Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
Health Research Institute of Santiago de Compostela (FIDIS), Santiago de Compostela, Spain.
J Antimicrob Chemother. 2023 Sep 5;78(9):2335-2342. doi: 10.1093/jac/dkad241.
Dapagliflozin has been proposed as a potential treatment for coronavirus disease 2019 (COVID-19) by reducing cytokine production and inflammation. However, there are limited data on its effectiveness. We aimed to evaluate the impact of dapagliflozin on COVID-19 severity (including hospitalization risk, ICU admission, in-hospital death and progression to severe COVID-19) and its potential on susceptibility to COVID-19 infection.
We conducted a population-based case-control study. For aim 1, we assessed COVID-19 severity in cases (positive PCR patients requiring hospitalization) and matched controls (negative PCR patients or positive PCR patients not requiring hospitalization). For aim 2, we compared positive PCR cases (hospitalized and non-hospitalized) with controls. Adjusted odds ratios (aORs) were calculated using a generalized linear mixed model.
We analysed 86 602 subjects: 3060 were hospitalized cases, 26 757 were non-hospitalized cases and 56 785 were controls. Among the hospitalized COVID-19 patients, 228 were admitted to the ICU and 413 died. Dapagliflozin had no effect on the risk of hospitalization (aOR 0.98; 95% CI 0.65-1.48; P = 0.915), ICU admissions (aOR 1.21; 95% CI 0.34-4.25; P = 0.767) or in-hospital death (aOR 1.33; 95% CI 0.53-3.30; P = 0.543). Dapagliflozin reduced the risk of progression to severe COVID-19 by 35%, but this was not statistically significant (aOR 0.65; 95% CI 0.40-1.06; P = 0.086). Dapagliflozin was associated with a 30% increased risk of susceptibility to COVID-19 infection (aOR 1.31; 95% CI 1.05-1.62; P = 0.015).
Use of dapagliflozin prior to SARS-CoV-2 infection was not associated with an increased risk of hospitalization, ICU admission, mortality or progression to severe COVID-19. However, it was associated with an increased risk of susceptibility to COVID-19 infection.
达格列净被认为通过减少细胞因子产生和炎症反应，可作为治疗 2019 年冠状病毒病（COVID-19）的潜在方法。然而，其疗效的数据有限。我们旨在评估达格列净对 COVID-19 严重程度（包括住院风险、入住 ICU、院内死亡和进展为重症 COVID-19）的影响及其对 COVID-19 感染易感性的潜在影响。
我们进行了一项基于人群的病例对照研究。目的 1 中，我们评估了病例（需要住院的阳性 PCR 患者）和匹配对照（阴性 PCR 患者或无需住院的阳性 PCR 患者）的 COVID-19 严重程度。目的 2 中，我们比较了阳性 PCR 病例（住院和非住院）与对照。使用广义线性混合模型计算调整后的优势比（aOR）。
我们分析了 86602 名受试者：3060 名住院病例、26757 名非住院病例和 56785 名对照。在住院 COVID-19 患者中，228 人入住 ICU，413 人死亡。达格列净对住院风险（aOR 0.98；95%CI 0.65-1.48；P=0.915）、入住 ICU（aOR 1.21；95%CI 0.34-4.25；P=0.767）或院内死亡（aOR 1.33；95%CI 0.53-3.30；P=0.543）的风险没有影响。达格列净降低了 COVID-19 进展为重症的风险 35%，但无统计学意义（aOR 0.65；95%CI 0.40-1.06；P=0.086）。达格列净与 COVID-19 感染易感性增加 30%相关（aOR 1.31；95%CI 1.05-1.62；P=0.015）。
在感染 SARS-CoV-2 之前使用达格列净与住院、入住 ICU、死亡率或进展为重症 COVID-19 的风险增加无关。然而，它与 COVID-19 感染易感性增加有关。
