Abstract: ORIGINAL RESEARCH published: 17 March 2022 doi: 10.3389/fphar.2022.833679 Acute Kidney Injury and Drugs Prescribed for COVID-19 in Diabetes Patients: A Real-World Disproportionality Analysis Yu Zhou 1, Jianbin Li 1, Linyao Wang 1, Xinyan Zhu 1, Meilian Zhang 2* and Jiaping Zheng 3* 1 Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fujian Medical University, Fuzhou, China, Department of Ultrasound, Fujian Provincial Maternity and Child Health Hospital, Fuzhou, China, 3Department of Rehabilitation Medicine, School of Health, Fujian Medical University, Fuzhou, China 2 Background: The information is relatively scarce regarding the occurrence of druginduced acute kidney injury (AKI) when anti-coronavirus disease 2019 (COVID-19) drugs are prescribed for patients with diabetes mellitus (DM). Edited by: Saibal Das, Indian Council of Medical Research (ICMR), India Reviewed by: Mainul Haque, National Defence University of Malaysia, Malaysia Kenichiro Sato, The University of Tokyo, Japan *Correspondence: Jiaping Zheng zhengjp@fjmu.edu.cn Meilian Zhang zmlzy0226@163.com Specialty section: This article was submitted to Translational Pharmacology, a section of the journal Frontiers in Pharmacology Received: 13 December 2021 Accepted: 14 February 2022 Published: 17 March 2022 Citation: Zhou Y, Li J, Wang L, Zhu X, Zhang M and Zheng J (2022) Acute Kidney Injury and Drugs Prescribed for COVID-19 in Diabetes Patients: A Real-World Disproportionality Analysis. Front. Pharmacol. 13:833679. doi: 10.3389/fphar.2022.833679 Objective: The objective of this study was to evaluate a pharmacovigilance signal for AKI upon the use of common drugs prescribed for COVID-19 treatment, especially in patients with DM. Methods: The FDA Adverse Event Reporting System (FAERS) database were used, and data from the first quarter of 2020 to the third quarter of 2021 were retrieved. A disproportionality analysis was performed to determine whether AKI was more frequently reported with anti-COVID-19 drugs compared to that with other drugs in different populations. Further, reporting odds ratios (RORs) and their 95% confidence intervals (CIs) were used to calculate disproportionality. Results: We identified 33,488 COVID-19 patients and 2397 COVID-19 patients with DM. AKI was the most frequent adverse drug reaction (ADR) reported in this patient population. The primary suspected drugs related to AKI in more than half of the reports (75.60%, 127/ 168) were four common anti-COVID-19 drugs (remdesivir, tocilizumab, hydroxychloroquine, and lopinavir/ritonavir). Compared with other drugs in the same time window, remdesivir and lopinavir/ritonavir were associated with an increased risk of AKI in all COVID-19 patients (ROR: 3.97, 95% CI: 3.51–4.50; ROR: 4.02, 95% CI: 3.11–5.19, respectively). In COVID-19 patients with DM, remdesivir was significantly associated with AKI (ROR: 5.65, 95% CI: 4.06–7.87); meanwhile, there was a new AKI signal associated with tocilizumab (ROR: 2.37, 95% CI: 1.19–4.72). After sensitivity analyses in COVID-19 patients with DM, consistent results for remdesivir were observed; however, the AKI signals for tocilizumab were unstable. Conclusion: Our study confirmed the association of AKI with the usage of common antiCOVID-19 drugs (especially remdesivir and tocilizumab) in DM patients. These safety signals suggested more individualized treatments for COVID-19 patients with Frontiers in Pharmacology | www.frontiersin.org 1 March 2022..