Impact of Antidiabetic Drugs on Risk and Outcome of Covid-19 Infection: A Review

Abstract

Based on many reports, an unmistakable link probably exists between diabetes mellitus and COVID-19. A major predisposing factor determining severity and mortality of COVID-19 is diabetes mellitus, diabetic patients were shown to be at higher risk for developing severe COVID-19 disease than non-diabetics; many recent studies reported a striking prevalence of DM in those diagnosed with COVID-19. Accordingly, antidiabetic drugs can possibly impact the clinical course and / or the outcome of this infection, either by alleviating diabetes-associated symptoms, minimizing its complications, or by mitigating or aggravating COVID-19 disease by effects independent from their direct antidiabetic effects. Several antidiabetic drug classes were shown to have varying effects, like blocking viral entry to cells, as well as having immunomodulatory, anti-inflammatory, antifibrotic, or cardioprotective effects; such effects could prove beneficial for COVID-19 patients. On the other hand, some antidiabetic agents may have adverse effects that aggravate patients' condition like hypoglycemia, fluid retention, increased weight or lactic acidosis, which require special consideration in patient management. Some of the drugs were found in observational studies to either reduce mortality from COVID-19 or pose no harm, but more solid evidence from clinical trials is still lacking.

Effects of Hydroxychloroquine on markers of oxidative stress and antioxidant reserve in rheumatoid arthritis patients

“…Finally, the current study shows that HCQ was a highly significant improvement in oxidative stress parameter (MDA), and TG concentrations in the serum patients with RA compared with RA patients on conventional therapy and control and was a highly significant improvement in MDA and TG levels in comparison with conventional therapy. It is worthy to mention that hydroxychloroquine is used in COVID-19 with an obscure mechanism of action [45][46][47][48][49], either alone or with zinc as a cofactor for potential therapy [50]. While the proposed mechanism also involved reduced oxidative and pro-inflammatory damage, nonetheless, these data need further confirmation at a molecular level to confirm the therapeutic activities.…”

Estimation of Oxidative Stress and Antioxidant Capacity in Covid-19 Patients, Cured Patients and Persons Taking Vaccine

“…This is because the vaccine's spike protein does not bind to ACE2. These pathways of coronavirus utilization to invade the host has been extensively reviewed by Adnan et al and the review has confirmed some antihypertensive drugs could be used whilst other should not be used, similarly antidiabetic and medication for various diseases has been reported to be safe or carrying deleterious impact on COVID-19 and associated illness; these could subsequently affect the course of vaccination or admission therapy (36).…”

The Correlation between Age and Coronavirus Infections

“…or patients' history of previous medications should be considered from the point of view of polypharmacy and its impact on geriatric patients [55][56][57][58], moreover, some drugs are tonic multivitamins [59][60][61]or zinc [62][63][64]which cud be used as add-on therapy for patients with other diseases and greatly impact the disease outcome or pathogenicity.…”