Background: Glucagon-like peptide 1 (GLP-1) is a gut incretin hormone, which induces post-prandial glucose-dependent insulin secretion. GLP-1 receptor agonists were found to reduce atherosclerosis and vascular inflammation and improved cardiovascular outcomes in patients with diabetes at high cardiovascular risk. We found GLP-1 levels to be associated with mortality in patients with acute myocardial infarction or sepsis. The aim of this study was to study the role of GLP-1 in patients with COVID-19. 

Methods: Circulating total GLP-1 levels were assessed at time of admission in 105 patients with COVID-19 at University Hospital Aachen (02/2020 – 01/2021); among them 43% presented with ARDS. The primary outcome of the study was all-cause mortality. 

Results: Kaplan-Meier survival plots (separated by tertiles with GLP-1 cut-off values of 39.5 and 83.2 pM) and univariable cox regression analyses found GLP-1 to be associated with adverse outcome (endpoint: all-cause mortality; p=0.0187; Time-dependent receiver operating characteristic curve AUC: 0.62). The association of GLP-1 and mortality remained significant after adjustment for age, sex, type 2 diabetes and chronic kidney disease (p=0.00758).

Conclusion: In patients hospitalized due to COVID-19 infection circulating GLP-1 levels are independently associated with all-cause mortality. Future studies are needed to investigate underlying mechanisms and potential therapeutical targets.