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Article: Use of DPP4i reduced odds of clinical deterioration and hyperinflammatory syndrome in COVID-19 patients with type 2 diabetes: propensity score analysis of a territory-wide cohort in Hong Kong

TitleUse of DPP4i reduced odds of clinical deterioration and hyperinflammatory syndrome in COVID-19 patients with type 2 diabetes: propensity score analysis of a territory-wide cohort in Hong Kong
Authors
KeywordsCOVID-19
DPP4i
Hyperinflammatory syndrome
In-hospital death
Viral clearance
Issue Date2022
PublisherElsevier Masson. The Journal's web site is located at http://www.elsevier-masson.fr/diabetes-metabolism-1262-3636.html
Citation
Diabetes & Metabolism, 2022, v. 48 n. 1, article no. 101307 How to Cite?
AbstractBackground and objectives: Type 2 diabetes mellitus (T2DM) patients with Coronavirus Disease 2019 (COVID-19) have poorer prognosis. Inconclusive evidence suggested dipeptidyl peptidase-4 inhibitors (DPP4i) might reduce inflammation and prevent Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) entry, hence further evaluation on DPP4i is needed. Methods: 1214 Patients with T2DM were admitted with COVID-19 between 21st January 2020 and 31st January 2021 in Hong Kong. Exposure was DPP4i use within the 90 days prior to admission for COVID-19. Assessed outcomes included clinical deterioration, clinical improvement, low viral load, positive Immunoglobulin G (IgG) antibody, hyperinflammatory syndrome, proportion of IgG antibody, clinical status and length of hospitalization. Multivariable logistic and linear regression models were performed to estimate odds ratios (OR) and their 95% confidence intervals (CI) of event outcomes and continuous outcomes, respectively. Results: DPP4i users (N = 107) was associated with lower odds of clinical deterioration (OR=0.71, 95%CI 0.54 to 0.93, P = 0.013), hyperinflammatory syndrome (OR=0.56, 95%CI 0.45 to 0.69, P < 0.001), invasive mechanical ventilation (OR=0.30, 95%CI 0.21 to 0.42, P < 0.001), reduced length of hospitalization (-4.82 days, 95%CI –6.80 to –2.84, P < 0.001), proportion of positive IgG antibody on day-3 (13% vs 8%, p = 0.007) and day-7 (41% vs 26%, P < 0.001), despite lack of association between DPP4i use and in-hospital mortality. Conclusion: DPP4i use was associated with reduced odds of clinical deterioration and hyperinflammatory syndrome. Prospective studies are warranted to elucidate the role of DPP4i in T2DM and COVID-19.
Persistent Identifierhttp://hdl.handle.net/10722/308956
ISSN
2020 Impact Factor: 6.041
2020 SCImago Journal Rankings: 1.480
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorWong, CKH-
dc.contributor.authorLui, DTW-
dc.contributor.authorLui, AYC-
dc.contributor.authorKwok, ACY-
dc.contributor.authorLow, MCH-
dc.contributor.authorLau, KTK-
dc.contributor.authorAu, ICH-
dc.contributor.authorXiong, X-
dc.contributor.authorChung, MSH-
dc.contributor.authorLau, EHY-
dc.contributor.authorCowling, BJ-
dc.date.accessioned2021-12-14T01:38:41Z-
dc.date.available2021-12-14T01:38:41Z-
dc.date.issued2022-
dc.identifier.citationDiabetes & Metabolism, 2022, v. 48 n. 1, article no. 101307-
dc.identifier.issn1262-3636-
dc.identifier.urihttp://hdl.handle.net/10722/308956-
dc.description.abstractBackground and objectives: Type 2 diabetes mellitus (T2DM) patients with Coronavirus Disease 2019 (COVID-19) have poorer prognosis. Inconclusive evidence suggested dipeptidyl peptidase-4 inhibitors (DPP4i) might reduce inflammation and prevent Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) entry, hence further evaluation on DPP4i is needed. Methods: 1214 Patients with T2DM were admitted with COVID-19 between 21st January 2020 and 31st January 2021 in Hong Kong. Exposure was DPP4i use within the 90 days prior to admission for COVID-19. Assessed outcomes included clinical deterioration, clinical improvement, low viral load, positive Immunoglobulin G (IgG) antibody, hyperinflammatory syndrome, proportion of IgG antibody, clinical status and length of hospitalization. Multivariable logistic and linear regression models were performed to estimate odds ratios (OR) and their 95% confidence intervals (CI) of event outcomes and continuous outcomes, respectively. Results: DPP4i users (N = 107) was associated with lower odds of clinical deterioration (OR=0.71, 95%CI 0.54 to 0.93, P = 0.013), hyperinflammatory syndrome (OR=0.56, 95%CI 0.45 to 0.69, P < 0.001), invasive mechanical ventilation (OR=0.30, 95%CI 0.21 to 0.42, P < 0.001), reduced length of hospitalization (-4.82 days, 95%CI –6.80 to –2.84, P < 0.001), proportion of positive IgG antibody on day-3 (13% vs 8%, p = 0.007) and day-7 (41% vs 26%, P < 0.001), despite lack of association between DPP4i use and in-hospital mortality. Conclusion: DPP4i use was associated with reduced odds of clinical deterioration and hyperinflammatory syndrome. Prospective studies are warranted to elucidate the role of DPP4i in T2DM and COVID-19.-
dc.languageeng-
dc.publisherElsevier Masson. The Journal's web site is located at http://www.elsevier-masson.fr/diabetes-metabolism-1262-3636.html-
dc.relation.ispartofDiabetes & Metabolism-
dc.subjectCOVID-19-
dc.subjectDPP4i-
dc.subjectHyperinflammatory syndrome-
dc.subjectIn-hospital death-
dc.subjectViral clearance-
dc.titleUse of DPP4i reduced odds of clinical deterioration and hyperinflammatory syndrome in COVID-19 patients with type 2 diabetes: propensity score analysis of a territory-wide cohort in Hong Kong-
dc.typeArticle-
dc.identifier.emailWong, CKH: carlosho@hku.hk-
dc.identifier.emailLui, DTW: dtwlui@hku.hk-
dc.identifier.emailLau, KTK: kristytk@hku.hk-
dc.identifier.emailChung, MSH: mattcsh@hku.hk-
dc.identifier.emailLau, EHY: ehylau@hku.hk-
dc.identifier.emailCowling, BJ: bcowling@hku.hk-
dc.identifier.authorityWong, CKH=rp01931-
dc.identifier.authorityLui, DTW=rp02803-
dc.identifier.authorityLau, EHY=rp01349-
dc.identifier.authorityCowling, BJ=rp01326-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1016/j.diabet.2021.101307-
dc.identifier.pmid34863934-
dc.identifier.pmcidPMC8632053-
dc.identifier.scopuseid_2-s2.0-85122782868-
dc.identifier.hkuros330896-
dc.identifier.volume48-
dc.identifier.issue1-
dc.identifier.spagearticle no. 101307-
dc.identifier.epagearticle no. 101307-
dc.publisher.placeFrance-

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