Skip to main content

Table 2 How notable studies reported the association of glucose-lowering drug classes with different outcomes in Covid-19

From: The management of type 2 diabetes before, during and after Covid-19 infection: what is the evidence?

Study Metformin SGLT2 inhibitors GLP-1 RA DPP-4 inhibitors Insulin
 ~ 3 million patients with type 2 diabetes, including ~ 13,500 who died due to Covid-19, in a UK nationwide population cohort [23] Covid-19 mortality less likely vs no metformin Covid-19 mortality less likely vs no SGLT2i No significant difference in Covid-19 mortality vs no GLP-1 RA Covid-19 mortality more likely vs no DPP-4i Covid-19 mortality more likely vs no insulin
 ~ 12,500 patients with a positive Covid-19 test in a US longitudinal cohort (N3C) [88] Not investigated Lower rates of 60-day mortality, ER visits and hospitalization vs DPP-4i Lower rates of 60-day mortality, ER visits and hospitalization vs DPP-4i 60-day mortality, ER visits and hospitalization more likely vs SGLT2i or GLP-1 RA Not investigated
1970 people on GLP-1 RA, SGLT2i or DPP-4i in nationwide registries in Denmark who were infected with Covid-19 [95] Not investigated No significant differences to GLP-1 RA or DPP-4i, but a trend towards reduced 30-day mortality vs DPP-4i No significant difference to SGLT2i A non-significant trend towards increased 30-day mortality vs SGLT2i Not investigated
2666 patients with type 2 diabetes in a nationwide Covid-19 registry in Spain (SEMI-COVID-19) [121] No significant differences after propensity matching Not investigated Not investigated No significant differences after propensity matching No significant differences after propensity matching
2796 patients with diabetes hospitalized for Covid-19 in a nationwide study in France (CORONADO) [10, 82, 96] 28-day mortality less likely vs insulin or no metformin Not investigated Not investigated Neutral effect vs patients not on DPP-4i [96] 28-day mortality more likely vs metformin
 ~ 25,000 patients on SGLT2i or DPP-4i in UK primary care [122] Not investigated Similar likelihood of Covid-19 onset vs DPP-4i Not investigated Similar likelihood of Covid-19 onset vs SGLT2i Not investigated
Randomized control trial of dapagliflozin vs placebo in 1250 patients hospitalized with Covid-19 (DARE-19) [106] Not investigated No significant difference but trend towards reduced organ failure and death vs placebo Not investigated Not investigated Not investigated
8121 patients hospitalized for Covid‐19 in a meta-analysis of five studies [123] Mortality less likely vs no metformin Not investigated Not investigated Not investigated Not investigated
7008 patients with Covid‐19 and diabetes in a meta-analysis of nine studies [83] Not investigated Not investigated Not investigated In-hospital administration associated with reduced mortality vs no DPP-4i, but overall neutral effect Not investigated
6256 patients with type 2 diabetes in a US claims database [79] Mortality less likely vs no metformin (in women only) Not investigated Not investigated Not investigated Not investigated
  1. Reported associations do not exclude confounding effects, and may be due to differences in patient characteristics rather than intrinsic drug properties