Inroduction
The pandemic caused by the coronavirus disease-2019 (COVID-19) has
caused millions of people’s death since December 2019 and continues to
do so. Although an effective drug treatment has not yet been found,
vaccines developed against COVID-19 have been applied all over the world
since the last months of 2020. On the other hand, studies on which
factors affect the severity of the disease are still continuing. Studies
to date indicate that age is the primary risk factor for
COVID-19-related hospitalization and/or death. In addition, it has been
revealed that the clinical course of COVID-19 is more severe in patients
with chronic diseases such as hypertension (HT), cardiovascular diseases
(CVD), diabetes mellitus (DM), obesity, chronic kidney failure, and
cancer [1–4].
The cellular structure and receptors of the severe acute respiratory
syndrome coronavirus-2 (SARS CoV-2) that causes COVID-19 was found in
March 2020. It was determined that the virus entered the cell with the
angiotensin converting enzyme-2 (ACE2) receptor and the transmembrane
protease serine 2 (TMPRSS2) receptor facilitated the entry of the virus
into the cell [5]. Since then, the use of drug groups such as ACE
inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) [6–8],
ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs)
[9,10], thiazolidinediones [11] which may cause an increase or
decrease in ACE2 expression, has been investigated in large-scale
studies during the COVID-19 pandemic. In general, it has been
demonstrated that these drugs do not affect the severity or mortality of
COVID-19. Besides, studies in which metformin was associated with
decreased mortality and insulin was associated with increased mortality
were published [11–14]. Regarding dipeptidyl peptidase-4 (DPP4)
inhibitors, results have been reported that they are associated with
good or poor clinical course of COVID-19 [11,15,16].
Considering that the rate of spread of COVID-19 may be related to the
expression status of ACE2 or TMPRSS2 receptors [17,18] or to some
other genetic factors that are not yet known, data in different parts of
the world are important. With this study, we aimed to examine the
effects of previous drug utilization in the last 6 months before
contracting COVID-19 on the clinical course of COVID-19 by presenting
data from Istanbul, Turkey.