ReviewDiabetes & metabolic syndrome
Use of pioglitazone in people with type 2 diabetes mellitus with coronavirus disease 2019 (COVID-19): Boon or bane?
Review in Diabetes & metabolic syndrome. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 25 citations in OpenAlex.
- Article
- Diabetic pulmonary microangiopathy and its association with glycated haemoglobin and other diabetic complications.Bioinformation · 2025Article
- The prognostic significance of insulin resistance in COVID-19: a review.Journal of diabetes and metabolic disorders · 2024Review
- Antidiabetic Drug Efficacy in Reduction of Mortality during the COVID-19 Pandemic.Medicina (Kaunas, Lithuania) · 2023Review
- Advances in Research on Type 2 Diabetes Mellitus Targets and Therapeutic Agents.International journal of molecular sciences · 2023Review
- Peroxisome Proliferator-Activated Receptor-Targeted Therapies: Challenges upon Infectious Diseases.Cells · 2023Review
- Potential Therapeutic Benefits of Metformin Alone and in Combination with Sitagliptin in the Management of Type 2 Diabetes Patients with COVID-19.Pharmaceuticals (Basel, Switzerland) · 2022Article
- The COVID-19-diabetes mellitus molecular tetrahedron.Molecular biology reports · 2022Review
- PPAR Ligands Induce Antiviral Effects Targeting Perturbed Lipid Metabolism during SARS-CoV-2, HCV, and HCMV Infection.Biology · 2022Review
- SARS-CoV-2-host proteome interactions for antiviral drug discovery.Molecular systems biology · 2021Article
- Interplay of Opposing Effects of the WNT/β-Catenin Pathway and PPARγ and Implications for SARS-CoV2 Treatment.Frontiers in immunology · 2021Review
- COVID-19 in Relation to Hyperglycemia and Diabetes Mellitus.Frontiers in cardiovascular medicine · 2021Review
- Blood Glucose Control Strategy for Type 2 Diabetes Patients With COVID-19.Frontiers in cardiovascular medicine · 2020Review
- Perspectives of Antidiabetic Drugs in Diabetes With Coronavirus Infections.Frontiers in pharmacology · 2020Review
- Cardiometabolic vigilance in COVID-19 and resource husbandry in resource-challenged times: Clinical practice- based expert opinion.Diabetes & metabolic syndromeReview
- Pros and cons for use of statins in people with coronavirus disease-19 (COVID-19).Diabetes & metabolic syndromeReview
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsPeople with type 2 diabetes mellitus (T2DM) have increased morbidity and mortality due to coronavirus disease-19(COVID-19). It has been speculated that use of pioglitazone might increase such risk. The aim of our brief commentary is to review the safety of pioglitazone in people with T2DM and mild/moderate COVID-19.
methodsWe searched PubMed database using specific keywords related to our aims till May 15, 2020. Full text of relevant articles published in English language were retrieved and reviewed.
resultsMedications, including pioglitazone, that upregulate tissue expression of angiotensin converting enzyme 2 (ACE2), might have a dual role in COVID-19; on the one hand they might increase risk of infection as SARS-CoV2 uses ACE2 as a coreceptor to enter alveolar cells, but on the other hand, by reducing angiotensin II levels, they can protect against acute lung injury. There is no evidence to date that pioglitazone upregulates ACE2 in the alveolar cells; rather, there is evidence from animal studies of upregulation of ACE2 in insulin sensitive tissues, which might have a protective effect on lung injury. Moreover by moderating the exaggerated host proinflammatory response, pioglitazone can potentially reduce SARS-CoV-2 driven hyperinflammation.
conclusionsPioglitazone has more potential for benefit than harm, and can be continued in people with T2DM and mild/moderate COVID-19, unless there are specific contraindications for its use. There is an urgent need to assess clinically relevant outcomes in people with diabetes and COVID-19 based upon baseline antidiabetes therapy, in particular pioglitazone.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.