Association between dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists and COVID-19 infection and adverse outcomes: a cohort study
Authors' conclusion
DPP4i/GLP1RA use was not associated with reduced risk of COVID-19 infection compared with SGLT2i/SU use. DPP4i/GLP1RA use was associated with reduced risk of 30-day hospitalization among COVID-19 positive older adults and a possible trend towards a lower associated risk of CV events.
Study context
- Population
- Persons ≥66 years with T2D taking metformin with ≥1 COVID-19 PCR test, January 2020–July 2021, Ontario, Canada
- Participants
- 26,485 vs 14,487
- Exposure
- DPP4i or GLP1RA vs SGLT2i or SU
- DPP4i/GLP1RAn = 26,485
- SGLT2i/SUn = 14,487reference
- Outcome
- COVID-19 infection
Main finding
As reported in the abstract
Each group vs SGLT2i/SUWeighted RD (95% CI)
DPP4i/GLP1RA
−0.06(−0.79 to 0.66)
Each group vs SGLT2i/SURelative risk (95% CI)
DPP4i/GLP1RA
0.99(0.93–1.07)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| All-cause hospitalization among COVID-19 positive patients · 30 daysDPP4i/GLP1RAvs SGLT2i/SU | adjusted weighted RR 0.79 (95% CI 0.70–0.89) | |
| Major CV events among COVID-19 positive patients · 30 daysDPP4i/GLP1RAvs SGLT2i/SU | RR 0.73 (95% CI 0.54–1.00) | |
| 0.512Ratio (log scale) |
| Outcome | Weighted RD (%) (95% CI) | |
|---|---|---|
| Major CV events among COVID-19 positive patients · 30 daysBetween DPP4i/GLP1RA and SGLT2i/SU | −1.91 (−4.00 to 0.18) | |
| −6−4−202Difference, % (linear scale) |
| Outcome | Weighted RD (%) (95% CI) |
|---|---|
| All-cause hospitalization among COVID-19 positive patients · 30 daysBetween DPP4i/GLP1RA and SGLT2i/SU | −6.72 (−3.02 to −10.4) |
Original publication
Association between dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists and COVID-19 infection and adverse outcomes: a cohort study. BMJ Open Diabetes Res Care. Published 7 August 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →