Use of dipeptidyl peptidase-4 inhibitors and prognosis of COVID-19 in hospitalized patients with type 2 diabetes: A propensity score analysis from the CORONADO study.

Abstract

AIM:

To investigate the association between routine use of dipeptidyl peptidase-4 (DPP-4) inhibitors and the severity of coronavirus disease 2019 (COVID-19) infection in patient with type 2 diabetes in a large multicentric study.

MATERIALS AND METHODS:

This study was a secondary analysis of the CORONADO study on 2449 patients with type 2 diabetes (T2D) hospitalized for COVID-19 in 68 French centres. The composite primary endpoint combined tracheal intubation for mechanical ventilation and death within 7 days of admission. Stabilized weights were computed for patients based on propensity score (DPP-4 inhibitors users vs. non-users) and were used in multivariable logistic regression models to estimate the average treatment effect in the treated as inverse probability of treatment weighting (IPTW).

RESULTS:

Five hundred and ninety-six participants were under DPP-4 inhibitors before admission to hospital (24.3%). The primary outcome occurred at similar rates in users and non-users of DPP-4 inhibitors (27.7% vs. 28.6%; p = .68). In propensity analysis, the IPTW-adjusted models showed no significant association between the use of DPP-4 inhibitors and the primary outcome by Day 7 (OR [95% CI]: 0.95 [0.77-1.17]) or Day 28 (OR [95% CI]: 0.96 [0.78-1.17]). Similar neutral findings were found between use of DPP-4 inhibitors and the risk of tracheal intubation and death.

CONCLUSIONS:

These data support the safety of DPP-4 inhibitors for diabetes management during the COVID-19 pandemic and they should not be discontinued.

• Authors: Ronan Roussel, Patrice Darmon, Matthieu Pichelin, Thomas Goronflot, Yawa Abouleka, Leila Ait Bachir, Ingrid Allix, Deborah Ancelle, Sara Barraud, Lyse Bordier, Aurélie Carlier, Nicolas Chevalier, Christine Coffin-Boutreux, Emmanuel Cosson, Anne Dorange, Olivier Dupuy, Pierre Fontaine, Bénédicte Fremy, Florence Galtier, Natacha Germain, Anne-Marie Guedj, Etienne Larger, Stéphanie Laugier-Robiolle, Bruno Laviolle, Lisa Ludwig, Arnaud Monier, Nathanaëlle Montanier, Philippe Moulin, Isabelle Moura, Gaëtan Prevost, Yves Reznik, Nadia Sabbah, Pierre-Jean Saulnier, Pierre Serusclat, Camille Vatier, Matthieu Wargny, Samy Hadjadj, Pierre Gourdy, Bertrand Cariou, CORONADO investigators
• Journal: Diabetes, obesity & metabolism (Diabetes Obes Metab) Vol. 23 Issue 5 Pg. 1162-1172 (05 2021) ISSN: 1463-1326 [Electronic] England
• PMID: 33528920 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: © 2021 John Wiley & Sons Ltd.

Chemical References

• Angiotensin Receptor Antagonists
• Angiotensin-Converting Enzyme Inhibitors
• Dipeptidyl-Peptidase IV Inhibitors

Topics

• Aged
• Aged, 80 and over
• Angiotensin Receptor Antagonists
• Angiotensin-Converting Enzyme Inhibitors
• COVID-19 (complications)
• Diabetes Mellitus, Type 2 (complications, drug therapy, epidemiology)
• Dipeptidyl-Peptidase IV Inhibitors (adverse effects, therapeutic use)
• Female
• Humans
• Male
• Middle Aged
• Pandemics
• Prognosis
• Propensity Score
• COVID-19 Drug Treatment