Abstract: Clinical and Translational Report Metformin Is Associated with Higher Incidence of Acidosis, but Not Mortality, in Individuals with COVID-19 and Pre-existing Type 2 Diabetes Graphical Abstract Authors Xu Cheng, Ye-Mao Liu, Haomiao Li, ..., Zhi-Gang She, Yan-Xiao Ji, Hongliang Li Correspondence lihl@whu.edu.cn (H.L.), yuanyf1971@whu.edu.cn (Y.Y.), xiangwei@tjh.tjmu.edu.cn (X.W.), zgshe@whu.edu.cn (Z.-G.S.), jiyanxiao@whu.edu.cn (Y.-X.J.) In Brief In a cohort of 1,213 hospitalized patients with COVID-19 and pre-existing type 2 diabetes, Cheng et al. show that metformin use is significantly associated with higher incidence of acidosis, particularly in cases with severe COVID19, but not with 28-day all-cause mortality. They also found that metformin use is significantly associated with reduced heart failure and inflammation. Highlights d A retrospective study of 1,213 patients on metformin with COVID-19 was performed d Metformin was associated with increased incidence of acidosis in such patients d Metformin was not associated with increased 28-day allcause mortality in the patients d Metformin was significantly associated with reduced heart failure and inflammation Cheng et al., 2020, Cell Metabolism 32, 537–547 October 6, 2020 ª 2020 Elsevier Inc. https://doi.org/10.1016/j.cmet.2020.08.013 ll ll Clinical and Translational Report Metformin Is Associated with Higher Incidence of Acidosis, but Not Mortality, in Individuals with COVID-19 and Pre-existing Type 2 Diabetes Xu Cheng,1,2,17 Ye-Mao Liu,2,3,17 Haomiao Li,2,3,17 Xin Zhang,2,17 Fang Lei,1,2,17 Juan-Juan Qin,2,3 Ze Chen,2,3 Ke-Qiong Deng,1 Lijin Lin,2,3 Ming-Ming Chen,2,3 Xiaohui Song,2,3 Meng Xia,2 Xuewei Huang,2,3 Weifang Liu,1,2 Jingjing Cai,4 Xiao-Jing Zhang,2,3 Feng Zhou,2,5 Peng Zhang,2,5 Yibin Wang,6 Xinliang Ma,7 Qingbo Xu,8 Juan Yang,2,3 Ping Ye,9 Weiming Mao,10 Xiaodong Huang,11 Jiahong Xia,12 Bing-Hong Zhang,13 Jiao Guo,14 Lihua Zhu,2,3 Zhibing Lu,1 Yufeng Yuan,15,* Xiang Wei,16,* Zhi-Gang She,2,3,* Yan-Xiao Ji,2,5,* and Hongliang Li1,2,3,5,18,* 1Department of Cardiology, Zhongnan Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China of Model Animal, Wuhan University, Wuhan, China 3Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China 4Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha 410000, China 5Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China 6Departments of Anesthesiology, Physiology, and Medicine, Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA 7Department of Emergency Medicine, Thomas Jefferson University, Philadelphia, PA 19004, USA 8Centre for Clinic Pharmacology, The William Harvey Research Institute, Queen Mary University of London, London, UK 9Department of Cardiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China 10Department of General Surgery, Huanggang Central Hospital, Huanggang, China 11Department of Gastroenterology, Wuhan Third Hospital and Tongren Hospital of Wuhan University, Wuhan, China 12Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China 13Department of Neonatology, Renmin Hospital of Wuhan University, Wuhan, China 14Guangdong Metabolic Diseases Research Center of Integrated Chinese..