---
title: "Semaglutide Lowers Risk of COVID-19 and Serious Infections in FLOW Trial Participants with T2D and"
id: "pubmed-41728915"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-41728915"
content_type: "clinical_feed_article"
specialty: "Nephrology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/41728915/"
doi: "10.1093/ndt/gfag036"
published_at: "2026-08-27T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Semaglutide Lowers Risk of COVID-19 and Serious Infections in FLOW Trial Participants with T2D and
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-41728915
- **Specialty:** [Nephrology](https://medichelpline.com/clinical-feed/nephrology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/41728915/)
- **DOI:** [10.1093/ndt/gfag036](https://doi.org/10.1093%2Fndt%2Fgfag036)
- **Published At:** 2026-08-27T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This prespecified analysis from the FLOW randomized trial evaluated the effect of once-weekly subcutaneous **semaglutide** 1.0 mg versus placebo on serious infections and **COVID-19** outcomes in participants with **type 2 diabetes** (T2D) and **chronic kidney disease** (CKD). - The primary composite outcome combined time to first infection serious adverse event (SAE), first hospitalization for infection, or all-cause death. - Semaglutide reduced the risk of the primary composite outcome versus placebo: hazard ratio (HR) 0.79 (95% CI 0.69–0.89), P = .0002. - Absolute and relative rates: the semaglutide group had lower rates of infection SAEs (17.9% vs 21.3%; P = .0070), hospitalization due to infection (17.5% vs 20.4%; P = .015), COVID-19 SAEs (6.7% vs 8.8%; P = .0155), and COVID-19 adverse events (20.3% vs 22.9%; P = .0190). - Subgroup analyses showed larger relative benefit among participants with baseline hemoglobin A1c >8% (HR 0.63; 95% CI 0.52–0.76) compared with ≤8% (HR 0.93; 95% CI 0.79–1.11); interaction P = .0027. - Greater benefit also observed for participants with higher baseline albuminuria: UACR ≥2000 mg/g (HR 0.53; 95% CI 0.39–0.72) versus UACR <100 mg/g (HR 0.90; 95% CI 0.58–1.39); interaction P = .0367. - The analysis included other endpoints such as all infection SAEs, death due to infection, and death concurrent with a COVID-19 SAE; specific numeric details for some secondary outcomes were not reported in the abstract. - Authors conclude that **semaglutide** reduced infection-related serious adverse events, infection hospitalizations, and all-cause death, with greater benefit in those with poorer glycemic control and higher albuminuria, suggesting potential benefits beyond kidney, cardiovascular, and metabolic outcomes in high-risk T2D with CKD patients.
## Clinical Analysis & Structured Key Points
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more resources ](https://pubmed.ncbi.nlm.nih.gov/41728915/#linkout) Title & authors Abstract Similar articles Publication types MeSH terms Substances Associated data Related information Grants and funding LinkOut - more resources Randomized Controlled Trial Nephrol Dial Transplant Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Nephrol+Dial+Transplant%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Nephrol+Dial+Transplant%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/41728915/) . 2026 Aug 27;41(9):1696-1708. doi: 10.1093/ndt/gfag036. # Effect of semaglutide on COVID-19 and other infections: an analysis from the FLOW randomized clinical trial [Brian Rayner](https://pubmed.ncbi.nlm.nih.gov/?term=Rayner+B&cauthor_id=41728915)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#full-view-affiliation-1 "Division of Nephrology and Hypertension, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa."), [Kenneth W Mahaffey](https://pubmed.ncbi.nlm.nih.gov/?term=Mahaffey+KW&cauthor_id=41728915)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#full-view-affiliation-2 "Department of Medicine, Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA, USA."), [Johannes F E Mann](https://pubmed.ncbi.nlm.nih.gov/?term=Mann+JFE&cauthor_id=41728915)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#full-view-affiliation-3 "KfH Kidney Centre, München, Germany.