Sodium-glucose-co-transporter-2 inhibitors and susceptibility to COVID-19: a population-based retrospective cohort study

Chris Sainsbury, Jingya Wang, Krishna Gokhale, Dionisio Acosta-Mena , Samir Dhalla , Nathan Byne , Joht Chandan, Astha Anand, Jennifer Cooper, Kelvin Okoth, Anuradhaa Subramanian, Mansoor Bangnash, Thomas Taverner, Wasim Hanif, Sandip Ghosh, Parth Narendran, KK Cheng, Tom Marshall, Georgios Gkoutos, Konstantinos ToulisG Neil Thomas, Abd Tahrani, Nicola Adderley, Shamil Haroon, Krishnarajah Nirantharakumar

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Sodium/glucose co-transporter-2 inhibitors (SGLT2i) are widely prescribed in people with type 2 diabetes. We aimed to investigate whether SGLT2i 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 SGLT2i (n=9,948) and a comparator group prescribed dipeptyl-peptidase 4 inhibitors (DPP4i; n=14,917) were followed up from 30th January to 27th July 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 SGLT2i and 24.7/1000 person-years among propensity score matched users of DPP4i. The adjusted hazard ratio was 0.92 (95% CI 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 SGLT2i compared to DPP4i, suggesting that clinicians may safely use these agents in the everyday care of people with type 2 diabetes during the COVID-19 pandemic.
Original languageEnglish
Pages (from-to)263-269
JournalDiabetes, obesity & metabolism
Issue number1
Early online date29 Sept 2020
Publication statusE-pub ahead of print - 29 Sept 2020


  • DPP‐4 inhibitor
  • SGLT2 inhibitor
  • antidiabetic drug
  • pharmaco‐epidemiology
  • type 2 diabetes


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