Scopus
🔓 Açık Erişim
Lower COVID-19 Mortality in Patients with Type 2 Diabetes Mellitus Taking Dipeptidyl Peptidase-4 Inhibitors: Results from a Turkish Nationwide Study
Diabetes Therapy · Kasım 2021
Makale Bilgileri
DergiDiabetes Therapy
Yayın TarihiKasım 2021
Cilt / Sayfa12 · 2857-2870
Scopus ID2-s2.0-85112491499
Erişim🔓 Açık Erişim
Özet
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.
Yazarlar (19)
1
Rıfat Emral
2
Cem Haymana
3
Ibrahim Demirci
ORCID: 0000-0002-6808-8550
4
İlker Taşçı
5
Mustafa Sahin
ORCID: 0000-0002-4718-0083
6
Erman Çakal
ORCID: 0000-0003-4455-7276
7
Naim Ata
8
Ugur Unluturk
9
Tevfik Demir
ORCID: 0000-0003-0319-9572
10
Derun Ertugrul
11
Ibrahim Sahin
12
Aysegul Atmaca
13
Osman Celik
14
Murat Caglayan
15
Kazim Yalcin Arga
16
Selçuk Daǧdelen
17
Serpil Salman
18
Ilhan Satman
19
Alper Sonmez
Anahtar Kelimeler
Anti-diabetic agents
COVID-19
DPP-4 inhibitor
Hospitalization
Intensive care unit admission
Mechanical ventilation
Mortality
Type 2 diabetes mellitus
Kurumlar
Ankara Provincial Health Directorate
Ankara Turkey
Ankara Üniversitesi
Ankara Turkey
Dokuz Eylül Üniversitesi
Izmir Turkey
Hacettepe Üniversitesi
Ankara Turkey
Health Institutes of Turkey
Istanbul Turkey
Inönü Üniversitesi Tip Fakültesi
Malatya Turkey
İstanbul Tıp Fakültesi
Istanbul Turkey
Marmara Üniversitesi
Istanbul Turkey
Medica Clinic
Istanbul Turkey
Ondokuz Mayis University, Medical School
Samsun Turkey
T.C. Sağlık Bakanlığı,
Ankara Turkey
University of Health Sciences
Istanbul Turkey
Metrikler
10
Atıf
19
Yazar
8
Anahtar Kelime