Association between type of antihyperglycemic therapy and COVID-19 outcomes in patients with type 2 DM

Abstract

<b>Background:</b> Diabetes mellitus(DM) is a common comorbidity in patients with coronavirus disease(COVID-19) associated with worse outcome. There are some uncertainties regarding the influence of different antihyperglycemic drugs on the COVID-19 prognosis. The objective of our trial was to evaluate association of COVID-19 outcome with different types of DM therapy. <b>Methods:</b> 136 patients with type 2DM and COVID-19 were observed in the Tareev Clinic from 15th April to 30th June, 2020:21(15,4%) received basal and bolus insulins, 60(44,1%)–metformin, 28(20,6%)–sulfonureas, 15(11,0%)–dipeptidyl peptidase type 4 inhibitors, 3(2,2%)–glucagon-like peptide receptor agonists, 7(5,1%)–gliflozins. The control age-sex matched group included 201 normoglycemic patients with COVID-19. ICU admission and death rate has been compared in patients with different types of DM therapy. <b>Results:</b> DM was associated with a higher ICU admission(15,4 vs 8,2%;OR=2,05, 95%CI=1,10-4,68;p=0,01) and death rate(14,7 vs 4,5%;OR=3,62,95%CI=1,31-9,99). Metformin therapy was associated with a lower ICU admission(8,3% vs 21,1%; OR=0,34, 95%CI=0,12-0,99; p=0,03) and death rate(5,0% vs 22,4%; OR=0,18, 95%CI=0,05-0,66; p=0,004) compared with other types of DM therapy. There was no association with ICU admission or death rate and other types of DM drugs. ICU admission (8,3% vs 8,2%) and death rate (5,0% vs 4,5%) rate were not statistically different in DM with metformin therapy and control normoglycemic group. <b>Conclusion:</b> Our results indicate clear association between metformin therapy and lower ICU admission and death rate in patients with type 2 DM and COVID-19, that must be further investigated in larger trials.