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#full-view-affiliation-4 "University Hospital, Friedrich-Alexander University, Erlangen, Germany."), [Richard E Pratley](https://pubmed.ncbi.nlm.nih.gov/?term=Pratley+RE&cauthor_id=41728915)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#full-view-affiliation-5 "AdventHealth Translational Research Institute, Orlando, FL, USA."), [Peter Rossing](https://pubmed.ncbi.nlm.nih.gov/?term=Rossing+P&cauthor_id=41728915)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#full-view-affiliation-6 "Steno Diabetes Center Copenhagen, Herlev, Denmark.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#full-view-affiliation-7 "Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark."), [Nicolas Belmar](https://pubmed.ncbi.nlm.nih.gov/?term=Belmar+N&cauthor_id=41728915)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#full-view-affiliation-8 "Novo Nordisk A/S, Søborg, Denmark."), [Heidrun Bosch-Traberg](https://pubmed.ncbi.nlm.nih.gov/?term=Bosch-Traberg+H&cauthor_id=41728915)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#full-view-affiliation-8 "Novo Nordisk A/S, Søborg, Denmark."), [Ole Kleist Jeppesen](https://pubmed.ncbi.nlm.nih.gov/?term=Jeppesen+OK&cauthor_id=41728915)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#full-view-affiliation-8 "Novo Nordisk A/S, Søborg, Denmark."), [Minh Chau Tran](https://pubmed.ncbi.nlm.nih.gov/?term=Tran+MC&cauthor_id=41728915)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#full-view-affiliation-8 "Novo Nordisk A/S, Søborg, Denmark."), [Gil Chernin](https://pubmed.ncbi.nlm.nih.gov/?term=Chernin+G&cauthor_id=41728915)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#full-view-affiliation-9 "Kaplan Medical Center, Hebrew University of Jerusalem, Rehovot, Israel."), [Katherine R Tuttle](https://pubmed.ncbi.nlm.nih.gov/?term=Tuttle+KR&cauthor_id=41728915)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#full-view-affiliation-10 "Division of Nephrology, University of Washington School of Medicine, Seattle, WA, USA.")[ 11 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#full-view-affiliation-11 "Providence Medical Research Center, Providence Inland Northwest Health, Spokane, WA, USA.") Affiliations Expand ### Affiliations * 1 Division of Nephrology and Hypertension, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa. * 2 Department of Medicine, Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA, USA. * 3 KfH Kidney Centre, München, Germany. * 4 University Hospital, Friedrich-Alexander University, Erlangen, Germany. * 5 AdventHealth Translational Research Institute, Orlando, FL, USA. * 6 Steno Diabetes Center Copenhagen, Herlev, Denmark. * 7 Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. * 8 Novo Nordisk A/S, Søborg, Denmark. * 9 Kaplan Medical Center, Hebrew University of Jerusalem, Rehovot, Israel. * 10 Division of Nephrology, University of Washington School of Medicine, Seattle, WA, USA. * 11 Providence Medical Research Center, Providence Inland Northwest Health, Spokane, WA, USA. * PMID: **41728915** * DOI: [ 10.1093/ndt/gfag036 ](https://doi.org/10.1093/ndt/gfag036) Free article Item in Clipboard Randomized Controlled Trial # Effect of semaglutide on COVID-19 and other infections: an analysis from the FLOW randomized clinical trial Brian Rayner et al. Nephrol Dial Transplant. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID Nephrol Dial Transplant Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Nephrol+Dial+Transplant%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Nephrol+Dial+Transplant%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/41728915/) . 