19-related hospitalization and mortality in patients with type 2 diabetes mellitus (T2DM). METHODS: A multicenter, retrospective cohort study was conducted using patient data extracted from the Turkish National Electronic Database. All patients who tested positive for COVID-19 (PCR test) between 11 March through to 30 May 2020 were screened for eligibility (n = 149,671). Following exclusion of patients based on pre-determined inclusion criteria, patients with T2DM using a DPP-4i or glucose-lowering medications other than a DPP-4i were compared for mortality and hospitalization. The propensity score method was used to match age, gender, micro- and macrovascular complications, and medications in the two groups. Independent associates of mortality were analyzed using multivariable analysis on the whole T2DM population. RESULTS: A total of 33,478 patients with T2DM who tested postive for COVID-19 who met the inclusion criteria were included in the analysis. Median (interquartile range) age was 54 (22) years and 42.4% were male. Of these, 9100 patients using DPP-4is (n = 4550) or other glucose-lowering drugs (n = 4550) were matched in two groups. After matching, analysis revealed a lower mortality in the DPP-4i group (9.5 vs. 11.8%; p < 0.001). In the multivariable model, the use of DPP-4is (odds ratio [OR] 0.57, 95% confidence interval [CI] 0.35-0.91; p = 0.02) was associated with lower mortality in the whole sample, while age, male gender, computed tomography finding of COVID-19, obesity, low glomerular filtration rate, and an insulin-based regimen also predicted increased risk of death. There was no association between the preexisting treatment with DPP-4is and COVID-19-related hospitalization in the matched analysis or multivariate model. The rate of admission to the intensive care unit and/or mechanical ventilation favored the DPP-4i group (21.7 vs. 25.2%; p = 0.001), although this association became saturated in the multivariate analysis (OR 0.65, 95% CI 0.39-1.08; p = 0.099). CONCLUSIONS: The results of this study demonstrate an association between DDP-4i use and reduced mortality in people with T2DM who tested PCR positive for COVID-19. CI - (c) 2021. The Author(s). FAU - Emral, Rifat AU - Emral R AD - Department of Endocrinology and Metabolism, Faculty of Medicine, Ankara University, Ankara, Turkey. rifatemral@gmail.com. FAU - Haymana, Cem AU - Haymana C AD - Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey. FAU - Demirci, Ibrahim AU - Demirci I AD - Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey. FAU - Tasci, Ilker AU - Tasci I AD - Department of Internal Medicine, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey. FAU - Sahin, Mustafa AU - Sahin M AD - Department of Endocrinology and Metabolism, Faculty of Medicine, Ankara University, Ankara, Turkey. FAU - Cakal, Erman AU - Cakal E AD - Department of Endocrinology and Metabolism, Faculty of Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey. FAU - Ata, Naim AU - Ata N AD - Department of Strategy Development, Ministry of Health of the Republic of Turkey, Ankara, Turkey. FAU - Unluturk, Ugur AU - Unluturk U AD - Department of Endocrinology and Metabolism, Faculty of Medicine, Hacettepe University, Ankara, Turkey. FAU - Demir, Tevfik AU - Demir T AD - Department of Endocrinology and Metabolism, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey. FAU - Ertugrul, Derun AU - Ertugrul D AD - Department of Endocrinology and Metabolism, Faculty of Medicine, Kecioren Training and Research Hospital, University of Health Sciences, Ankara, Turkey. FAU - Sahin, Ibrahim AU - Sahin I AD - Department of Endocrinology and Metabolism, Faculty of Medicine, Inonu University, Malatya, Turkey. FAU - Atmaca, Aysegul AU - Atmaca A AD - Department of Endocrinology and Metabolism, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey. FAU - Celik, Osman AU - Celik O AD - Public Hospitals General Directorate, Ministry of Health of the Republic of Turkey, Ankara, Turkey. FAU - Caglayan, Murat AU - Caglayan M AD - Ankara Provincial Health Directorate, Ankara, Turkey. FAU - Arga, Kazim Yalcin AU - Arga KY AD - Department of Bioengineering, Faculty of Engineering, Marmara University, Istanbul, Turkey. AD - Institute of Public Health and Chronic Diseases, The Health Institutes of Turkey, Istanbul, Turkey. FAU - Dagdelen, Selcuk AU - Dagdelen S AD - Department of Endocrinology and Metabolism, Faculty of Medicine, Hacettepe University, Ankara, Turkey. FAU - Salman, Serpil AU - Salman S AD - Department of Endocrinology and Metabolism, Medica Clinic, Istanbul, Turkey. FAU - Satman, Ilhan AU - Satman I AD - Institute of Public Health and Chronic Diseases, The Health Institutes of Turkey, Istanbul, Turkey. AD - Department of Endocrinology and Metabolism, Faculty of Medicine, Istanbul University, Istanbul, Turkey. FAU - Sonmez, Alper AU - Sonmez A AD - Department of Endocrinology and Metabolism, Gulhane Faculty of Medicine and Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey. LA - eng PT - Journal Article DEP - 20210816 PL - United States TA - Diabetes Ther JT - Diabetes therapy : research, treatment and education of diabetes and related disorders JID - 101539025 EIN - Diabetes Ther. 2021 Sep 24;:. PMID: 34559403 PMC - PMC8365288 OTO - NOTNLM OT - Anti-diabetic agents OT - COVID-19 OT - DPP-4 inhibitor OT - Hospitalization OT - Intensive care unit admission OT - Mechanical ventilation OT - Mortality OT - Type 2 diabetes mellitus EDAT- 2021/08/17 06:00 MHDA- 2021/08/17 06:01 PMCR- 2021/08/16 CRDT- 2021/08/16 13:04 PHST- 2021/06/02 00:00 [received] PHST- 2021/07/28 00:00 [accepted] PHST- 2021/08/17 06:00 [pubmed] PHST- 2021/08/17 06:01 [medline] PHST- 2021/08/16 13:04 [entrez] PHST- 2021/08/16 00:00 [pmc-release] AID - 10.1007/s13300-021-01133-8 [pii] AID - 1133 [pii] AID - 10.1007/s13300-021-01133-8 [doi] PST - ppublish SO - Diabetes Ther. 2021 Nov;12(11):2857-2870. doi: 10.1007/s13300-021-01133-8. Epub 2021 Aug 16.