Sitagliptin treatment at the time of hospitalization was associated with reduced mortality in patients with type 2 diabetes and covid-19: A multicenter case-control retrospective observational study

Sebastiano Bruno Solerte, Francesca D’Addio, Roberto Trevisan, Elisabetta Lovati, Antonio Rossi, Ida Pastore, Marco Dell Acqua, Elio Ippolito, Cristiana Scaranna, Rosalia Bellante, Silvia Galliani, Alessandro Roberto Dodesini, Giuseppe Lepore, Francesca Geni, Roberta Maria Fiorina, Emanuele Catena, Angelo Corsico, Riccardo Colombo, Marco Mirani, Carlo Riva DeSalvatore Endrio Oleandri, Reza Abdi, Joseph V. Bonventre, Stefano Rusconi, Franco Folli, Antonio Di Sabatino, Gianvincenzo Zuccotti, Massimo Galli, Paolo Fiorina

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE Poor outcomes have been reported in patients with type 2 diabetes and coronavirus disease 2019 (COVID-19); thus, it is mandatory to explore novel therapeutic approaches for this population. RESEARCH DESIGN AND METHODS In a multicenter, case-control, retrospective, observational study, sitagliptin, an oral and highly selective dipeptidyl peptidase 4 inhibitor, was added to standard of care (e.g., insulin administration) at the time of hospitalization in patients with type 2 diabetes who were hospitalized with COVID-19. Every center also recruited at a 1:1 ratio untreated control subjects matched for age and sex. All patients had pneumonia and exhibited oxygen saturation <95% when breathing ambient air or when receiving oxygen support. The primary end points were discharge from the hospital/death and improvement of clinical outcomes, defined as an increase in at least two points on a seven-category modified ordinal scale. Data were collected retrospectively from patients receiving sitagliptin from 1 March through 30 April 2020. RESULTS Of the 338 consecutive patients with type 2 diabetes and COVID-19 admitted in Northern Italy hospitals included in this study, 169 were on sitagliptin, while 169 were on standard of care. Treatment with sitagliptin at the time of hospitalization was associated with reduced mortality (18% vs. 37% of deceased patients; hazard ratio 0.44 [95% CI 0.29–0.66]; P = 0.0001), with an improvement in clinical outcomes (60% vs. 38% of improved patients; P = 0.0001) and with a greater number of hospital discharges (120 vs. 89 of discharged patients; P = 0.0008) compared with patients receiving standard of care, respectively. CONCLUSIONS In this multicenter, case-control, retrospective, observational study of patients with type 2 diabetes admitted to the hospital for COVID-19, sitagliptin treatment at the time of hospitalization was associated with reduced mortality and improved clinical outcomes as compared with standard-of-care treatment. The effects of sitagliptin in patients with type 2 diabetes and COVID-19 should be confirmed in an ongoing randomized, placebo-controlled trial.

Original languageEnglish
Pages (from-to)2999-3006
Number of pages8
JournalDiabetes Care
Volume43
Issue number12
DOIs
Publication statusPublished - Dec 2020

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing

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