Association of Premorbid GLP-1RA and SGLT-2i Prescription Alone and in Combination with COVID-19 Severity

• DOI: 10.1007/s13300-024-01562-1
• Publication Date: 2024-03-27T06:39:41Z
• Authors: Klara R. Klein; Trine J. Abrahamsen; Anna R. Kahkoska; G. Caleb Alexander; Christopher G. Chute; Melissa Haendel; Stephanie S. Hong; Hemalkumar Mehta; Richard Moffitt; Til Stürmer; Kajsa Kvist; John B. Buse
• Keywords: Concomitant; Incretin

People with type 2 diabetes are at heightened risk for severe outcomes related to COVID-19 infection, including hospitalization, intensive care unit admission, and mortality. This study was designed examine the impact of premorbid use glucagon-like peptide-1 receptor agonist (GLP-1RA) monotherapy, sodium-glucose cotransporter-2 inhibitor (SGLT-2i) concomitant GLP1-RA/SGLT-2i therapy on severity in individuals acute respiratory syndrome coronavirus (SARS-CoV-2) infection. Utilizing observational data from National COVID Cohort Collaborative through September 2022, we compared 78,806 a prescription GLP-1RA SGLT-2i versus dipeptidyl peptidase 4 inhibitors (DPP-4i) within 24 months positive SARS-CoV-2 PCR test. We also GLP-1RA/SGLT-2i monotherapy. The primary outcome 60-day mortality, measured test date. Secondary included emergency room (ER) visits, mechanical ventilation 14 days. Using super learner approach accounting baseline characteristics, associations were quantified odds ratios (OR) estimated targeted maximum likelihood estimation (TMLE). Use (OR 0.64, 95% confidence interval [CI] 0.56–0.72) 0.62, CI 0.57–0.68) associated lower mortality DPP-4i use. Additionally, OR ER visits hospitalizations similarly reduced GLP1-RA Concomitant showed similar when or alone 0.92, 0.81–1.05 0.88, 0.76–1.01, respectively). However, all secondary alone. Among adults who tested SARS-CoV-2, either is DPP-4i. Furthermore, linked other outcomes, hospitalizations, ventilation, Graphical abstract available this article.