SGLT2 inhibitors prevent long-COVID-associated cognitive and pain symptoms in type 2 diabetes patients, 2025, Yeh et al

[forestglip]

SGLT2 inhibitors prevent long-COVID-associated cognitive and pain symptoms in type 2 diabetes patients

Spoiler: Authors

Yeh, Han-Wei; Chaou, Chung-Hsien; Yang, Shun-Fa; Wang, Yu-Hsun; Kuan, Yu-Hsiang; Yeh, Chao-Bin

Background
Long COVID presents significant health challenges, especially for patients with type 2 diabetes. Emerging evidence suggests that sodium-glucose cotransporter-2 (SGLT2) inhibitors may provide protective effects against COVID-19 complications, but their role in reducing long COVID risk remains unclear.

Methods
Utilizing the TriNetX platform, a retrospective cohort study was conducted among adults with type 2 diabetes diagnosed with COVID-19 between January 1, 2020, and June 30, 2024. Propensity score matching balanced demographic, clinical, and comorbidity profiles between SGLT2 inhibitor users and non-users. Cox proportional hazards regression assessed the risk of long COVID, defined by a spectrum of post-COVID-19 conditions.

Results
Among 5,162 matched pairs, SGLT2 inhibitor use was associated with a significantly lower risk of long COVID (HR = 0.85, 95% CI: 0.79–0.91). In the category of long-COVID symptoms such as abdominal symptoms, anxiety/depression, pain, headache, and cognitive symptoms, there were lower risks observed in the SGLT2 inhibitor group. Subgroup analyses showed consistent risk reduction across different age groups and sexes.

Conclusions
SGLT2 inhibitor use in patients with type 2 diabetes was linked to a reduced risk of long COVID. These findings suggest potential therapeutic benefits beyond glycemic control and highlight the need for further investigation into SGLT2 inhibitors as part of post-COVID-19 management strategies.

Web | DOI | PDF | Virology Journal | Open Access

 

[forestglip]

The results section says:

The hazard ratio (HR) for long-COVID at 3 to 6 months was 0.82 (95% CI: 0.74–0.91), at 3 to 9 months was 0.83 (95% CI: 0.77–0.89), and at 3 to 12 months was 0.85 (95% CI: 0.79–0.91).

But the discussion gives a different hazard ratio for 3 to 6 months. I'm not sure if this is referring to something else.

After PSM matching, we observed that the use of SGLT2 inhibitors in patients with T2DM was associated with a modest reduction in the risk of developing long COVID compared to non-SGLT2 inhibitor users. Although the overall HRs were close to unity (HR = 0.94, 95% CI: 0.87–1.00 for six months; HR = 0.92, 95% CI: 0.84–1.00 for three to six months), specific long COVID symptoms such as fatigue, anxiety/depression, headache, cognitive symptoms, and myalgia were significantly less prevalent among SGLT2 inhibitor users.

And the discussion talks about a figure for mortality that I can't find in the results or supplementary file, and I don't see anything about measuring mortality in the methods.

Additionally, a lower mortality rate was observed in this group (HR = 0.68, 95% CI: 0.50–0.92)