2026 Aug 27;41(9):1696-1708. doi: 10.1093/ndt/gfag036. ### Authors [Brian Rayner](https://pubmed.ncbi.nlm.nih.gov/?term=Rayner+B&cauthor_id=41728915)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#short-view-affiliation-1 "Division of Nephrology and Hypertension, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa."), [Kenneth W Mahaffey](https://pubmed.ncbi.nlm.nih.gov/?term=Mahaffey+KW&cauthor_id=41728915)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#short-view-affiliation-2 "Department of Medicine, Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA, USA."), [Johannes F E Mann](https://pubmed.ncbi.nlm.nih.gov/?term=Mann+JFE&cauthor_id=41728915)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#short-view-affiliation-3 "KfH Kidney Centre, München, Germany.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#short-view-affiliation-4 "University Hospital, Friedrich-Alexander University, Erlangen, Germany."), [Richard E Pratley](https://pubmed.ncbi.nlm.nih.gov/?term=Pratley+RE&cauthor_id=41728915)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#short-view-affiliation-5 "AdventHealth Translational Research Institute, Orlando, FL, USA."), [Peter Rossing](https://pubmed.ncbi.nlm.nih.gov/?term=Rossing+P&cauthor_id=41728915)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#short-view-affiliation-6 "Steno Diabetes Center Copenhagen, Herlev, Denmark.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#short-view-affiliation-7 "Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark."), [Nicolas Belmar](https://pubmed.ncbi.nlm.nih.gov/?term=Belmar+N&cauthor_id=41728915)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#short-view-affiliation-8 "Novo Nordisk A/S, Søborg, Denmark."), [Heidrun Bosch-Traberg](https://pubmed.ncbi.nlm.nih.gov/?term=Bosch-Traberg+H&cauthor_id=41728915)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#short-view-affiliation-8 "Novo Nordisk A/S, Søborg, Denmark."), [Ole Kleist Jeppesen](https://pubmed.ncbi.nlm.nih.gov/?term=Jeppesen+OK&cauthor_id=41728915)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#short-view-affiliation-8 "Novo Nordisk A/S, Søborg, Denmark."), [Minh Chau Tran](https://pubmed.ncbi.nlm.nih.gov/?term=Tran+MC&cauthor_id=41728915)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#short-view-affiliation-8 "Novo Nordisk A/S, Søborg, Denmark."), [Gil Chernin](https://pubmed.ncbi.nlm.nih.gov/?term=Chernin+G&cauthor_id=41728915)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#short-view-affiliation-9 "Kaplan Medical Center, Hebrew University of Jerusalem, Rehovot, Israel."), [Katherine R Tuttle](https://pubmed.ncbi.nlm.nih.gov/?term=Tuttle+KR&cauthor_id=41728915)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#short-view-affiliation-10 "Division of Nephrology, University of Washington School of Medicine, Seattle, WA, USA.")[ 11 ](https://pubmed.ncbi.nlm.nih.gov/41728915/#short-view-affiliation-11 "Providence Medical Research Center, Providence Inland Northwest Health, Spokane, WA, USA.") ### Affiliations * 1 Division of Nephrology and Hypertension, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa. * 2 Department of Medicine, Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA, USA. * 3 KfH Kidney Centre, München, Germany. * 4 University Hospital, Friedrich-Alexander University, Erlangen, Germany. * 5 AdventHealth Translational Research Institute, Orlando, FL, USA. * 6 Steno Diabetes Center Copenhagen, Herlev, Denmark. * 7 Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. * 8 Novo Nordisk A/S, Søborg, Denmark. * 9 Kaplan Medical Center, Hebrew University of Jerusalem, Rehovot, Israel. * 10 Division of Nephrology, University of Washington School of Medicine, Seattle, WA, USA. * 11 Providence Medical Research Center, Providence Inland Northwest Health, Spokane, WA, USA. * PMID: **41728915** * DOI: [ 10.1093/ndt/gfag036 ](https://doi.org/10.1093/ndt/gfag036) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** In the FLOW trial (Evaluate Renal Function with Semaglutide Once-Weekly; ClinicalTrials.gov, [NCT03819153](http://clinicaltrials.gov/show/NCT03819153 "See in ClinicalTrials.gov")), once-weekly