PMID- 34580086
OWN - NLM
STAT- MEDLINE
DCOM- 20211216
LR  - 20211229
IS  - 1939-327X (Electronic)
IS  - 0012-1797 (Print)
IS  - 0012-1797 (Linking)
VI  - 70
IP  - 12
DP  - 2021 Dec
TI  - Diabetes, Drug Treatment, and Mortality in COVID-19: A Multinational 
      Retrospective Cohort Study.
PG  - 2903-2916
LID - 10.2337/db21-0385 [doi]
AB  - Patients with type 2 diabetes mellitus (T2DM) are at increased risk of severe 
      coronavirus disease 2019 (COVID-19) outcomes possibly because of dysregulated 
      inflammatory responses. Glucose-regulating medications, such as glucagon-like 
      peptide 1 receptor (GLP-1R) agonists, dipeptidyl peptidase 4 (DPP-4) inhibitors, 
      and pioglitazone, are known to have anti-inflammatory effects that may improve 
      outcomes in patients with severe acute respiratory syndrome coronavirus 2 
      (SARS-CoV-2) infection. In a multinational retrospective cohort study, we used 
      the TriNetX COVID-19 Research Network of 56 large health care organizations to 
      examine these medications in relation to the incidence of hospital admissions, 
      respiratory complications, and mortality within 28 days after a COVID-19 
      diagnosis. After matching for age, sex, race, ethnicity, BMI, and significant 
      comorbidities, use of GLP-1R agonists and/or pioglitazone was associated with 
      significant reductions in hospital admissions (GLP-1R: 15.7% vs. 23.5%, risk 
      ratio [RR] 0.67 [95% CI 0.57-0.79; P < 0.001]; pioglitazone: 20.0% vs. 28.2%; RR 
      0.71 [95% CI 0.54-0.93; P = 0.01]). Use of GLP-1R agonists was also associated 
      with reductions in respiratory complications (15.3% vs. 24.9%, RR 0.62 [95% CI 
      0.52-0.73]; P < 0.001) and incidence of mortality (1.9% vs. 3.3%, RR 0.58 [95% CI 
      0.35-0.97]; P = 0.04). Use of DPP-4 inhibitors was associated with a reduction in 
      respiratory complications (24.0% vs. 29.2%, RR 0.82 [95% CI 0.74-0.90]; P < 
      0.001), and continued use of DPP-4 inhibitors after hospitalization was 
      associated with a decrease in mortality compared with those who discontinued use 
      (9% vs. 19%, RR 0.45 [95% CI 0.28-0.72]; P < 0.001). In conclusion, use of 
      glucose-regulating medications, such as GLP-1R agonists, DPP-4 inhibitors, or 
      pioglitazone, may improve COVID-19 outcomes for patients with T2DM; randomized 
      clinical trials are needed to further investigate this possibility.
CI  - (c) 2021 by the American Diabetes Association.
FAU - Nyland, Jennifer E
AU  - Nyland JE
AUID- ORCID: 0000-0002-4549-3617
AD  - Department of Neural and Behavioral Sciences, Penn State College of Medicine, 
      Hershey, PA psg6@psu.edu jnyland@pennstatehealth.psu.edu.
FAU - Raja-Khan, Nazia T
AU  - Raja-Khan NT
AD  - Department of Neural and Behavioral Sciences, Penn State College of Medicine, 
      Hershey, PA.
FAU - Bettermann, Kerstin
AU  - Bettermann K
AD  - Department of Neural and Behavioral Sciences, Penn State College of Medicine, 
      Hershey, PA.
FAU - Haouzi, Philippe A
AU  - Haouzi PA
AD  - Department of Neural and Behavioral Sciences, Penn State College of Medicine, 
      Hershey, PA.
FAU - Leslie, Douglas L
AU  - Leslie DL
AD  - Department of Neural and Behavioral Sciences, Penn State College of Medicine, 
      Hershey, PA.
FAU - Kraschnewski, Jennifer L
AU  - Kraschnewski JL
AD  - Department of Neural and Behavioral Sciences, Penn State College of Medicine, 
      Hershey, PA.
FAU - Parent, Leslie J
AU  - Parent LJ
AD  - Department of Neural and Behavioral Sciences, Penn State College of Medicine, 
      Hershey, PA.
FAU - Grigson, Patricia Sue
AU  - Grigson PS
AD  - Department of Neural and Behavioral Sciences, Penn State College of Medicine, 
      Hershey, PA psg6@psu.edu jnyland@pennstatehealth.psu.edu.
LA  - eng
SI  - figshare/10.2337/figshare.16594847
GR  - R37 DA009815/DA/NIDA NIH HHS/United States
GR  - UL1 TR002014/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, N.I.H., Extramural
DEP - 20210927
PL  - United States
TA  - Diabetes
JT  - Diabetes
JID - 0372763
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - COVID-19/*complications/*mortality
MH  - Cohort Studies
MH  - Diabetes Mellitus, Type 2/complications/*drug therapy
MH  - Female
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Male
MH  - Retrospective Studies
MH  - *SARS-CoV-2
PMC - PMC8660979
EDAT- 2021/09/29 06:00
MHDA- 2021/12/17 06:00
PMCR- 2021/09/27
CRDT- 2021/09/28 05:49
PHST- 2021/04/30 00:00 [received]
PHST- 2021/08/31 00:00 [accepted]
PHST- 2021/09/29 06:00 [pubmed]
PHST- 2021/12/17 06:00 [medline]
PHST- 2021/09/28 05:49 [entrez]
PHST- 2021/09/27 00:00 [pmc-release]
AID - db21-0385 [pii]
AID - 210385 [pii]
AID - 10.2337/db21-0385 [doi]
PST - ppublish
SO  - Diabetes. 2021 Dec;70(12):2903-2916. doi: 10.2337/db21-0385. Epub 2021 Sep 27.