The association between metformin treatment and COVID-19 outcomes according to metformin continuation during hospitalisation
Al-Salameh et al.
, The association between metformin treatment and COVID-19 outcomes according to metformin continuation during..
, Diabetes & Metabolism, doi:10.1016/j.diabet.2021.101297
Retrospective 140 diabetic patients in France, showing lower mortality for patients where metformin use was continued after hospitalization.
risk of death/ICU, 55.5% lower, RR 0.45, p = 0.04, treatment 9 of 47 (19.1%), control 22 of 50 (44.0%), NNT 4.0, adjusted per study, odds ratio converted to relative risk, metformin continued, multivariable.
risk of death/ICU, 68.4% higher, RR 1.68, p = 0.02, treatment 34 of 43 (79.1%), control 22 of 50 (44.0%), adjusted per study, odds ratio converted to relative risk, metformin discontinued, multivariable.
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Al-Salameh et al., 30 Nov 2021, retrospective, France, peer-reviewed, 4 authors.
Abstract: Diabetes & Metabolism 47 (2021) 101297
Available online at
The association between metformin treatment and COVID-19 outcomes
according to metformin continuation during hospitalisation
Abdallah Al-Salameha,b,*, Youssef Bennisc,d, Bertrand Carioue, Jean-Daniel Lalaua,b,*
Department of Endocrinology- Diabetes Mellitus and Nutrition, Amiens University Hospital, Amiens, France
PeriTox, UMR_I 01, University of Picardie Jules Verne, Amiens, France
Department of Clinical Pharmacology, Amiens University Hospital, Amiens, France
MP3CV Laboratory, UR UPJV 7517, University of Picardie Jules Verne, Amiens, France
^pital Guillaume et Rene Laennec, 44093
Departement d’Endocrinologie, Diabetologie et Nutrition, l'institut du thorax, Inserm, CNRS, UNIV Nantes, CHU Nantes, Ho
Nantes Cedex 01, France
A R T I C L E
I N F O
Received 25 August 2021
Received in revised form 9 October 2021
Accepted 11 October 2021
Available online 23 October 2021
Coronavirus disease 2019
Along with antidiabetic effects, metformin has anti-infective and
anti-inﬂammatory properties . We  and others  have showed
that metformin treatment is associated with better outcomes in diabetic patients hospitalised for coronavirus disease 2019 (COVID-19).
However, it is not known whether this beneﬁcial association is due to
metformin treatment prior to hospital admission, its continuation
during the hospital stay, or both. Here, we assessed differences in
outcomes for patients who continued to take metformin in hospital
versus those who did not. We also studied the correlations between
blood levels of metformin and common inﬂammatory markers.
The study population and methods have been described elsewhere . Brieﬂy, we collected data on consecutive diabetic patients
admitted to Amiens University Hospital (Amiens, France) with PCRconﬁrmed COVID-19 between the start of the outbreak in France and
May 23rd, 2020 (n = 145). We recorded each patient’s baseline characteristics, medications, laboratory results, and COVID-19 outcomes.
Medical and prescription records were screened for metformin prescription / administration during the hospital stay. Plasma and erythrocyte metformin levels were analysed in a subset of the patients
(n = 25), according to a previously described method . All the
patients were followed up until discharge or death.
Patients were categorised into “continuation of metformin
throughout the hospital stay”, “discontinuation of metformin on
tologie et Nutrition,
* Corresponding author at: Service d’Endocrinologie, Diabe
^ pital Nord, CHU Amiens-Picardie, Amiens, F-80054 cedex 01, France.
E-mail addresses: Al-Salameh.Abdallah@chu-amiens.fr (A. Al-Salameh), Lalau.JeanDaniel@chu-amiens.fr (J.-D. Lalau).
1262-3636/© 2021 Elsevier Masson SAS. All rights reserved.
admission”, and “no metformin” groups. Between-group comparisons were performed with the Mann−Whitney−Wilcoxon test (for
two groups) or the Kruskal−Wallis test (for more than two groups)
for numerical variables and Fisher’s exact test for categorical variables. The association between these groups and the primary endpoint
(a composite of intensive care unit admission or death) was probed
in a logistic regression analysis. The secondary endpoints were the
components of the primary endpoint, the need for mechanical ventilation and a..
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