subcutaneous semaglutide 1.0 mg versus placebo reduced the risk of major kidney, cardiovascular (CV) and mortality outcomes in participants with type 2 diabetes (T2D) and chronic kidney disease (CKD). This pre-specified analysis assesses the impact of semaglutide on risks of serious infections and coronavirus disease 2019 (COVID-19) in the FLOW trial. **Methods:** The main outcome was a three-component composite [time from randomization to first infection serious adverse event (SAE), first hospitalization due to infection, or all-cause death]. Other outcomes included all infection SAEs, COVID-19 adverse events, COVID-19 SAEs, death due to infection and death concurrent with a COVID-19 SAE. **Results:** Semaglutide reduced the risk of the main outcome versus placebo [hazard ratio (HR) (95% confidence interval) 0.79 (0.69-0.89); P = .0002]. This risk reduction was greater in subgroups with baseline hemoglobin A1c >8% [HR 0.63 (0.52-0.76)] versus ≤8% [HR 0.93 (0.79-1.11); Pinteraction = .0027], and urine albumin-to-creatinine ratio (UACR) ≥2000 mg/g [HR 0.53 (0.39-0.72)] versus UACR <100 mg/g [HR 0.90 (0.58-1.39); Pinteraction = .0367]. The semaglutide group had a lower rate of infection SAEs (17.9% versus 21.3%; P = .0070), COVID-19 SAEs (6.7% versus 8.8%; P = .0155), COVID-19 adverse events (20.3% versus 22.9%; P = .0190) and hospitalization due to infection (17.5% versus 20.4%; P = .015). **Conclusions:** Semaglutide reduced risks of infection SAEs, hospitalization due to infection, and all-cause death with greater benefit among those with poorer glycemic control and greater baseline albuminuria. These findings support potential clinical benefits of semaglutide beyond kidney, CV and metabolic outcomes in high-risk patients with T2D and CKD. **Keywords:** CKD; clinical trial; diabetic kidney disease; pneumonia; type 2 diabetes. © The Author(s) 2026. Published by Oxford University Press on behalf of the ERA. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Kidney and Survival Outcomes with Semaglutide by CKD Severity in the FLOW Trial. ](https://pubmed.ncbi.nlm.nih.gov/41706532/) Tuttle KR, Mann JFE, Mayrdorfer MM, Rayner B, Pugliese G, Pratley RE, Perkovic V, Mahaffey KW, Kashihara N, Jeppesen OK, Gumprecht J, Correa-Rotter R, Cherney DZI, Bosch-Traberg H, Arici M, Rossing P; FLOW Trial Investigators.Tuttle KR, et al.Clin J Am Soc Nephrol. 2026 Feb 18;21(5):841-51. doi: 10.2215/CJN.0000000974. Online ahead of print.Clin J Am Soc Nephrol. 2026.PMID: 41706532Free PMC article. * [ Effects of Semaglutide With or Without Concomitant Mineralocorticoid Receptor Antagonist Use in Participants With Type 2 Diabetes and Chronic Kidney Disease: A FLOW Trial Prespecified Secondary Analysis. ](https://pubmed.ncbi.nlm.nih.gov/40730031/) Rossing P, Bakris G, Perkovic V, Pratley R, Tuttle KR, Mahaffey KW, Idorn T, Belmar N, Bosch-Traberg H, Rasmussen S, Busch RS, Schmieder RE, Gillard P, Mann JFE; FLOW Investigator Group.Rossing P, et al.Diabetes Care. 2025 Nov 1;48(11):1878-1887. doi: 10.2337/dc25-0472.Diabetes Care. 2025.PMID: 40730031Free PMC article.Clinical Trial. * [ Oral Semaglutide and Heart Failure Outcomes in Persons With Type 2 Diabetes: A Secondary Analysis of the SOUL Randomized Clinical Trial. ](https://pubmed.ncbi.nlm.nih.gov/41627802/) Pop-Busui R, Rasmussen S, Deanfield JE, Buse JB, Marx N, Mulvagh SL, Inzucchi SE, Mann JFE, Emerson SS, Poulter NR, Engelmann MDM, Hovingh GK, Bayer Tanggaard K, Birkenfeld AL, Connelly KA, Haluzik M, Cavender MA, Kellerer M, Jhund PS, Gregersen S, Nielsen OW, Lam CSP, McGuire DK; SOUL Study Group.Pop-Busui R, et al.JAMA Intern Med. 2026 Apr 1;186(4):426-436. doi: 10.1001/jamainternmed.2025.7774.JAMA Intern Med. 2026.PMID: 41627802Free PMC article.Clinical Trial. * [ Semaglutide: a key medication for managing cardiovascular-kidney-metabolic syndrome. ](https://pubmed.ncbi.nlm.nih.gov/40458885/) MacIsaac RJ.MacIsaac RJ.Future Cardiol. 2025 Jul
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