Anti-inflammatory effects of sodium-glucose cotransporter-2 inhibitors in COVID-19

The ongoing pandemic of COVID-19 is intrinsically a systemic inflammatory disorder; hence, those patients suffering an underlying chronic inflammatory disease such as diabetes mellitus are at high risk of severe complications. Preventing or suppressing the inflammatory responses are of importance in diabetic patients. Sodium-glucose cotransporters-2 inhibitors (SGLT2i) are a newly introduced anti-diabetic drugs that have hypoglycemic effects through the urinary excretion of glucose. They also have an anti-inflammatory potential in diabetes patients, in addition to improving glycemic control, and while there is no direct data available in diabetic patients with COVID-19 disease, there is evidence that suggests that SGLT2i can reduce systemic inflammation and diminish the cytokine storm effect via several cellular mechanisms. In the current review, our aim was to classify and describe the molecular and cellular pathways by which SGLT2i have anti-inflammatory effects in diabetic patients with COVID-19 disease.

Automated summary

COVID-19 is a systemic inflammatory disorder, and patients with underlying chronic inflammatory diseases like diabetes mellitus are at high risk of severe complications. Preventing or suppressing inflammation is crucial in diabetic patients. Sodium-glucose cotransporters-2 inhibitors (SGLT2i) are new anti-diabetic drugs with hypoglycemic effects and potential anti-inflammatory properties. Although there is no direct data in diabetic patients with COVID-19, evidence suggests that SGLT2i can reduce systemic inflammation and the cytokine storm effect through various cellular mechanisms. This review aims to categorize and describe the molecular and cellular pathways by which SGLT2i exert anti-inflammatory effects in diabetic patients with COVID-19.