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

IIS-Fundación Jiménez Diaz, Department of Medicine, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain
Red de Investigación Renal (REDINREN), Instituto Carlos III-FEDER, 28040 Madrid, Spain
Department of Nephrology, Hospital Clínico Universitario, INCLIVA, 46010 Valencia, Spain
Medicine Department, Universidad de Valencia, 46010 Valencia, Spain
Nephrology Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Nephrology Research Group, Vall d’Hebron Research Institute, 08035 Barcelona, Spain
Department of Medicine, Division of Nephrology, Koc University School of Medicine, 43010 Istanbul, Turkey
Department of Medicine, Hospital Universitario de Canarias, 38320 Tenerife, Spain
Instituto de Tecnologías Biomédicas, University of La Laguna, 38320 Tenerife, Spain
Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(7), 2030;
Received: 28 May 2020 / Revised: 16 June 2020 / Accepted: 22 June 2020 / Published: 28 June 2020
(This article belongs to the Special Issue COVID-19: From Pathophysiology to Clinical Practice)
Hospital admissions and mortality from the Coronavirus disease 2019 (COVID-19) pandemic are spreading throughout the world, and second and third waves are thought to be likely. Risk factors for severe COVID-19 include diabetes, chronic kidney disease and cardiovascular disease. Currently, there is no vaccine and no approved therapy. Therapeutic approaches are aimed at preventing viral replication and spread, limiting the impact of the inflammatory overdrive (cytokine storm), preventing thromboembolic complications and replacing or supporting organ function. However, despite organ support, mortality is currently 65% for those receiving advanced respiratory support and 78% for those requiring renal replacement therapies. Thus, efforts should be made to provide adjuvant organ protection therapy. This may imply novel therapies in clinical development (e.g., the Fas ligand trap asunercept), but uptake of repurposed drugs already in clinical use may be faster. In this regard, sodium glucose co-transporter-2 (SGLT2) inhibitors were recently shown to protect the heart and kidney both within and outside of a diabetic milieu context. Further, preclinical data support a beneficial effect for the lung. We now discuss the potential benefits and risks of SGLT2 inhibitors in COVID-19 and an ongoing clinical trial testing the impact of dapagliflozin on outcomes in COVID-19 patients with respiratory failure. View Full-Text
Keywords: COVID-19; diabetes; chronic kidney disease; cardiovascular; SGLT2; canagliflozin; dapagliflozin; empagliflozin COVID-19; diabetes; chronic kidney disease; cardiovascular; SGLT2; canagliflozin; dapagliflozin; empagliflozin
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Fernandez-Fernandez, B.; D’Marco, L.; Górriz, J.L.; Jacobs-Cachá, C.; Kanbay, M.; Luis-Lima, S.; Porrini, E.; Sarafidis, P.; Soler, M.J.; Ortiz, A. Exploring Sodium Glucose Co-Transporter-2 (SGLT2) Inhibitors for Organ Protection in COVID-19. J. Clin. Med. 2020, 9, 2030.

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