Is there an association between metformin use and clinical outcomes in diabetes patients with COVID-19?
et al., Diabetes & Metabolism, doi:10.1016/j.diabet.2020.10.006, Jul 2021
Metformin for COVID-19
3rd treatment shown to reduce risk in
July 2020, now with p < 0.00000000001 from 110 studies.
Lower risk for mortality, ventilation, ICU, hospitalization, progression, recovery, and viral clearance.
No treatment is 100% effective. Protocols
combine treatments.
6,400+ studies for
210+ treatments. c19early.org
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Retrospective 1,865 diabetes patients with COVID-19 in South Korea showing no significant differences in survival with metformin use.
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risk of death, 7.5% higher, HR 1.08, p = 0.81, treatment 469, control 1,301, combined.
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risk of death, 38.0% higher, HR 1.38, p = 0.08, treatment 469, control 1,301, metformin vs. no diabetes drug.
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risk of death, 23.0% lower, HR 0.77, p = 0.05, treatment 469, control 95, metformin vs. non-metformin.
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risk of mechanical ventilation, 35.2% higher, HR 1.35, p = 0.16, treatment 469, control 1,301, combined.
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risk of mechanical ventilation, 40.0% higher, HR 1.40, p = 0.17, treatment 469, control 1,301, metformin vs. no diabetes drug.
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risk of mechanical ventilation, 20.0% higher, HR 1.20, p = 0.68, treatment 469, control 95, metformin vs. non-metformin.
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| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
Do et al., 31 Jul 2021, retrospective, South Korea, peer-reviewed, 5 authors, study period 1 February, 2020 - 15 May, 2020.
Contact: kangkang@ynu.ac.kr.
Is there an association between metformin use and clinical outcomes in diabetes patients with COVID-19?
Diabetes & Metabolism, doi:10.1016/j.diabet.2020.10.006
Aim. -Previous studies have reported inconsistent results regarding the association between metformin use and clinical outcomes in diabetes mellitus (DM) patients with coronavirus disease 2019 . This study aimed to evaluate the association between metformin use and clinical outcomes in DM patients with COVID-19. Methods. -This retrospective study was based on claims data. All diseases, including COVID-19, were defined using International Classification of Diseases 10th Revision (ICD-10) codes. Patients were divided into three groups depending on metformin use: CON (those not taking DM medication); N-MFOM (those taking DM medications other than metformin); and MFOM (those taking metformin for DM). Ultimately, 1865 patients were included; CON, N-MFOM and MFOM groups comprised 1301, 95 and 469 patients, respectively. Results. -Kaplan-Meier analyses showed that MFOM patients had poorer survival rates than those in the CON group, but there were no significant differences in survival rates between MFOM and N-MFOM groups. Multivariate Cox regression analyses revealed more favourable survival in CON than in N-MFOM patients, but there was no statistically significant difference in MFOM vs the other groups. Also, there were no significant differences in rates of use of inotropes, extracorporeal membrane oxygenation, conventional oxygen therapy, high-flow nasal cannulas or mechanical ventilators, nor in the rates of acute kidney injury or cardiac events across all study groups. Conclusion. -No definite association could be found between metformin use and clinical outcomes, including survival. However, given the disproportionate participant numbers in our groups and small number of events, further studies are needed to determine whether the use of metformin has favourable or unfavourable effects in DM patients with COVID-19.
Ethics approval and consent to participate The study was approved by the Institutional Review Board of the Yeungnam University Medical Centre, which waived the need for obtaining informed consent (IRB No: YUMC 2020-07-024). The study was conducted in accordance with the principles of the Declaration of Helsinki. Authors' contributions S.H.K. and K.H.C. conceived and planned the study. S.H.K. and S.W.K. identified and obtained the data for this analysis. S.H.K., S.W.K. and J.Y.D. extracted and processed the data. S.W.K. and J.W.P. carried out the statistical analyses. S.H.K. wrote the first draft of the manuscript. All authors read and approved the final manuscript.
Consent for publication Not applicable.
Competing interests The authors have no competing interests to declare.
Appendix A. Supplementary data Supplementary material related to this article can be found, in the online version, at doi: https://doi.org/10.1016/j.diabet.2020.10. 006 .
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