COVID-19 clinical outcomes in type-2 diabetic patients on DPP4-inhibitors

Atousa Najmaldin; Pardis Sadeghipour; Hoda Aryan; Homa Abri; Nahid Hashemi-Madani; Nadaer Tavakoli; Mohammad Ebrahim Khamseh

Atousa Najmaldin Department of Internal Medicine, Kowsar Hospital, Semnan University of Medical Medicine, Semnan, Iran https://orcid.org/0000-0002-8434-1341
Pardis Sadeghipour Department of Internal Medicine, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran https://orcid.org/0000-0002-9260-4279
Hoda Aryan Department of Internal Medicine, Kowsar Hospital, Semnan University of Medical Medicine, Semnan, Iran https://orcid.org/0000-0002-1480-8460
Homa Abri Department of Internal Medicine, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran https://orcid.org/0000-0003-1859-8023
Nahid Hashemi-Madani Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran https://orcid.org/0000-0002-6134-9906
Nadaer Tavakoli Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran https://orcid.org/0000-0002-5767-7771
Mohammad Ebrahim Khamseh Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran https://orcid.org/0000-0003-4313-8440

Keywords: COVID-19 infection, ICU admission, mortality, severity, type 2 diabetes

Abstract

It has been suggested that dipeptidyl peptidase 4 (DPP4) overexpression is associated with COVID-19 severity. We aimed to evaluate the clinical outcomes in people with COVID-19 infections and type 2 diabetes (T2DM) treated with DPP4 inhibitors in order to explore the impact of treatment with DPP4 inhibitors on adverse in-hospital outcomes. This retrospective multi-center study included 400 hospitalized people with T2DM and confirmed COVID-19 infection. The composite outcomes, including ICU admission, invasive ventilation and in-hospital mortality, were compared between patients who received DPP4 inhibitors before admission and those treated by other glucose-lowering drugs (GLDs), applying regression models. A total of 54 (13.5%) patients were treated with DPP4 inhibitors. Considering the potential confounders, the odds of the composite outcome of intensive care unit (ICU) admission, invasive ventilation, and death were significantly lower in patients treated with DPP4 inhibitors compared to their counterpart group (OR: 2.52, (1.05–6.01), P=0.04). Previous treatment with DPP4 inhibitors lowers the risk of adverse in-hospital outcomes in people with T2DM and COVID-19 infection.