Dapagliflozin and Kidney Outcomes in Hospitalized Patients with COVID-19 Infection: Results from the DARE-19 Randomized Controlled Trial
Bibliographic record
Abstract
Background: Hospitalized patients with COVID-19 infection are at high risk of acute kidney injury (AKI) and renal replacement therapy, especially in the presence of chronic kidney disease (CKD). The DARE-19 trial showed that in hospitalized patients with COVID-19, treatment with dapagliflozin (DAPA) vs placebo resulted in numerically fewer patients experiencing organ failure or death, although these differences were not statistically significant. We performed a pre-specified secondary analysis of DARE-19 to determine the efficacy and safety of DAPA on kidney outcomes in the overall population and by CKD status. Methods: The DARE-19 trial randomized 1250 hospitalized patients (231 [18.5%] had eGFR <60 mL/min/1.73m2) with COVID-19 and cardiometabolic risk factors to DAPA or placebo. Dual primary outcomes (time to new or worsened organ dysfunction or death, and a hierarchical composite endpoint of recovery [change in clinical status by Day 30]), and the specific kidney outcome (composite of AKI, renal replacement therapy or death), as well as safety were assessed in patients with baseline eGFR <60 and ≥60 mL/min/1.73m2. Results: The effect of DAPA vs placebo on the primary prevention outcome (hazard ratio [HR] 0.80 [95%CI 0.58, 1.10]) and primary recovery outcome (win ratio 1.09 [95%CI 0.97, 1.22]) was consistent across eGFR subgroups (p for interaction 0.98 and 0.67, respectively). The effect on the composite kidney outcome (HR 0.74 [95%CI 0.50, 1.07]) was also consistent in eGFR subgroups (p for interaction 0.44). There were numerically fewer AKI events with DAPA in patients with eGFR<60 ml/min/1.73m2 (HR 0.71 [95%CI 0.29, 1.77]) and ≥60 ml/min/1.73m2 (HR 0.69 [95%CI 0.37, 1.29]). DAPA was well tolerated in patients with eGFR <60 and ≥60 mL/min/1.73m2. Conclusions: The effects of DAPA on primary and secondary outcomes in hospitalized patients with COVID-19 were consistent in those with/without CKD. DAPA was well tolerated and did not increase the risk of AKI in patients with/without CKD. Funding: Commercial Support - AstraZeneca
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".