{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T06:48:20Z","timestamp":1772779700662,"version":"3.50.1"},"reference-count":54,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T00:00:00Z","timestamp":1667779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Type 2 diabetes mellitus (T2DM) is a potential risk factor for the development of COVID-19 and is associated with higher severity and mortality rates. T2DM patients are commonly treated with metformin monotherapy or metformin plus sitagliptin. In the present case-control, single-center cohort study, a total number of 112 T2DM patients suffering from COVID-19 and aged 44\u201362 years old were compared with 78 T2DM patients without COVID-19 and aged 42\u201356 years old. Both the patient group and the control group were allocated into four groups. Group A: T2DM patients with COVID-19 on metformin treatments plus standard therapy (n = 60); group B: T2DM patients with COVID-19 on metformin plus sitagliptin plus standard therapy (n = 52); group C: T2DM patients without COVID-19 on metformin treatments (n = 40); and group D: T2DM patients without COVID-19 on metformin plus sitagliptin (n = 38). The investigation duration was 2\u20133 weeks. Anthropometric measurements, serological and biochemical investigations, pulmonary radiological findings, and clinical outcomes were evaluated. Only 101 T2DM patients with COVID-19 continued the study, 71 (70.29%) with mild-moderate COVID-19 and 30 (29.7%) with severe COVID-19 were compared with 78 T2DM patients as a control. Inflammatory biomarkers (C reactive protein, ferritin, and procalcitonin), a lung injury biomarker (lactate dehydrogenase), and a coagulopathy biomarker (D-dimer) were elevated in severe COVID-19 patients compared with mild-moderate COVID-19 (p &lt; 0.05) and T2DM patients (p &lt; 0.05). However, metformin plus sitagliptin was more effective than metformin monotherapy in T2DM patients with COVID-19, as evidenced by the mitigation of oxidative stress, CT scan score, and clinical outcomes. The present study confirmed the protective effects of this combination against the development of COVID-19 severity, as most T2DM COVID-19 patients develop mild-moderate forms. Herein, the combination of metformin and sitagliptin may lead to more beneficial effects than metformin monotherapy.<\/jats:p>","DOI":"10.3390\/ph15111361","type":"journal-article","created":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T10:49:51Z","timestamp":1667904591000},"page":"1361","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Potential Therapeutic Benefits of Metformin Alone and in Combination with Sitagliptin in the Management of Type 2 Diabetes Patients with COVID-19"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3097-2962","authenticated-orcid":false,"given":"Hayder M.","family":"Al-Kuraishy","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology and Medicine, College of Medicine, AL-Mustansiriyia University, Baghdad 14132, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali I.","family":"Al-Gareeb","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Medicine, College of Medicine, AL-Mustansiriyia University, Baghdad 14132, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0774-5550","authenticated-orcid":false,"given":"Sarah M.","family":"Albogami","sequence":"additional","affiliation":[{"name":"Department of Biotechnology, College of Science, Taif University, Taif 21944, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9040-5647","authenticated-orcid":false,"given":"Sabatier","family":"Jean-Marc","sequence":"additional","affiliation":[{"name":"Aix-Marseille Universit\u00e9, Institut de Neurophysiopathologie (INP), CNRS UMR 7051, Facult\u00e9 des sciences m\u00e9di-cales et param\u00e9dicales, 27 Bd Jean Moulin, 13005 Marseille, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8963-790X","authenticated-orcid":false,"given":"Eman Hassan","family":"Nadwa","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Therapeutics, College of Medicine, Jouf University, Sakaka 72345, Saudi Arabia"},{"name":"Department of Medical Pharmacology, Faculty of Medicine, Cairo University, Cairo 12613, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amin A.","family":"Hafiz","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca 24382, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0463-8047","authenticated-orcid":false,"given":"Walaa","family":"A. Negm","sequence":"additional","affiliation":[{"name":"Department of Pharmacognosy, Faculty of Pharmacy, Tanta University, Tanta 31527, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3261-0327","authenticated-orcid":false,"given":"Marwa","family":"Kamal","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Department, Faculty of Pharmacy, Fayoum University, Fayoum 63514, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Al-Jouboury","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and Statistics, College of Medicine, Baghdad University, Baghdad 10071, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8287-1026","authenticated-orcid":false,"given":"Engy","family":"Elekhnawy","sequence":"additional","affiliation":[{"name":"Pharmaceutical Microbiology Department, Faculty of Pharmacy, Tanta University, Tanta 31527, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7817-425X","authenticated-orcid":false,"given":"Gaber El-Saber","family":"Batiha","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour 22511, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2782-9615","authenticated-orcid":false,"given":"Michel De","family":"Waard","sequence":"additional","affiliation":[{"name":"Smartox Biotechnology, 6 Rue des Platanes, 38120 Saint-Egr\u00e8ve, France"},{"name":"L\u2019institut du thorax, INSERM, CNRS, Universit\u00e9 de Nantes, 44007 Nantes, France"},{"name":"LabEx \u00abIon Channels, Science & Therapeutics\u00bb, Universit\u00e9 de Nice Sophia-Antipolis, 06560 Valbonne, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1080\/10408363.2020.1783198","article-title":"The COVID-19 pandemic","volume":"57","author":"Ciotti","year":"2020","journal-title":"Crit. 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