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<p>Dipeptidyl peptidase-4 inhibitors (DPP-4is) have been hypothesized to impact COVID-19 outcomes by modulating immune and inflammatory responses. This study aimed to assess the association between DPP-4i use and COVID-19 severity in patients with type 2 diabetes. Adult (≥ 18 years) patients with T2DM hospitalized for COVID-19 across seven hospitals in Saudi Arabia between March 2020 and November 2021 were included. Outcomes were in-hospital mortality, progression to mechanical ventilation (MV), intensive care unit (ICU) admission, and length of stay. We performed time-to-event analyses using Cox proportional hazards models with propensity score weighting to account for confounders. Ordinal proportional odds model were for the length of stay outcomes. A total of 166 patients were included in the DPP-4i group, and 351 were included in the non-DPP-4i group. Propensity score weighting achieved a well-balanced comparison between the groups. The DPP-4i group showed a nonsignificant decrease in mortality (adjusted hazard ratio [HRadj] = 0.73; 95% confidence interval [CI]: 0.40–1.34; <i>p</i> = 0.319), a significant reduction in progression to MV (HRadj = 0.40; 95% CI: 0.21–0.77; <i>p</i> = 0.006), and a nonsignificant reduction in ICU admissions (HRadj = 0.83; 95% CI: 0.57–1.21; <i>p</i> = 0.338). Length of stay did not differ significantly between groups. This study revealed that prior usage of DPP-4is in T2DM patients with COVID-19 is linked to a significant reduction in progression to MV in this high-risk group. However, there is a need for further investigation through well-powered prospective studies and randomized controlled trials to confirm these findings.</p>

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DPP4 inhibitors and COVID19 outcomes in patients with type II diabetes: a multicenter retrospective cohort study in Saudi Arabia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月10日

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  • El Walid El Hassan,
  • Ahmad Alamer,
  • Sarah Saad Alnami,
  • Ibrahem Abdullah Alhawaj,
  • Ali Hussain Alsmail,
  • Mohammed Abdulhadi Alshawaf,
  • Muhammad Abdulhaddi Aljazeeri,
  • Maram Jafar Alghafli,
  • Fatimah Yahya Alhejji,
  • Osamah M. Alfayez,
  • Mayar Mohammed Alharthi,
  • Hamzah Redha Alturfi,
  • Maha Fahad AlEssa,
  • Rahaf Hamoud Alzuman,
  • Sawsan M. Kurdi,
  • Omar A. Almohammed,
  • Abdulaziz S. Almulhim,
  • Majed S. Al Yami

摘要

Dipeptidyl peptidase-4 inhibitors (DPP-4is) have been hypothesized to impact COVID-19 outcomes by modulating immune and inflammatory responses. This study aimed to assess the association between DPP-4i use and COVID-19 severity in patients with type 2 diabetes. Adult (≥ 18 years) patients with T2DM hospitalized for COVID-19 across seven hospitals in Saudi Arabia between March 2020 and November 2021 were included. Outcomes were in-hospital mortality, progression to mechanical ventilation (MV), intensive care unit (ICU) admission, and length of stay. We performed time-to-event analyses using Cox proportional hazards models with propensity score weighting to account for confounders. Ordinal proportional odds model were for the length of stay outcomes. A total of 166 patients were included in the DPP-4i group, and 351 were included in the non-DPP-4i group. Propensity score weighting achieved a well-balanced comparison between the groups. The DPP-4i group showed a nonsignificant decrease in mortality (adjusted hazard ratio [HRadj] = 0.73; 95% confidence interval [CI]: 0.40–1.34; p = 0.319), a significant reduction in progression to MV (HRadj = 0.40; 95% CI: 0.21–0.77; p = 0.006), and a nonsignificant reduction in ICU admissions (HRadj = 0.83; 95% CI: 0.57–1.21; p = 0.338). Length of stay did not differ significantly between groups. This study revealed that prior usage of DPP-4is in T2DM patients with COVID-19 is linked to a significant reduction in progression to MV in this high-risk group. However, there is a need for further investigation through well-powered prospective studies and randomized controlled trials to confirm these findings.