Infection Rates and Impact of Glucose Lowering Medications on the Clinical Course of COVID-19 in People with Type 2 Diabetes: A Retrospective Observational Study

Figures & data

Table 1 Baseline Characteristics of the Positive Diabetic Population Treated with Hypoglycemic Drugs

	Total	Insulin	Metformin	Sulphonylureas, Glinides	Acarbose, Pioglitazone	DPP4i	GLP-1 RA	SGLT2i
N. of subjects by group of treatment (n)/(%)	1923	611 (31.8%)	1462 (76.0%)	455 (23.7%)	82 (4.3%)	348 (18.1%)	216 (11.2%)	230 (12.0%)
Age, median (years)	69.2	67.2	69.7	72.1	68.3	73.5	62.9	64.2
Sex, Male (n)/(%)	1150 (59.8%)	346 (56.6%)	887 (60.7%)	265 (58.2%)	49 (59.8%)	207 (59.5%)	137 (63.4%)	159 (69.1%)
Duration of diabetic disease, median	11.5	14.3	10.9	12.9	11.8	13	10.3	11
Comorbidities (n)/(%)
Hypertension	1439 (74.8%)	435 (71.2%)	1120 (76.6%)	347 (76.3%)	58 (70.7%)	267 (76.7%)	169 (78.2%)	181 (78.7%)
Dyslipidemia	1205 (62.7%)	365 (59.7%)	926 (63.3%)	295 (64.8%)	54 (65.9%)	236 (67.8%)	140 (64.8%)	174 (75.7%)
Other CV diseases	955 (49.7%)	329 (53.8%)	728 (49.8%)	241 (53.0%)	36 (43.9%)	216 (62.1%)	97 (44.9%)	125 (54.3%)
Renal faliure	47 (2.4%)	31 (5.1%)	17 (1.2%)	8 (1.8%)	2 (2.4%)	18 (5.2%)	4 (1.9%)	4 (1.7%)
Primary immunodeficiencies	0 (0.0%)	0 (0.0%)	0 (0.0%)	0 (0.0%)	0 (0.0%)	0 (0.0%)	0 (0.0%)	0 (0.0%)
Acquired immunodeficiencies	54 (2.8%)	30 (4.9%)	36 (2.5%)	11 (2.4%)	3 (3.7%)	13 (3.7%)	4 (1.9%)	10 (4.3%)
Cancer	234 (12.2%)	68 (11.1%)	195 (13.3%)	56 (12.3%)	3 (3.7%)	41 (11.8%)	17 (7.9%)	34 (14.8%)
Chronic respiratory diseases	86 (4.5%)	35 (5.7%)	62 (4.2%)	32 (7.0%)	2 (2.4%)	19 (5.5%)	10 (4.6%)	9 (3.9%)
Patients with >1 comorbidities (n)/(%)	1723 (89%)	523 (85.6%)	1339 (91.6%)	420 (92.3%)	69 (84.2%)	323 (92.8%)	196 (90.7%)	215 (93.5%)
Hospitalizations (n)/(%)
For SARS-CoV-2 infections	437 (95.8%)	161 (94.7%)	320 (97.0%)	128 (97.0%)	21 (100.0%)	95 (96.9%)	42 (93.3%)	43 (93.5%)
For thrombotic/CV disease	19 (4.2%)	9 (5.3%)	10 (3.0%)	4 (3.0%)	0 (0.0%)	3 (3.1%)	3 (6.7%)	3 (6.5%)
Total	456 (23.7%)	170 (27.8%)	330 (22.6%)	132 (29.0%)	21 (25.6%)	98 (28.2%)	45 (20.8%)	46 (20.0%)
Deaths (n)/(%)	167 (8.7%)	77 (12.6%)	104 (7.1%)	49 (10.8%)	6 (7.3%)	45 (12.9%)	10 (4.6%)	13 (5.7%)

Abbreviations: DPP4i, Dipeptidyl-Peptidase-4 inhibitors; GLP-1 RA, Glucagon-like peptide-1 receptor agonists; SGLT2i, Sodium-glucose cotransporter 2 inhibitors; CV, Cardiovascular.

Table 2 Analysis of Hospitalization as a Function of Hypoglycemic Therapy

	OR	95% C.I. Lower Limit	95% C.I. Upper Limit	P value
Sex (M vs F)	1.81	1.42	2.29	<0.01
Age Class (ref 18–49)
50–59	3.55	1.60	7.91	<0.01
60–69	3.92	1.80	8.57	<0.01
70–79	5.53	2.52	12.12	<0.01
Over 80	9.98	4.52	22.04	<0.01
Insulin	1.48	1.15	1.92	<0.01
Metformin	0.85	0.64	1.12	0.25
Sulphonylureas/Glinides	1.34	1.04	1.73	0.02
Acarbose/Pioglitazone	1.12	0.66	1.91	0.68
DPP4i	1.02	0.76	1.36	0.90
GLP-1 RA	1.09	0.75	1.58	0.65
SGLT2i	0.89	0.62	1.29	0.54
Hypertension	1.11	0.83	1.49	0.47
Dyslipidemia	0.98	0.77	1.25	0.88
Other CV diseases	1.23	0.95	1.58	0.12
Renal faliure	2.37	1.27	4.43	0.01
Acquired immunodeficiencies	1.41	0.76	2.61	0.28
Cancer	0.75	0.53	1.06	0.10
Chronic respiratory diseases	1.36	0.84	2.20	0.22
Duration of diabetic disease	0.99	0.97	1.01	0.30

Abbreviations: DPP4i, Dipeptidyl-Peptidase-4 inhibitors; GLP-1 RA, Glucagon-like peptide-1 receptor agonists; SGLT2i, Sodium-glucose cotransporter 2 inhibitors; CV, Cardiovascular.

Table 3 Analysis of Death as a Function of Hypoglycemic Therapy

	OR	95% C.I. Lower Limi	95% C.I. Upper Limit	P value
Sex (M vs F)	1.66	1.14	2.42	0.01
Age class (ref 18–49)
50–59	0.58	0.03	9.82	0.70
60–69	8.01	0.99	64.96	0.05
70–79	12.72	1.58	102.68	0.02
Over 80	82.06	10.19	660.50	<0.01
Insulin	1.90	1.28	2.84	<0.01
Metformin	0.62	0.41	0.93	0.02
Sulphonylureas/Glinides	1.20	0.80	1.79	0.38
Acarbose/Pioglitazone	0.96	0.38	2.42	0.93
DPP4i	1.17	0.76	1.79	0.48
GLP-1 RA	1.33	0.64	2.77	0.45
SGLT2i	1.28	0.65	2.53	0.48
Hypertension	1.21	0.73	2.00	0.46
Dyslipidemia	0.72	0.49	1.06	0.10
Other CV diseases	1.55	1.00	2.41	0.05
Renal faliure	1.39	0.56	3.45	0.47
Acquired immunodeficiencies	10.13	4.67	21.99	<0.01
Cancer	0.13	0.05	0.34	<0.01
Chronic respiratory diseases	0.96	0.46	2.01	0.91
Duration of diabetic disease	0.98	0.95	1.01	0.19

Abbreviations: DPP4i, Dipeptidyl-Peptidase-4 inhibitors; GLP-1 RA, Glucagon-like peptide-1 receptor agonists; SGLT2i, Sodium-glucose cotransporter 2 inhibitors; CV, Cardiovascular.