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02-10-2020 | COVID-19 | News

SGLT2 inhibitors unlikely to increase SARS-CoV-2 infection risk

Eleanor McDermid

medwireNews: The incidence of COVID-19 is no higher among people taking sodium-glucose cotransporter (SGLT)2 inhibitors than those taking dipeptidyl peptidase (DPP)-4 inhibitors, research shows.

The researchers note that SGLT2 inhibitors “are associated with promotion of ACE2 activity, which may facilitate viral entry into cells, thereby increasing the susceptibility to clinically evident disease.”

They therefore say their findings “are reassuring and suggest that clinicians can use these agents to improve glycaemic control in people with type 2 diabetes in the primary care setting during the COVID-19 pandemic, particularly given that hyperglycaemia is a poor prognostic outcome of COVID-19.”

Christopher Sainsbury (University of Birmingham, UK) and colleagues used The Health Improvement Network (THIN) database to identify 7676 UK primary care patients taking an SGLT2 inhibitor, and matched them by a propensity score for SGLT2 inhibitor use to an equal number of people taking a DPP-4 inhibitor.

Between January 30 and July 22, 2020, the rates of suspected or confirmed COVID-19 were 19.1 and 19.9 per 1000 person–years in the SGLT2 inhibitor and DPP-4 inhibitor groups, respectively, giving a nonsignificant adjusted hazard ratio of 0.92.

There were 15 cases of confirmed COVID-19 with one death in the SGLT2 inhibitor group and 18 cases with four deaths in the DPP-4 inhibitor group.

Despite the lack of an adverse effect of SGLT2 inhibitors in this study, Sainsbury and team caution that people with diabetes and COVID-19 have reportedly presented with euglycemic ketoacidosis.

“SGLT2 [inhibition] selectively reduces interstitial volume and may exert anti-inflammatory effects, which could further influence outcomes from COVID-19,” they write in Diabetes, Obesity and Metabolism.

“The current recommendation of stopping SGLT2 [inhibition] when admitted to hospital should therefore still be followed in people with type 2 diabetes and COVID-19.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2020 Springer Healthcare Ltd, part of the Springer Nature Group

2 October 2020: The coronavirus pandemic is affecting all healthcare professionals across the globe. Medicine Matters’ focus, in this difficult time, is the dissemination of the latest data to support you in your research and clinical practice, based on the scientific literature. We will update the information we provide on the site, as the data are published. However, please refer to your own professional and governmental guidelines for the latest guidance in your own country.

Diabetes Obes Metab 2020; doi:10.1111/dom.14203