Use of SGLT‐2 inhibitor in COVID‐19: A cautionary tale

SGLT-2 inhibitors have an added benefit of weight loss and a reduction of blood pressure. TABLE 1 Laboratory parameters and characteristics of patient Variable Day 1 (admission) Day 5 (discharge) Follow-up (day 58) WBC (106/μL) 14.2 10.8 6.8 Hemoglobin (g/dL) 16.7 13.6 13.7 Hematocrit (%) 53.3 40.6 40 Platelets (106/μL) 299 291 390 CRP (mg/L) 245 76.9 10.1 Ferritin (μg/L) 1091 764 243 Creatinine 80 47 41 Alkaline phosphatase (units/L) 128 60 55 Interleukin-6 (pg/mL) 36 – 26 Blood sugar (mmol/L) 6.3 8.2 7.9 B hydroxybutyrates (mmol/L) 6.56 0.06 – Ethanol level Negative – – pH 7.21 7.42 – pCO2 (mm Hg) 30 30 – pO2 (mm Hg) 85 80 – HCO3 (mmol/L) 14 20 24 Sodium (mmol/L) 143 136 135 Potassium (mmol/L) 4.8 3.8 4.6 Chloride (mmol/L) 111 108 102 Lactic acid (mmol/L) 1.1 1.3 1.8 Albumin (g/L) 22 20 26 Anion gap (mmol/L) 18 8 9 Delta gap (mmol/L) 6 −4 −3 Delta ratio 0.6 −1 – Albumin corrected anion gap (mmol/L) 23.5 13 12.5 Albumin corrected delta gap (mmol/L) 10.5 1 0.5 Albumin corrected delta ratio 1.1 0.3 – SGLT-2 inhibitors have a pro-ketogenic and calorie restriction effect due to the loss of glucose in urine. CONFLICT OF INTEREST The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.