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

Research output: Contribution to journalArticlepeer-review


External organisations

  • University Hospitals Birmingham NHS Foundation Trust
  • University Hospitals Birmingham


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
JournalDiabetes, obesity & metabolism
Early online date29 Sep 2020
Publication statusE-pub ahead of print - 29 Sep 2020


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