Evaluating the effects of sodium glucose co-transporter -2 inhibitors from a renin-angiotensin-aldosterone system perspective in patients infected with COVID-19: contextualizing findings from the dapagliflozin in respiratory failure in patients with COVID-19 study

Mol Biol Rep. 2022 Mar;49(3):2321-2324. doi: 10.1007/s11033-022-07183-w. Epub 2022 Jan 31.

Abstract

Numerous studies demonstrate parallels between CVD, type 2 diabetes mellitus (T2DM) and COVID-19 pathology, which accentuate pre-existing complications in patients infected with COVID-19 and potentially exacerbate the infection course. Antidiabetic drugs such as sodium-glucose transporter-2 (SGLT-2) inhibitors have garnered substantial attention recently due to their efficacy in reducing the severity of cardiorenal disease. The effect of SGLT-2 inhibitors in patients with COVID-19 remains unclear particularly since SGLT-2 inhibitors contribute to altering the RAAS cascade activity, which includes ACE-2, the major cell entry receptor for SARS-CoV2. A study, DARE-19, was carried out to unveil the effects of SGLT-2 inhibitor treatment on comorbid disease complications and concomitant COVID-19 outcomes and demonstrated no statistical significance. However, the need for further studies is essential to provide conclusive clinical findings.

Keywords: ACE-2; COVID-19; DARE-19; Dapagliflozin; Renin angiotensin aldosterone system; SGLT-2.

Publication types

  • Review

MeSH terms

  • Angiotensin-Converting Enzyme 2 / physiology
  • Benzhydryl Compounds / therapeutic use*
  • COVID-19 / complications*
  • Clinical Trials, Phase III as Topic
  • Double-Blind Method
  • Drug Repositioning
  • Glucosides / therapeutic use*
  • Heart Diseases / prevention & control
  • Humans
  • Kidney Diseases / prevention & control
  • Mitochondria / drug effects
  • Multicenter Studies as Topic
  • Oxidative Stress / drug effects
  • Randomized Controlled Trials as Topic
  • Receptors, Virus / physiology
  • Renin-Angiotensin System / drug effects*
  • Respiratory Insufficiency / drug therapy*
  • Respiratory Insufficiency / etiology
  • SARS-CoV-2*
  • Sodium-Glucose Transporter 2 / physiology
  • Sodium-Glucose Transporter 2 Inhibitors / pharmacology
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use*

Substances

  • Benzhydryl Compounds
  • Glucosides
  • Receptors, Virus
  • SLC5A2 protein, human
  • Sodium-Glucose Transporter 2
  • Sodium-Glucose Transporter 2 Inhibitors
  • dapagliflozin
  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2