Division of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, Padjadjaran University, Bandung, West Java 45363, Indonesia.
Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Karawaci, Tangerang 15811, Indonesia.
Diabetes Res Clin Pract. 2023 Jan;195:110205. doi: 10.1016/j.diabres.2022.110205. Epub 2022 Dec 9.
This study aims to examine the effectiveness of using sodium glucose transporter-2 inhibitor (SGLT-2i) before hospital admission on Covid-19 outcomes in diabetic patients.
A literature search was conducted using specific keywords until October 24th, 2022 on 4 databases: Medline, Scopus, Cochrane Library, and ClinicalTrials.gov. All articles regarding SGLT-2i in diabetic patients with Covid-19 were included in the study. Outcomes in this study were calculated using random-effect models to generate pooled odds ratio (OR) with 95% confidence intervals (CI).
A total of 17 studies were included in the analysis. Our meta-analysis showed that pre-admission use of SGLT-2i was associated with reduced mortality (OR 0.69; 95 %CI: 0.56 - 0.87, p = 0.001, I = 91 %) and severity of Covid-19 (OR 0.88; 95 %CI: 0.80 - 0.97, p = 0.008, I = 13 %). This benefit of SGLT-2i on Covid-19 mortality was not significantly affected by patient's factors such as age (p = 0.2335), sex (p = 0.2742), hypertension (p = 0.2165), heart failure (p = 0.1616), HbA1c levels (p = 0.4924), metformin use (p = 0.6617), duration of diabetes (p = 0.7233), and BMI (p = 0.1797).
This study suggests that SGLT-2i as glucose lowering treatment in patients with diabetes has a positive effect on Covid-19 outcomes, therefore can be considered as an antidiabetic drug of choice, especially during the Covid-19 pandemic. Short Title: SGLT-2i in diabetes and Covid-19.
CRD42022369784.
本研究旨在探讨糖尿病患者入院前使用钠-葡萄糖协同转运蛋白-2 抑制剂(SGLT-2i)对新冠病毒感染结局的影响。
使用特定关键词在 4 个数据库(Medline、Scopus、Cochrane 图书馆和 ClinicalTrials.gov)进行文献检索,检索时间截至 2022 年 10 月 24 日。所有关于新冠病毒感染合并糖尿病患者使用 SGLT-2i 的文章均纳入本研究。使用随机效应模型计算本研究中的结局指标,以生成汇总优势比(OR)及其 95%置信区间(CI)。
共有 17 项研究纳入分析。荟萃分析显示,入院前使用 SGLT-2i 可降低死亡率(OR 0.69;95%CI:0.56 - 0.87,p = 0.001,I² = 91%)和新冠病毒感染严重程度(OR 0.88;95%CI:0.80 - 0.97,p = 0.008,I² = 13%)。SGLT-2i 对新冠病毒感染死亡率的这种获益不受患者年龄(p = 0.2335)、性别(p = 0.2742)、高血压(p = 0.2165)、心力衰竭(p = 0.1616)、糖化血红蛋白水平(p = 0.4924)、二甲双胍使用(p = 0.6617)、糖尿病病程(p = 0.7233)和体重指数(p = 0.1797)等因素的显著影响。
本研究表明,SGLT-2i 作为糖尿病患者的降糖治疗药物对新冠病毒感染结局有积极影响,因此可考虑将其作为新冠大流行期间的首选降糖药物。简短标题:SGLT-2i 在糖尿病和新冠病毒感染中的应用。
CRD42022369784。