SGLT2 inhibitors prevent long-COVID-associated cognitive and pain symptoms in type 2 diabetes patients

Background: Long COVID presents significant health challenges, especially for patients with type 2 diabetes. Emerging evidence suggests that sodium-glucose cotransporter-2 (SGLT2) inhibitors may provide protective effects against COVID-19 complications, but their role in reducing long COVID risk remains unclear. Methods: Utilizing the TriNetX platform, a retrospective cohort study was conducted among adults with type 2 diabetes diagnosed with COVID-19 between January 1, 2020, and June 30, 2024. Propensity score matching balanced demographic, clinical, and comorbidity profiles between SGLT2 inhibitor users and non-users. Cox proportional hazards regression assessed the risk of long COVID, defined by a spectrum of post-COVID-19 conditions. Results: Among 5,162 matched pairs, SGLT2 inhibitor use was associated with a significantly lower risk of long COVID (HR = 0.85, 95% CI: 0.79–0.91). In the category of long-COVID symptoms such as abdominal symptoms, anxiety/depression, pain, headache, and cognitive symptoms, there were lower risks observed in the SGLT2 inhibitor group. Subgroup analyses showed consistent risk reduction across different age groups and sexes. Conclusions: SGLT2 inhibitor use in patients with type 2 diabetes was linked to a reduced risk of long COVID. These findings suggest potential therapeutic benefits beyond glycemic control and highlight the need for further investigation into SGLT2 inhibitors as part of post-COVID-19 management strategies.