Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, Korea.
Data Science Team, Hanmi Pharm. Co. Ltd., Seoul, Korea.
Diabetes Metab J. 2021 Mar;45(2):251-259. doi: 10.4093/dmj.2020.0206. Epub 2021 Mar 5.
Dipeptidyl peptidase-4 inhibitor (DPP-4i) and renin-angiotensin system (RAS) blockade are reported to affect the clinical course of coronavirus disease 2019 (COVID-19) in patients with diabetes mellitus (DM).
As of May 2020, analysis was conducted on all subjects who could confirm their history of claims related to COVID-19 in the National Health Insurance Review and Assessment Service (HIRA) database in Korea. Using this dataset, we compared the short-term prognosis of COVID-19 infection according to the use of DPP-4i and RAS blockade. Additionally, we validated the results using the National Health Insurance Service (NHIS) of Korea dataset.
Totally, data of 67,850 subjects were accessible in the HIRA dataset. Of these, 5,080 were confirmed COVID-19. Among these, 832 subjects with DM were selected for analysis in this study. Among the subjects, 263 (31.6%) and 327 (39.3%) were DPP4i and RAS blockade users, respectively. Thirty-four subjects (4.09%) received intensive care or died. The adjusted odds ratio for severe treatment among DPP-4i users was 0.362 (95% confidence interval [CI], 0.135 to 0.971), and that for RAS blockade users was 0.599 (95% CI, 0.251 to 1.431). These findings were consistent with the analysis based on the NHIS data using 704 final subjects. The adjusted odds ratio for severe treatment among DPP-4i users was 0.303 (95% CI, 0.135 to 0.682), and that for RAS blockade users was 0.811 (95% CI, 0.391 to 1.682).
This study suggests that DPP-4i is significantly associated with a better clinical outcome of patients with COVID-19.
二肽基肽酶-4 抑制剂（DPP-4i）和肾素-血管紧张素系统（RAS）阻滞剂被报道会影响糖尿病（DM）患者 2019 年冠状病毒病（COVID-19）的临床病程。
截至 2020 年 5 月，对韩国国民健康保险审查与评估服务（HIRA）数据库中所有能够确认与 COVID-19 相关索赔记录的患者进行了分析。使用该数据集，我们比较了 DPP-4i 和 RAS 阻滞剂使用情况下 COVID-19 感染的短期预后。此外，我们还使用了韩国国民健康保险服务（NHIS）数据集来验证结果。
在 HIRA 数据集中共获得了 67850 名患者的数据。其中，5080 例确诊 COVID-19。在这些患者中，选择了 832 例 DM 患者进行本研究分析。其中，263 例（31.6%）和 327 例（39.3%）分别为 DPP4i 和 RAS 阻滞剂使用者。34 例（4.09%）患者接受了重症监护或死亡。DPP-4i 使用者严重治疗的调整比值比为 0.362（95%置信区间[CI]，0.135 至 0.971），RAS 阻滞剂使用者为 0.599（95%CI，0.251 至 1.431）。这些发现与使用最终 704 名患者的 NHIS 数据进行的分析一致。DPP-4i 使用者严重治疗的调整比值比为 0.303（95%CI，0.135 至 0.682），RAS 阻滞剂使用者为 0.811（95%CI，0.391 至 1.682）。
本研究表明 DPP-4i 与 COVID-19 患者的临床结局显著相关。
