Anti-diabetes agent as potential therapeutic treatment for
COVID-19
Some therapeutic agents used to treat diabetes have shown evidence of
effectiveness against Sars-Cov and MERS, epidemics similar to
Sars-Cov-2. It is now known that in the most severe stages of COVID-19
infection an overactive and uncontrolled inflammatory host system caused
by a cytokinic cascade is responsible for multi-organ dysfunction and
serious fatal lung lesions. The use of metformin has shown a decrease in
inflammatory markers in patients with Sars-Cov and MERS, however its use
in the severe COVID-19 patient should be carefully assessed in view of
the risks described above. (23)(24) The use of DPP IV inhibitors
(glyptine) is being studied in the COVID-19 patient. The DPP4 protein is
expressed in many cells including alveolar epithelium and inflammatory
cells. MERS-CoV uses DPP4 to enter host cells (25), but it is not known
whether Sars-Cov-2 also uses the same protein to enter the cell, in
addition to ACE-2. If this is demonstrated, the use of glyptins could
decrease the risk of Sars-Cov-2 infection but this has not been
demonstrated so far. The potential benefit in the treatment of
Sars-Cov-2 infection with DPP IV inhibitors remains to be further
investigated (26). Similar to metformin, the effects of reducing
inflammatory markers are also known for GLP-1RA and have also
demonstrated a potential therapeutic benefit in acute lung lesions (27).
However, the available data are limited to experimental models and their
benefit still remains to be studied.