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Glucose-lowering drugs and outcome from COVID-19 among patients with type 2 diabetes mellitus: a population-wide analysis in Hong Kong.
Luk, Andrea On Yan; Yip, Terry C F; Zhang, Xinge; Kong, Alice Pik Shan; Wong, Vincent Wai-Sun; Ma, Ronald Ching Wan; Wong, Grace Lai-Hung.
  • Luk AOY; Department of Medicine and Therapeutics, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong Special Administrative Region, People's Republic of China.
  • Yip TCF; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.
  • Zhang X; Department of Medicine and Therapeutics, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong Special Administrative Region, People's Republic of China.
  • Kong APS; Department of Medicine and Therapeutics, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong Special Administrative Region, People's Republic of China.
  • Wong VW; Department of Medicine and Therapeutics, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong Special Administrative Region, People's Republic of China.
  • Ma RCW; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.
  • Wong GL; Department of Medicine and Therapeutics, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong Special Administrative Region, People's Republic of China.
BMJ Open ; 11(10): e052310, 2021 10 20.
Article in English | MEDLINE | ID: covidwho-1476607
ABSTRACT

OBJECTIVES:

To investigate the association between baseline use of glucose-lowering drugs and serious clinical outcome among patients with type 2 diabetes.

DESIGN:

Territory-wide retrospective cohort of confirmed cases of COVID-19 between January 2020 and February 2021.

SETTING:

All public health facilities in Hong Kong.

PARTICIPANTS:

1220 patients with diabetes who were admitted for confirmed COVID-19. PRIMARY AND SECONDARY OUTCOME

MEASURES:

Composite clinical endpoint of intensive care unit admission, requirement of invasive mechanical ventilation and/or in-hospital death.

RESULTS:

In this cohort (median age 65.3 years, 54.3% men), 737 (60.4%) patients were treated with metformin, 385 (31.6%) with sulphonylureas, 199 (16.3%) with dipeptidyl peptidase-4 (DPP-4) inhibitors and 273 (22.4%) with insulin prior to admission. In multivariate Cox regression, use of metformin and DPP-4 inhibitors was associated with reduced incidence of the composite endpoint relative to non-use, with respective HRs of 0.51 (95% CI 0.34 to 0.77, p=0.001) and 0.46 (95% CI 0.29 to 0.71, p<0.001), adjusted for age, sex, diabetes duration, glycated haemoglobin (HbA1c), smoking, comorbidities and drugs. Use of sulphonylureas (HR 1.55, 95% CI 1.07 to 2.24, p=0.022) and insulin (HR 6.34, 95% CI 3.72 to 10.78, p<0.001) were both associated with increased hazards of the composite endpoint.

CONCLUSIONS:

Users of metformin and DPP-4 inhibitors had fewer adverse outcomes from COVID-19 compared with non-users, whereas insulin and sulphonylurea might predict a worse prognosis.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pharmaceutical Preparations / Diabetes Mellitus, Type 2 / Dipeptidyl-Peptidase IV Inhibitors / COVID-19 / Metformin Type of study: Cohort study / Observational study / Prognostic study Limits: Aged / Female / Humans / Male Country/Region as subject: Asia Language: English Journal: BMJ Open Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pharmaceutical Preparations / Diabetes Mellitus, Type 2 / Dipeptidyl-Peptidase IV Inhibitors / COVID-19 / Metformin Type of study: Cohort study / Observational study / Prognostic study Limits: Aged / Female / Humans / Male Country/Region as subject: Asia Language: English Journal: BMJ Open Year: 2021 Document Type: Article