Hassan El Walid El, Alamer Ahmad, Alnami Sarah Saad, Alhawaj Ibrahem Abdullah, Alsmail Ali Hussain, Alshawaf Mohammed Abdulhadi, Aljazeeri Muhammad Abdulhaddi, Alghafli Maram Jafar, Alhejji Fatimah Yahya, Alfayez Osamah M, Alharthi Mayar Mohammed, Alturfi Hamzah Redha, AlEssa Maha Fahad, Alzuman Rahaf Hamoud, Kurdi Sawsan M, Almohammed Omar A, Almulhim Abdulaziz S, Al Yami Majed S
Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al Ahsa, Saudi Arabia.
Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia.
Cardiovasc Diabetol Endocrinol Rep. 2025 May 10;11(1):9. doi: 10.1186/s40842-025-00221-z.
Dipeptidyl peptidase-4 inhibitors (DPP-4is) have been hypothesized to impact COVID-19 outcomes by modulating immune and inflammatory responses. This study aimed to assess the association between DPP-4i use and COVID-19 severity in patients with type 2 diabetes. Adult (≥ 18 years) patients with T2DM hospitalized for COVID-19 across seven hospitals in Saudi Arabia between March 2020 and November 2021 were included. Outcomes were in-hospital mortality, progression to mechanical ventilation (MV), intensive care unit (ICU) admission, and length of stay. We performed time-to-event analyses using Cox proportional hazards models with propensity score weighting to account for confounders. Ordinal proportional odds model were for the length of stay outcomes. A total of 166 patients were included in the DPP-4i group, and 351 were included in the non-DPP-4i group. Propensity score weighting achieved a well-balanced comparison between the groups. The DPP-4i group showed a nonsignificant decrease in mortality (adjusted hazard ratio [HRadj] = 0.73; 95% confidence interval [CI]: 0.40-1.34; p = 0.319), a significant reduction in progression to MV (HRadj = 0.40; 95% CI: 0.21-0.77; p = 0.006), and a nonsignificant reduction in ICU admissions (HRadj = 0.83; 95% CI: 0.57-1.21; p = 0.338). Length of stay did not differ significantly between groups. This study revealed that prior usage of DPP-4is in T2DM patients with COVID-19 is linked to a significant reduction in progression to MV in this high-risk group. However, there is a need for further investigation through well-powered prospective studies and randomized controlled trials to confirm these findings.
二肽基肽酶-4抑制剂（DPP-4i）被认为可通过调节免疫和炎症反应来影响新冠病毒病（COVID-19）的预后。本研究旨在评估2型糖尿病患者使用DPP-4i与COVID-19严重程度之间的关联。纳入了2020年3月至2021年11月期间在沙特阿拉伯七家医院因COVID-19住院的成年（≥18岁）2型糖尿病患者。结局指标包括住院死亡率、进展为机械通气（MV）、入住重症监护病房（ICU）以及住院时间。我们使用Cox比例风险模型并结合倾向评分加权进行事件发生时间分析，以考虑混杂因素。对于住院时间结局指标，使用了有序比例优势模型。DPP-4i组共纳入166例患者，非DPP-4i组共纳入351例患者。倾向评分加权实现了两组之间良好的均衡比较。DPP-4i组死亡率呈非显著性下降（调整后风险比[HRadj]=0.73；95%置信区间[CI]：0.40-1.34；p=0.319），进展为MV显著减少（HRadj=0.40；95%CI：0.21-0.77；p=0.006），入住ICU呈非显著性减少（HRadj=0.83；95%CI：0.57-1.21；p=0.338）。两组住院时间差异无统计学意义。本研究表明，COVID-19的2型糖尿病患者先前使用DPP-4i与该高危组进展为MV的显著减少有关。然而，需要通过有充分统计学效力的前瞻性研究和随机对照试验进行进一步调查，以证实这些发现。
