The effect of chronic treatments of type 2-diabetes mellitus on COVID-19 morbidity and symptoms severity

Coronavirus disease 2019 (COVID-19) is a highly contagious viral disease that causes the severe acute respiratory syndrome (SARS), and has had a disastrous impact on demographics around the world. Studies have classified type 2-diabetes mellitus (T2DM) as a risk factor for increasing mortality and se-verity of disease symptoms. However, the effect of different T2DM-chronic medications on disease progression is still unclear. The aim of this study was to determine the effect of glycemic control on COVID-19-related mortality and symptom severity, as well as the impact of commonly used T2DM therapeutic approaches on disease outcomes. This study included 109 COVID-19 patients with (68 patients) or without (41 patients) type 2-diabetes mellitus. Diabetic patients were further classified according to: 1) their glycemic control [HbA1c levels >6.5% (Well-controlled) and > 6.5% (Less-controlled)], or 2) their pre-hospital anti-hyperglycemic med-ication [metformin (50%) or sulfonylureas (50%)]. Our results showed that diabetes is associated with a significantly higher risk of death in COVID-19 pa-tients. We also found that metformin treatment reduces plasma C-reactive protein levels and mortality Compared with sulfonylureas, and continuing with metformin during the hospital stay had a better prog-nostic for survival. We also, demonstrated that taking sulfonylurea is associated with an increase in COVID-19 mortality as compared to metformin by increasing cardiovascular events.