Potential use of sodium glucose co-transporter 2 inhibitors during acute illness: a systematic review based on COVID-19.

Tisch, Carmen; Xourgia, Eleni; Exadaktylos, Aristomenis; Ziaka, Mairi (2024). Potential use of sodium glucose co-transporter 2 inhibitors during acute illness: a systematic review based on COVID-19. Endocrine, 85(2), pp. 660-675. Springer 10.1007/s12020-024-03758-8

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OBJECTIVE

SGLT-2i are increasingly recognized for their benefits in patients with cardiometabolic risk factors. Additionally, emerging evidence suggests potential applications in acute illnesses, including COVID-19. This systematic review aims to evaluate the effects of SGLT-2i in patients facing acute illness, particularly focusing on SARS-CoV-2 infection.

METHODS

Following PRISMA guidelines, a systematic search of PubMed, Scopus, medRxiv, Research Square, and Google Scholar identified 22 studies meeting inclusion criteria, including randomized controlled trials and observational studies. Data extraction and quality assessment were conducted independently.

RESULTS

Out of the 22 studies included in the review, six reported reduced mortality in DM-2 patients taking SGLT-2i, while two found a decreased risk of hospitalization. Moreover, one study demonstrated a lower in-hospital mortality rate in DM-2 patients under combined therapy of metformin plus SGLT-2i. However, three studies showed a neutral effect on the risk of hospitalization. No increased risk of developing COVID-19 was associated with SGLT-2i use in DM-2 patients. Prior use of SGLT-2i was not associated with ICU admission and need for MV. The risk of acute kidney injury showed variability, with inconsistent evidence regarding diabetic ketoacidosis.

CONCLUSION

Our systematic review reveals mixed findings on the efficacy of SGLT-2i use in COVID-19 patients with cardiometabolic risk factors. While some studies suggest potential benefits in reducing mortality and hospitalizations, others report inconclusive results. Further research is needed to clarify optimal usage and mitigate associated risks, emphasizing caution in clinical interpretation.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Xourgia, Eleni, Exadaktylos, Aristomenis, Ziaka, Mairi

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1559-0100

Publisher:

Springer

Language:

English

Submitter:

Pubmed Import

Date Deposited:

07 Mar 2024 10:43

Last Modified:

01 Aug 2024 00:12

Publisher DOI:

10.1007/s12020-024-03758-8

PubMed ID:

38448675

Uncontrolled Keywords:

Acute Illness COVID-19 Diabetic Ketoacidosis Intensive Care Unit Mechanical Ventilation SGLT-2 Inhibitors

BORIS DOI:

10.48350/193932

URI:

https://boris.unibe.ch/id/eprint/193932

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