COVID-19 Evidence Alerts
from McMaster PLUSTM

Current best evidence for clinical care (more info)

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Treatment Yang Y, Cai Z, Zhang J DPP-4 inhibitors may improve the mortality of coronavirus disease 2019: A meta-analysis. PLoS One. 2021 May 20;16(5):e0251916. doi: 10.1371/journal.pone.0251916. eCollection 2021.

AIMS: DPP-4 inhibitors are predicted to exert a protective effect on the progression of coronavirus disease 2019 (COVID-19). We conducted this meta-analysis to investigate this hypothesis.

METHODS: Four databases, namely, PubMed, Web of Science, EMBASE and the Cochrane Library, were used to identify studies on DPP-4 and COVID-19. The outcome indicators were the mortality of COVID-19. Funnel plots, Begg's tests and Egger's tests were used to assess publication bias.

RESULTS: Four articles were included with a total of 1933 patients with COVID-19 and type 2 diabetes. The use of DPP-4 inhibitors was negatively associated with the risk of mortality (odds ratio (OR) = 0.58 95% confidence interval (CI), 0.34-0.99).

CONCLUSIONS: DPP-4 inhibitors may improve the mortality of patients with COVID-19 and type 2 diabetes. As few relevant studies are available, more large-scale studies need to be performed.

Discipline / Specialty Area Score
Emergency Medicine
Infectious Disease
Hospital Doctor/Hospitalists
Internal Medicine
Comments from MORE raters

Emergency Medicine rater

This is a meta-analysis of studies comparing gliptins (DPP-4) with controls in patients with covid-19 and diabetes with the outcome of mortality. The meta-analysis was well done. Although the 4 studies found are all observational, with no randomized controlled trials, they had low risk of bias, nor was there evidence of publication bias. The results show a reduction in mortality: odds ratio 0.58 (95% confidence interval: 0.34, 0.99). However, the size of the effect in terms of absolute risk reduction or number needed to treat cannot be calculated from the data given.

Hospital Doctor/Hospitalists rater

I’m losing interest in COVID-19 articles.

Infectious Disease rater

Very interesting PRELIMINARY findings that well-designed research will need to support or refute their results.