Dulaglutide for COVID-19

Aim: To determine the impact of initiation of dulaglutide therapy on the course of COVID-19 and the dynamics of inflammatory markers in hospitalized patients with type 2 diabetes mellitus (T2DM). Methods: The inclusion criteria were history of T2DM, BMI > 27 kg/m2, PCR-confirmed diagnosis of COVID-19. The intervention group of 53 patients started dulaglutide therapy (1.5 mg once weekly) during the first 24 hours of admission, the control group consisted of 50 patients, who proceeded with glucose-lowering therapy. In both groups we compared COVID-19 outcomes (mortality/survival rate, ICU admission, need for assisted ventilation) and the duration of hospitalization. On days 3 and 7 of hospitalization we assessed laboratory parameters (FPG, CRP, ALT, AST, LDH, lymphocyte levels, D-dimer). Results: The initiation of dulaglutide therapy reduced the risk of death and transfer to assisted ventilation by 3.5 times in the intervention group compared to the control one (5.7% vs 20.0%, p=0.038). No differences were found in the risk of ICU admission (17.0% vs 28.0%, p=0.18) and the duration of hospitalization (10 bed-days vs 11-bed days, p=0.26). The groups were comparable in respect to carbohydrate metabolic compensation. Compared to those in the control group, patients on dulaglutide therapy demonstrated a lower CRP level (15.8 vs 24.6 mg/L, p=0.035), higher lymphocyte levels (1.2 vs 0.9 × 10*9/L, p=0.049) on day 3 of hospitalization, and a significantly lower LDH concentration level on day 7 (261.6 vs 326.1 U/L, p=0.016). There were no differences in ALT, AST, and D-dimer levels. Conclusion: The initiation of dulaglutide therapy in hospitalized patients with T2DM and COVID-19 decreased the risk of lethal outcomes and transfer to assisted ventilation, as well as proved effective in regards to inflammatory markers (CRP, lymphocytes levels). Disclosure T.Markova: None. M.Stas: None. A.Anchutina: None.