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- Publisher Website: 10.1016/j.diabet.2021.101307
- Scopus: eid_2-s2.0-85122782868
- PMID: 34863934
- WOS: WOS:000758467500008
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Article: Use of DPP4i reduced odds of clinical deterioration and hyperinflammatory syndrome in COVID-19 patients with type 2 diabetes: propensity score analysis of a territory-wide cohort in Hong Kong
Title | Use of DPP4i reduced odds of clinical deterioration and hyperinflammatory syndrome in COVID-19 patients with type 2 diabetes: propensity score analysis of a territory-wide cohort in Hong Kong |
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Authors | |
Keywords | COVID-19 DPP4i Hyperinflammatory syndrome In-hospital death Viral clearance |
Issue Date | 2022 |
Publisher | Elsevier Masson. The Journal's web site is located at http://www.elsevier-masson.fr/diabetes-metabolism-1262-3636.html |
Citation | Diabetes & Metabolism, 2022, v. 48 n. 1, article no. 101307 How to Cite? |
Abstract | Background and objectives:
Type 2 diabetes mellitus (T2DM) patients with Coronavirus Disease 2019 (COVID-19) have poorer prognosis. Inconclusive evidence suggested dipeptidyl peptidase-4 inhibitors (DPP4i) might reduce inflammation and prevent Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) entry, hence further evaluation on DPP4i is needed.
Methods:
1214 Patients with T2DM were admitted with COVID-19 between 21st January 2020 and 31st January 2021 in Hong Kong. Exposure was DPP4i use within the 90 days prior to admission for COVID-19. Assessed outcomes included clinical deterioration, clinical improvement, low viral load, positive Immunoglobulin G (IgG) antibody, hyperinflammatory syndrome, proportion of IgG antibody, clinical status and length of hospitalization. Multivariable logistic and linear regression models were performed to estimate odds ratios (OR) and their 95% confidence intervals (CI) of event outcomes and continuous outcomes, respectively.
Results:
DPP4i users (N = 107) was associated with lower odds of clinical deterioration (OR=0.71, 95%CI 0.54 to 0.93, P = 0.013), hyperinflammatory syndrome (OR=0.56, 95%CI 0.45 to 0.69, P < 0.001), invasive mechanical ventilation (OR=0.30, 95%CI 0.21 to 0.42, P < 0.001), reduced length of hospitalization (-4.82 days, 95%CI –6.80 to –2.84, P < 0.001), proportion of positive IgG antibody on day-3 (13% vs 8%, p = 0.007) and day-7 (41% vs 26%, P < 0.001), despite lack of association between DPP4i use and in-hospital mortality.
Conclusion:
DPP4i use was associated with reduced odds of clinical deterioration and hyperinflammatory syndrome. Prospective studies are warranted to elucidate the role of DPP4i in T2DM and COVID-19. |
Persistent Identifier | http://hdl.handle.net/10722/308956 |
ISSN | 2023 Impact Factor: 4.6 2023 SCImago Journal Rankings: 1.557 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Wong, CKH | - |
dc.contributor.author | Lui, DTW | - |
dc.contributor.author | Lui, AYC | - |
dc.contributor.author | Kwok, ACY | - |
dc.contributor.author | Low, MCH | - |
dc.contributor.author | Lau, KTK | - |
dc.contributor.author | Au, ICH | - |
dc.contributor.author | Xiong, X | - |
dc.contributor.author | Chung, MSH | - |
dc.contributor.author | Lau, EHY | - |
dc.contributor.author | Cowling, BJ | - |
dc.date.accessioned | 2021-12-14T01:38:41Z | - |
dc.date.available | 2021-12-14T01:38:41Z | - |
dc.date.issued | 2022 | - |
