Should anti-diabetic medications be reconsidered amid COVID-19 pandemic?

Pal, Rimesh; Bhadada, Sanjay Kumar

doi:10.1016/j.diabres.2020.108146

Cited by 119 publications

(117 citation statements)

References 9 publications

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“…In addition, good glycemic control should be ensured. Certain anti-diabetic drugs like pioglitazone (via peroxisome proliferator-activated receptor γ activation) and liraglutide (via glucagon-like peptide 1 receptor activation) have been shown to upregulate ACE2 in animal models [11,12]; however, the current evidence does not support any change in the ongoing medications [13]. Similarly, international organizations recommend patients on ACEi/ARBs to carry on with their medications.…”

Section: Covid-19 and Endocrine Pancreasmentioning

confidence: 88%

COVID-19 and the endocrine system: exploring the unexplored

Pal

Banerjee

2020

J Endocrinol Invest

239

235

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Section: Covid-19 and Endocrine Pancreasmentioning

confidence: 88%

COVID-19 and the endocrine system: exploring the unexplored

Pal

Banerjee

2020

J Endocrinol Invest

239

235

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“…Moreover, we missed the data about antidiabetic treatments of patients which might lead to bias in analysis and interpretation, as indicated by Chen et al that insulin users had poor prognosis of COVID-19 [19]. Furthermore, there is also discussion on harmful effects of some oral hypoglycemic agents such as Sodium-Glucose-Transporter-2 inhibitors versus bene cial effects of metformin on COVID-19 infected individuals with diabetes [31,32]. Therefore, further studies investigating impact of different glucose-lowering medications on infected diabetic patients are warranted.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with the Poor Outcomes in Diabetic Patients with COVID-19

Rastad

Ejtahed

Ghorabi

et al. 2020

Preprint

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Abstract Background: Diabetic’s patients are supposed to experience higher rates of COVID-19 related poor outcomes. We aimed to determined factors predicting poor outcomes in hospitalized diabetic patients with COVID-19. Methods: This retrospective cohort study included all adult diabetic patients with radiological or laboratory confirmed COVID-19 who hospitalized between 20 February 2020 and 27 April 2020 in Alborz province, Iran. Data on demographic, medical history, and laboratory test at presentation were obtained from electronic medical records. Diagnosis of diabetes mellitus was self-reported. Comorbidities including cancer, rheumatism, immunodeficiency, or chronic diseases of respiratory, liver, and blood were classified as “other comorbidities” due to low frequency. The assessed poor outcomes were in-hospital mortality, need to ICU care, and receiving invasive mechanical ventilation. Self-reported. Multivariate logistic regression models were fitted to quantify the predictors of in-hospital mortality from COVID-19 in patients with DM. Results: Of 455 included patients, 98(21.5%) received ICU care, 65(14.3%) required invasive mechanical ventilation, and 79 (17.4%) dead. In the multivariate model, significant predictors of “death of COVID-19” were age 65 years or older (OR (95% CI): 2.0 (1.16-3.44), chronic kidney disease (CKD) (2.05 (1.16 -3.62), presence of “other comorbidities” (2.20 (1.04-4.63)), neutrophil count ≥ 8.0 × 10⁹/L )6.62 (3.73-11.7 ((, Hb level <12.5 g/dl (2.05 (1.13-3.72)(, and creatinine level ≥1.36 mg/dl (3.10 (1.38-6.98)). (All p –values < 0.05). Some of these factors were also associated with other assessed poor outcomes, e.g., need to ICU care or invasive mechanical ventilation.Conclusions: Diabetic patients with age 65 years or older, comorbidity CKD, “other comorbidities”, as well as neutrophil count ≥ 8.0 × 10⁹/L, Hb level <12.5 g/dl, and creatinine level ≥1.36 mg/dl, were more likely to dead after COVID-19. Presence of hypertension and cardiovascular disease were associated with none of the poor outcomes.

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“…Indeed, ACEi/ARBs act upregulating the receptor for entry of the virus into host pneumocytes. However, Metformin does not interfere with ACE2, and it is not clear how it could act on patients' outcome [34,35].…”

Section: Antiviral Proprieties Of Existing Drugs Targeting Sars-cov-2mentioning

confidence: 99%

A protein interaction map identifies existing drugs targeting SARS-CoV-2

Cava

Bertoli

Castiglioni

2020

Preprint

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Background: Severe acute respiratory syndrome coronavirus (SARS-CoV-2), an emerging Betacoronavirus, is the causative agent of COVID-19. Angiotensin converting enzyme 2 (ACE2), being the main cell receptor of SARS-CoV-2, plays a role in the entry of the virus into the cell. Currently, there are no specific antiviral drugs for the treatment and neither preventive drugs such as vaccines. Results: We proposed a bioinformatics analysis in order to test in silico existing drugs as a fast way to identify an efficient therapy. We found differentially expressed genes in COVID-19 patients correlated with ACE-2 and we explored their direct relations with a network approach. Conclusions: In this network we integrated drug-gene interactions and we proposed several drugs with antiviral activity that, alone or in combination with other treatment options, could be considered as therapeutic approaches against COVID-19.

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Should anti-diabetic medications be reconsidered amid COVID-19 pandemic?

Cited by 119 publications

References 9 publications

COVID-19 and the endocrine system: exploring the unexplored

COVID-19 and the endocrine system: exploring the unexplored

Factors Associated with the Poor Outcomes in Diabetic Patients with COVID-19

A protein interaction map identifies existing drugs targeting SARS-CoV-2

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