Al-Kuraishy Hayder M, Al-Gareeb Ali I, Albogami Sarah M, Jean-Marc Sabatier, Nadwa Eman Hassan, Hafiz Amin A, A Negm Walaa, Kamal Marwa, Al-Jouboury Mohammed, Elekhnawy Engy, Batiha Gaber El-Saber, Waard Michel De
Department of Clinical Pharmacology and Medicine, College of Medicine, AL-Mustansiriyia University, Baghdad 14132, Iraq.
Department of Biotechnology, College of Science, Taif University, Taif 21944, Saudi Arabia.
Pharmaceuticals (Basel). 2022 Nov 7;15(11):1361. doi: 10.3390/ph15111361.
Type 2 diabetes mellitus (T2DM) is a potential risk factor for the development of COVID-19 and is associated with higher severity and mortality rates. T2DM patients are commonly treated with metformin monotherapy or metformin plus sitagliptin. In the present case-control, single-center cohort study, a total number of 112 T2DM patients suffering from COVID-19 and aged 44−62 years old were compared with 78 T2DM patients without COVID-19 and aged 42−56 years old. Both the patient group and the control group were allocated into four groups. Group A: T2DM patients with COVID-19 on metformin treatments plus standard therapy (n = 60); group B: T2DM patients with COVID-19 on metformin plus sitagliptin plus standard therapy (n = 52); group C: T2DM patients without COVID-19 on metformin treatments (n = 40); and group D: T2DM patients without COVID-19 on metformin plus sitagliptin (n = 38). The investigation duration was 2−3 weeks. Anthropometric measurements, serological and biochemical investigations, pulmonary radiological findings, and clinical outcomes were evaluated. Only 101 T2DM patients with COVID-19 continued the study, 71 (70.29%) with mild-moderate COVID-19 and 30 (29.7%) with severe COVID-19 were compared with 78 T2DM patients as a control. Inflammatory biomarkers (C reactive protein, ferritin, and procalcitonin), a lung injury biomarker (lactate dehydrogenase), and a coagulopathy biomarker (D-dimer) were elevated in severe COVID-19 patients compared with mild-moderate COVID-19 (p < 0.05) and T2DM patients (p < 0.05). However, metformin plus sitagliptin was more effective than metformin monotherapy in T2DM patients with COVID-19, as evidenced by the mitigation of oxidative stress, CT scan score, and clinical outcomes. The present study confirmed the protective effects of this combination against the development of COVID-19 severity, as most T2DM COVID-19 patients develop mild-moderate forms. Herein, the combination of metformin and sitagliptin may lead to more beneficial effects than metformin monotherapy.
2型糖尿病（T2DM）是新冠病毒病（COVID-19）发生的一个潜在风险因素，且与更高的严重程度和死亡率相关。T2DM患者通常采用二甲双胍单药治疗或二甲双胍联合西他列汀治疗。在本病例对照单中心队列研究中，将112例年龄在44 - 62岁的患有COVID-19的T2DM患者与78例年龄在42 - 56岁的未患COVID-19的T2DM患者进行比较。患者组和对照组均分为四组。A组：接受二甲双胍治疗加标准治疗的COVID-19的T2DM患者（n = 60）；B组：接受二甲双胍联合西他列汀加标准治疗的COVID-19的T2DM患者（n = 52）；C组：接受二甲双胍治疗的未患COVID-19的T2DM患者（n = 40）；D组：接受二甲双胍联合西他列汀治疗的未患COVID-19的T2DM患者（n = 38）。研究持续时间为2 - 3周。评估了人体测量学指标、血清学和生化指标、肺部影像学表现及临床结局。仅有101例患有COVID-19的T2DM患者继续参与研究，将71例（70.29%）患有轻 - 中度COVID-19的患者和30例（29.7%）患有重度COVID-19的患者与78例T2DM患者作为对照进行比较。与轻 - 中度COVID-19患者（p < 0.05）和T2DM患者（p < 0.05）相比，重度COVID-19患者的炎症生物标志物（C反应蛋白、铁蛋白和降钙素原）、肺损伤生物标志物（乳酸脱氢酶）和凝血病生物标志物（D - 二聚体）升高。然而，对于患有COVID-19的T2DM患者，二甲双胍联合西他列汀比二甲双胍单药治疗更有效，氧化应激减轻、CT扫描评分及临床结局均证明了这一点。本研究证实了这种联合用药对COVID-19严重程度发展的保护作用，因为大多数患有COVID-19的T2DM患者表现为轻 - 中度形式。在此，二甲双胍和西他列汀联合使用可能比二甲双胍单药治疗产生更有益的效果。
