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Exploring Sodium Glucose Co-Transporter-2 (SGLT2) Inhibitors for Organ Protection in COVID-19

Beatriz Fernandez-Fernandez1,2, Luis D'Marco3, Jose Luis Górriz3,4

  • 1IIS-Fundación Jiménez Diaz, Department of Medicine, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain.

Journal of Clinical Medicine
|July 2, 2020
PubMed

Insights

Sodium glucose co-transporter-2 (SGLT2) inhibitors show potential for protecting organs in patients with Coronavirus disease 2019 (COVID-19). Research is exploring their use to improve outcomes, especially in those with respiratory failure.

Area of Science:

  • Cardiology
  • Nephrology
  • Pulmonology
  • Infectious Diseases
  • Pharmacology

Background:

  • Coronavirus disease 2019 (COVID-19) poses a significant global health threat with high mortality rates, particularly in patients with comorbidities like diabetes, chronic kidney disease, and cardiovascular disease.
  • Current therapeutic strategies for COVID-19 focus on viral replication, cytokine storm management, thromboembolic complications, and organ support, yet mortality remains high, underscoring the need for adjuvant organ protection therapies.
  • Sodium glucose co-transporter-2 (SGLT2) inhibitors, known for their cardioprotective and nephroprotective effects, are being investigated for potential benefits in COVID-19.

Purpose of the Study:

  • To discuss the potential benefits and risks of utilizing SGLT2 inhibitors as an adjuvant organ protection therapy in Coronavirus disease 2019 (COVID-19) patients.
  • To highlight the emerging evidence supporting the protective effects of SGLT2 inhibitors on the heart, kidney, and potentially the lung.
  • To introduce an ongoing clinical trial evaluating the impact of dapagliflozin, an SGLT2 inhibitor, on outcomes in COVID-19 patients experiencing respiratory failure.

Main Methods:

  • Review of existing literature on the mechanisms and clinical evidence of SGLT2 inhibitors in cardiovascular and renal protection.
  • Analysis of preclinical data suggesting potential benefits of SGLT2 inhibitors in lung protection.
  • Description of the design and objectives of a clinical trial investigating dapagliflozin in COVID-19 patients with respiratory failure.

Main Results:

  • SGLT2 inhibitors have demonstrated efficacy in protecting cardiac and renal function, irrespective of diabetic status.
  • Preclinical studies indicate a potential beneficial role for SGLT2 inhibitors in mitigating lung injury.
  • An ongoing clinical trial is actively assessing the therapeutic impact of dapagliflozin on mortality and morbidity in severe COVID-19.

Conclusions:

  • SGLT2 inhibitors represent a promising class of repurposed drugs for adjuvant organ protection in Coronavirus disease 2019 (COVID-19).
  • Further clinical investigation, including the ongoing trial on dapagliflozin, is crucial to establish the safety and efficacy of SGLT2 inhibitors in managing COVID-19.
  • The potential to leverage existing therapies like SGLT2 inhibitors could expedite the development of effective treatments for this global pandemic.

Keywords:
COVID-19SGLT2canagliflozincardiovascularchronic kidney diseasedapagliflozindiabetesempagliflozin

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