Association of SGLT2I vs. DPP4I with Pneumonia, COVID-19, and Adverse Respiratory Events in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis
Abstract
OBJECTIVE
To systematically assess the association of Sodium-Glucose Co-Transporter 2 Inhibitors (SGLT2I) vs. Dipeptidyl Peptidase-4 Inhibitors (DPP4I) with pneumonia, COVID-19, and adverse respiratory events in patients with type 2 diabetes mellitus (DM).
METHOD
PubMed, Embase, and Cochrane Library databases were retrieved to include studies on DM patients receiving SGLT2I (exposure group) or DPP4I (control group). Stata.15.0 statistical software was employed for meta-analysis.
RESULT
Ten studies were included, 10 of which were used for the qualitative review and 7 for the meta-analysis. According to the meta-analysis, patients receiving SGLT2I had lower pneumonia incidence (OR=0.62, 95% Cl, 0.51-0.74) and pneumonia risk (OR=0.63, 95% Cl, 0.60-0.68, P=0.000) compared to those receiving DPP4I. The same situation occurs in mortality rate of pneumonia (OR=0.49, 95% Cl, 0.39-0.60) and pneumonia mortality risk (OR=0.47, 95% Cl, 0.42-0.51) . Lower mortality of COVID-19 (OR=0.31, 95% Cl, 0.28 -0.34), and a lower hospitalization rate and incidence of mechanical ventilation (OR=0.61, 95% Cl, 0.56-0.68, P=0.000, OR=0.69, 95% Cl, 0.58-0.83, P=0.000) due to COVID-19 in patients with type 2 DM receiving SGLT2I. The qualitative analysis results showed that SGLT2I was associated with a lower incidence of COVID-19, lower risk of obstructive Airway disease (OAD) events, and lower hospitalization rate of healthcare-associated pneumonia (HCAP) than DPP4I.
CONCLUSION
In patients with type 2…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 19 participants or records.
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