Exposure to DPP-4 inhibitors and COVID-19 among people with type 2 diabetes. A case-control study

Because other coronaviruses enter the cells by binding to dipeptidyl-peptidase-4 (DPP-4), it has been speculated that DPP-4 inhibitors (DPP-4i) may exert an activity against SARS-CoV-2. In the absence of clinical trial results, we analyzed epidemiological data to support or discard such hypothesis. We retrieved information on exposure to DPP-4i among patients with type 2 diabetes (T2D) hospitalized for COVID-19 at an outbreak hospital in Italy. As reference, we retrieved exposure to DPP-4i among matched T2D patients in the same Region. Of 403 hospitalized COVID-19 patients, 85 had T2D. The rate of exposure to DPP-4i was similar between T2D patients with COVID-19 (10.6%) and 14 857 matched patients in the Region (8.8%), or 793 matched patients in the local outpatient clinic (15.4%), 8284 matched patients hospitalized for other reasons (8.5%), and when comparing 71 patients hospitalized for COVID-19 pneumonia (11.3%) to 351 matched patients with pneumonia of other etiology (10.3%). T2D patients with COVID-19 who were on DPP-4i had a similar disease outcome as those who were not. In summary, we found no evidence that DPP-4i might affect hospitalization for COVID-19. This article is protected by copyright. All rights reserved.