Minireviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Virol. Nov 25, 2022; 11(6): 399-410
Published online Nov 25, 2022. doi: 10.5501/wjv.v11.i6.399
Dipeptidyl peptidase 4 inhibitors in COVID-19: Beyond glycemic control
Niya Narayanan, Dukhabandhu Naik, Jayaprakash Sahoo, Sadishkumar Kamalanathan
Niya Narayanan, Department of Endocrinology, Baby Memorial Hospital, Kozhikode 673005, Kerala, India
Dukhabandhu Naik, Jayaprakash Sahoo, Sadishkumar Kamalanathan, Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India
Author contributions: Naik D conceptualized the work; Narayanan N wrote the first draft and provided critical inputs; Sahoo J, Naik D, and Kamalanathan S supervised the writing and critically revised the manuscript; Narayanan N edited the final draft; all authors have read and approved the final version of the manuscript
Conflict-of-interest statement: All authors have no conflicts of interest to report.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dukhabandhu Naik, MD, Additional Professor, Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, 4th Floor, Super-speciality Block, JIPMER Campus, Dhanvantri Nagar, Puducherry 605006, India. drnaik2000@gmail.com
Received: March 27, 2022
Peer-review started: March 27, 2022
First decision: May 30, 2022
Revised: June 30, 2022
Accepted: October 4, 2022
Article in press: October 4, 2022
Published online: November 25, 2022
Processing time: 241 Days and 1.9 Hours
Abstract

Coronavirus disease 2019 (COVID-19) is associated with a high risk of mortality and complications in patients with diabetes mellitus. Achieving good glycemic control is very important in diabetic patients to reduce complications and mortality due to COVID-19. Recent studies have shown the mortality benefit and anti-inflammatory effects of Dipeptidyl-peptidase-4 inhibitors (DPP-4i) in diabetic patients with COVID-19. DPP-4i may have a beneficial role in halting the severity of infection primarily by three routes, namely viral entry inhibition, anti-inflammatory and anti-fibrotic effects and glycemic control. This has raised the pro-mising hypothesis that DPP-4i might be an optimal strategy for treating COVID-19 in patients with diabetes. This review aims to summarise the possible therapeutic non-glycemic effects of DPP-4i in diabetic patients diagnosed with COVID-19 in the light of available evidence.

Keywords: Dipeptidyl-peptidase-4; Diabetes mellitus; COVID-19; Mortality

Core Tip: Patients with pre-existing comorbidities, particularly diabetes mellitus (DM), are at increased risk of complications from coronavirus disease 2019 (COVID-19). Beyond their glycemic effects, Dipeptidyl-peptidase-4 inhibitors (DPP-4i) have proven effective in COVID-19 individuals with DM. Available observational studies and trials have shown a significant mortality reduction in COVID-19 patients with DM when DPP-4i were continued during the course of illness. As a result, COVID-19 individuals with DM may choose DPP-4i as the preferred anti-diabetic medication if it is not contraindicated.