tetano
Editor, Senior Moderator
Diabetes Metab
. 2021 Dec 1;101307.
doi: 10.1016/j.diabet.2021.101307. Online ahead of print.
Use of DPP4i reduced odds of clinical deterioration and hyperinflammatory syndrome in COVID-19 patients with type 2 diabetes: propensity score analysis of a territory-wide cohort in Hong Kong
Carlos K H Wong[SUP] 1 [/SUP], David T W Lui[SUP] 2 [/SUP], Angel Y C Lui[SUP] 3 [/SUP], Ashley C Y Kwok[SUP] 3 [/SUP], Marshall C H Low[SUP] 3 [/SUP], Kristy T K Lau[SUP] 3 [/SUP], Ivan C H Au[SUP] 3 [/SUP], Xi Xiong[SUP] 3 [/SUP], Matthew S H Chung[SUP] 3 [/SUP], Eric H Y Lau[SUP] 4 [/SUP], Benjamin J Cowling[SUP] 4 [/SUP]
Affiliations
Abstract
Background and objectives: Type 2 diabetes mellitus (T2DM) patients with Coronavirus Disease 2019 (COVID-19) have poorer prognosis. Inconclusive evidence suggested dipeptidyl peptidase-4 inhibitors (DPP4i) might reduce inflammation and prevent Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) entry hence further evaluation on DPP4i is needed.
Methods: 1214 Patients with T2DM were admitted with COVID-19 between 21[SUP]st[/SUP] January 2020 and 31[SUP]st[/SUP] January 2021 in Hong Kong. Exposure was DPP4i use within the 90 days prior to admission for COVID-19. Assessed outcomes included clinical deterioration, clinical improvement, low viral load, positive Immunoglobulin G (IgG) antibody, hyperinflammatory syndrome, proportion of IgG antibody, clinical status and length of hospitalization. Multivariable logistic and linear regression models were performed to estimate odds ratios (OR) and their 95% confidence intervals (CI) of event outcomes and continuous outcomes, respectively.
Results: DPP4i users (N=107) was associated with lower odds of clinical deterioration (OR=0.71, 95%CI 0.54 to 0.93, P = 0.013), hyperinflammatory syndrome (OR=0.56, 95%CI 0.45 to 0.69, P < 0.001), invasive mechanical ventilation (OR=0.30, 95%CI 0.21 to 0.42, P < 0.001), reduced length of hospitalization (-4.82 days, 95%CI -6.80 to -2.84, P < 0.001), proportion of positive IgG antibody on day-3 (13% vs 8%, p=0.007) and day-7 (41% vs 26%, P < 0.001), despite lack of association between DPP4i use and in-hospital mortality.
Conclusion: DPP4i use was associated with reduced odds of clinical deterioration and hyperinflammatory syndrome. Prospective studies are warranted to elucidate the role of DPP4i in T2DM and COVID-19.
Keywords: COVID-19; DPP4i; Hyperinflammatory syndrome; In-hospital death; Viral clearance.
. 2021 Dec 1;101307.
doi: 10.1016/j.diabet.2021.101307. Online ahead of print.
Use of DPP4i reduced odds of clinical deterioration and hyperinflammatory syndrome in COVID-19 patients with type 2 diabetes: propensity score analysis of a territory-wide cohort in Hong Kong
Carlos K H Wong[SUP] 1 [/SUP], David T W Lui[SUP] 2 [/SUP], Angel Y C Lui[SUP] 3 [/SUP], Ashley C Y Kwok[SUP] 3 [/SUP], Marshall C H Low[SUP] 3 [/SUP], Kristy T K Lau[SUP] 3 [/SUP], Ivan C H Au[SUP] 3 [/SUP], Xi Xiong[SUP] 3 [/SUP], Matthew S H Chung[SUP] 3 [/SUP], Eric H Y Lau[SUP] 4 [/SUP], Benjamin J Cowling[SUP] 4 [/SUP]
Affiliations
- PMID: 34863934
- DOI: 10.1016/j.diabet.2021.101307
Abstract
Background and objectives: Type 2 diabetes mellitus (T2DM) patients with Coronavirus Disease 2019 (COVID-19) have poorer prognosis. Inconclusive evidence suggested dipeptidyl peptidase-4 inhibitors (DPP4i) might reduce inflammation and prevent Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) entry hence further evaluation on DPP4i is needed.
Methods: 1214 Patients with T2DM were admitted with COVID-19 between 21[SUP]st[/SUP] January 2020 and 31[SUP]st[/SUP] January 2021 in Hong Kong. Exposure was DPP4i use within the 90 days prior to admission for COVID-19. Assessed outcomes included clinical deterioration, clinical improvement, low viral load, positive Immunoglobulin G (IgG) antibody, hyperinflammatory syndrome, proportion of IgG antibody, clinical status and length of hospitalization. Multivariable logistic and linear regression models were performed to estimate odds ratios (OR) and their 95% confidence intervals (CI) of event outcomes and continuous outcomes, respectively.
Results: DPP4i users (N=107) was associated with lower odds of clinical deterioration (OR=0.71, 95%CI 0.54 to 0.93, P = 0.013), hyperinflammatory syndrome (OR=0.56, 95%CI 0.45 to 0.69, P < 0.001), invasive mechanical ventilation (OR=0.30, 95%CI 0.21 to 0.42, P < 0.001), reduced length of hospitalization (-4.82 days, 95%CI -6.80 to -2.84, P < 0.001), proportion of positive IgG antibody on day-3 (13% vs 8%, p=0.007) and day-7 (41% vs 26%, P < 0.001), despite lack of association between DPP4i use and in-hospital mortality.
Conclusion: DPP4i use was associated with reduced odds of clinical deterioration and hyperinflammatory syndrome. Prospective studies are warranted to elucidate the role of DPP4i in T2DM and COVID-19.
Keywords: COVID-19; DPP4i; Hyperinflammatory syndrome; In-hospital death; Viral clearance.