dc.identifier.citation | Diabetes & Metabolism, 2022, v. 48 n. 1, article no. 101307 | - |
dc.identifier.issn | 1262-3636 | - |
dc.identifier.uri | http://hdl.handle.net/10722/308956 | - |
dc.description.abstract | Background and objectives: Type 2 diabetes mellitus (T2DM) patients with Coronavirus Disease 2019 (COVID-19) have poorer prognosis. Inconclusive evidence suggested dipeptidyl peptidase-4 inhibitors (DPP4i) might reduce inflammation and prevent Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) entry, hence further evaluation on DPP4i is needed. Methods: 1214 Patients with T2DM were admitted with COVID-19 between 21st January 2020 and 31st January 2021 in Hong Kong. Exposure was DPP4i use within the 90 days prior to admission for COVID-19. Assessed outcomes included clinical deterioration, clinical improvement, low viral load, positive Immunoglobulin G (IgG) antibody, hyperinflammatory syndrome, proportion of IgG antibody, clinical status and length of hospitalization. Multivariable logistic and linear regression models were performed to estimate odds ratios (OR) and their 95% confidence intervals (CI) of event outcomes and continuous outcomes, respectively. Results: DPP4i users (N = 107) was associated with lower odds of clinical deterioration (OR=0.71, 95%CI 0.54 to 0.93, P = 0.013), hyperinflammatory syndrome (OR=0.56, 95%CI 0.45 to 0.69, P < 0.001), invasive mechanical ventilation (OR=0.30, 95%CI 0.21 to 0.42, P < 0.001), reduced length of hospitalization (-4.82 days, 95%CI –6.80 to –2.84, P < 0.001), proportion of positive IgG antibody on day-3 (13% vs 8%, p = 0.007) and day-7 (41% vs 26%, P < 0.001), despite lack of association between DPP4i use and in-hospital mortality. Conclusion: DPP4i use was associated with reduced odds of clinical deterioration and hyperinflammatory syndrome. Prospective studies are warranted to elucidate the role of DPP4i in T2DM and COVID-19. | - |
dc.language | eng | - |
dc.publisher | Elsevier Masson. The Journal's web site is located at http://www.elsevier-masson.fr/diabetes-metabolism-1262-3636.html | - |
dc.relation.ispartof | Diabetes & Metabolism | - |
dc.subject | COVID-19 | - |
dc.subject | DPP4i | - |
dc.subject | Hyperinflammatory syndrome | - |
dc.subject | In-hospital death | - |
dc.subject | Viral clearance | - |
dc.title | Use of DPP4i reduced odds of clinical deterioration and hyperinflammatory syndrome in COVID-19 patients with type 2 diabetes: propensity score analysis of a territory-wide cohort in Hong Kong | - |
dc.type | Article | - |
dc.identifier.email | Wong, CKH: carlosho@hku.hk | - |
dc.identifier.email | Lui, DTW: dtwlui@hku.hk | - |
dc.identifier.email | Lau, KTK: kristytk@hku.hk | - |
dc.identifier.email | Chung, MSH: mattcsh@hku.hk | - |
dc.identifier.email | Lau, EHY: ehylau@hku.hk | - |
dc.identifier.email | Cowling, BJ: bcowling@hku.hk | - |
dc.identifier.authority | Wong, CKH=rp01931 | - |
dc.identifier.authority | Lui, DTW=rp02803 | - |
dc.identifier.authority | Lau, EHY=rp01349 | - |
dc.identifier.authority | Cowling, BJ=rp01326 | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1016/j.diabet.2021.101307 | - |
dc.identifier.pmid | 34863934 | - |
dc.identifier.pmcid | PMC8632053 | - |
dc.identifier.scopus | eid_2-s2.0-85122782868 | - |
dc.identifier.hkuros | 330896 | - |
dc.identifier.volume | 48 | - |
dc.identifier.issue | 1 | - |
dc.identifier.spage | article no. 101307 | - |
dc.identifier.epage | article no. 101307 | - |
dc.identifier.isi | WOS:000758467500008 | - |
dc.publisher.place | France | - |