Sodium‐glucose co‐transporter‐2 inhibitors and susceptibility to <scp>COVID</scp> ‐19: A population‐based retrospective cohort study
Christopher Sainsbury, Jingya Wang, Krishna Gokhale, Dionisio Acosta‐Mena, Samir Dhalla, Nathan Byne, Joht Singh Chandan, Astha Anand, Jennifer Cooper, Kelvin Okoth, Anuradhaa Subramanian, Mansoor N. Bangash, Thomas Taverner, Wasim Hanif, Sandip Ghosh, Parth Narendran, Kar Keung Cheng, Tom Marshall, Georgios V. Gkoutos, Konstantinos A. Toulis, G. Neil Thomas, Abd A. Tahrani, Nicola J. Adderley, Shamil Haroon, Krishnarajah Nirantharakumar
Abstract
Sodium-glucose co-transporter-2 (SGLT2) inhibitors are widely prescribed in people with type 2 diabetes. We aimed to investigate whether SGLT2 inhibitor prescription is associated with COVID-19, when compared with an active comparator. We performed a propensity-score-matched cohort study with active comparators and a negative control outcome in a large UK-based primary care dataset. Participants prescribed SGLT2 inhibitors (n = 9948) and a comparator group prescribed dipeptidyl peptidase-4 (DPP-4) inhibitors (n = 14 917) were followed up from January 30 to July 27, 2020. The primary outcome was confirmed or clinically suspected COVID-19. The incidence rate of COVID-19 was 19.7/1000 person-years among users of SGLT2 inhibitors and 24.7/1000 person-years among propensity-score-matched users of DPP-4 inhibitors. The adjusted hazard ratio was 0.92 (95% confidence interval 0.66 to 1.29), and there was no evidence of residual confounding in the negative control analysis. We did not observe an increased risk of COVID-19 in primary care amongst those prescribed SGLT2 inhibitors compared to DPP-4 inhibitors, suggesting that clinicians may safely use these agents in the everyday care of people with type 2 diabetes during the COVID-19 pandemic.