Ethnicity and risks of severe COVID-19 outcomes associated with glucose-lowering medications: A cohort study
3rd treatment shown to reduce risk in
July 2020 *, now known with p < 0.00000000001 from 88 studies.
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Retrospective 624,771 people with type 2 diabetes in the UK, showing lower COVID-19 mortality and hospitalization with metformin use.
risk of death, 34.3% lower, RR 0.66, p < 0.001, meta analysis of 6 groups reported.
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risk of hospitalization, 31.2% lower, RR 0.69, p < 0.001, meta analysis of 6 groups reported.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Zaccardi et al., 13 Sep 2022, retrospective, United Kingdom, peer-reviewed, 11 authors.
Contact:
frazac@fastwebnet.it.
Abstract: Revised: 31 August 2022
Accepted: 10 September 2022
DOI: 10.1111/dom.14872
RESEARCH LETTER
Ethnicity and risks of severe COVID-19 outcomes associated
with glucose-lowering medications: A cohort study
Francesco Zaccardi PhD 1
|
Pui San Tan PhD 2
4
| Ash Kieran Clift MBBS
Baiju R. Shah PhD
2
Martina Patone PhD
| Simon J. Griffin DM 6,7
Kamlesh Khunti PhD 1
| Carol Coupland PhD 2,3
2,5
|
2
| Defne Saatci MBBS
|
| Hajira Dambha-Miller PhD 8 |
| Julia Hippisley-Cox FRCP 2
1
Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, Leicester, UK
2
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
3
Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
4
Department of Medicine, University of Toronto; Division of Endocrinology, Sunnybrook Health Sciences Centre, Institute for Clinical Evaluative Sciences, Toronto,
Ontario, Canada
5
Cancer Research UK Oxford Centre, University of Oxford, Oxford, UK
6
Primary Care Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
7
MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
8
Primary Care Research Centre, University of Southampton, Southampton, UK
Correspondence
Francesco Zaccardi, Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester General Hospital Gwendolen Road, Leicester, LE5 4PW, UK.
Email: frazac@fastwebnet.it
Funding information
National Insitute for Health and Care Research (NIHR), Grant/Award Number: COV0130 /MR/V027778/1; UK Research and Innovation; Academic Clinical Lecturer;
Leicester Biomedical Research Centre (BRC), Grant/Award Number: NIHR200171; Applied Research Collaboration East Midlands (ARC EM); Cancer Research UK
Oxford Centre, and the Oxford Wellcome Institutional, Grant/Award Number: 204826/Z/16/Z; National Institute for Health Research, Oxford, John Fell Oxford
University Press Research Fund, Cancer Research UK, Grant/Award Number: C5255/A18085; Clinical Research Fellowship from Cancer Research UK, Grant/Award
Number: C2195/A31310; MRC Epidemiology Unit programme, Grant/Award Number: MC_UU_12015/4
1
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I N T RO DU CT I O N
[metformin (MF), sodium-glucose cotransporter-2 inhibitors (SGLT-2i),
sulphonylurea].5
During the early phases of the COVID-19 pandemic, diabetes became
Alongside the role of diabetes, multiple large observational stud-
associated with a poorer prognosis,1 with an approximately three-fold
ies also showed higher risks of COVID-19-related hospitalization,
increased risk of a COVID-19 death in those with diabetes compared
intensive care unit admission and death in people from ethnic minor-
with those without.2,3 In an effort to understand this association,
ity populations.6,7
there was an increasing interest in the role of glucose-lowering medi-
As type 2 diabetes is more prevalent in ethnic minority
cations on the risk of COVID-19 outcomes, given their pharmacologi-
populations—particularly South Asians—determining the risk of COVID-
cal differences and potential direct effect on shared immunometabolic
19 outcomes in relation to different glucose-lowering therapies has impli-
pathways4: the available evidence would suggest small absolute
cations for both patients and health care professionals.8 We therefore
increased rates of COVID-19 mortality with some dipeptidyl pepti-
designed a cohort study within the QResearch UK nationwide..
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