Prevalent Metformin Use in Adults With Diabetes and the Incidence of Long COVID: An EHR-Based Cohort Study From the RECOVER Program

{ 'indexed': {'date-parts': [[2024, 9, 17]], 'date-time': '2024-09-17T18:40:21Z', 'timestamp': 1726598421108}, 'reference-count': 0, 'publisher': 'American Diabetes Association', 'license': [ { 'start': { 'date-parts': [[2024, 9, 17]], 'date-time': '2024-09-17T00:00:00Z', 'timestamp': 1726531200000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://www.diabetesjournals.org/journals/pages/license'}], 'funder': [ { 'DOI': '10.13039/100006108', 'name': 'National Center for Advancing Translational Sciences', 'doi-asserted-by': 'publisher', 'award': ['UM1TR004406', 'UM1TR004528'], 'id': [{'id': '10.13039/100006108', 'id-type': 'DOI', 'asserted-by': 'publisher'}]}, { 'DOI': '10.13039/100000062', 'name': 'National Institute of Diabetes and Digestive and Kidney Diseases', 'doi-asserted-by': 'publisher', 'award': ['DK124654'], 'id': [{'id': '10.13039/100000062', 'id-type': 'DOI', 'asserted-by': 'publisher'}]}, {'name': 'NC Diabetes Research Center', 'award': ['P30DK124723']}, { 'DOI': '10.13039/100000050', 'name': 'National Heart, Lung, and Blood Institute', 'doi-asserted-by': 'publisher', 'award': ['OT2HL16184701'], 'id': [{'id': '10.13039/100000050', 'id-type': 'DOI', 'asserted-by': 'publisher'}]}, { 'DOI': '10.13039/100000049', 'name': 'National Institute on Aging', 'doi-asserted-by': 'publisher', 'award': ['AG056479'], 'id': [{'id': '10.13039/100000049', 'id-type': 'DOI', 'asserted-by': 'publisher'}]}], 'content-domain': {'domain': ['diabetesjournals.org'], 'crossmark-restriction': True}, 'abstract': '<jats:sec>\n' ' <jats:title>OBJECTIVE</jats:title>\n' ' <jats:p>Studies show metformin use before and during SARS-CoV-2 infection ' 'reduces severe COVID-19 and postacute sequelae of SARS-CoV-2 (PASC) in adults. Our objective ' 'was to describe the incidence of PASC and possible associations with prevalent metformin use ' 'in adults with type 2 diabetes mellitus (T2DM).</jats:p>\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>RESEARCH DESIGN AND METHODS</jats:title>\n' ' <jats:p>This is a retrospective cohort analysis using the National COVID ' 'Cohort Collaborative (N3C) and Patient-Centered Clinical Research Network (PCORnet) ' 'electronic health record (EHR) databases with an active comparator design that examined ' 'metformin-exposed individuals versus nonmetformin-exposed individuals who were taking other ' 'diabetes medications. T2DM was defined by HbA1C ≥6.5 or T2DM EHR diagnosis code. The outcome ' 'was death or PASC within 6 months, defined by EHR code or computable phenotype.</jats:p>\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>RESULTS</jats:title>\n' ' <jats:p>In the N3C, the hazard ratio (HR) for death or PASC with a U09.9 ' 'diagnosis code (PASC-U09.0) was 0.79 (95% CI 0.71–0.88; P &amp;lt; 0.001), and for death or ' 'N3C computable phenotype PASC (PASC-N3C) was 0.85 (95% CI 0.78–0.92; P &amp;lt; 0.001). In ' 'PCORnet, the HR for death or PASC-U09.9 was 0.87 (95% CI 0.66–1.14; P = 0.08), and for death ' 'or PCORnet computable phenotype PASC (PASC-PCORnet) was 1.04 (95% CI 0.97–1.11; P = 0.58). ' 'Incident PASC by diagnosis code was 1.6% metformin vs. 2.0% comparator in the N3C, and 2.1% ' 'metformin vs. 2.5% comparator in PCORnet. By computable phenotype, incidence was 4.8% ' 'metformin and 5.2% comparator in the N3C and 24.7% metformin vs. 26.1% comparator in ' 'PCORnet.</jats:p>\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>CONCLUSIONS</jats:title>\n' ' <jats:p>Prevalent metformin use is associated with a slightly lower ' 'incidence of death or PASC after SARS-CoV-2 infection. PASC incidence by computable phenotype ' 'is higher than by EHR code, especially in PCORnet. These data are consistent with other ' 'observational analyses showing prevalent metformin is associated with favorable outcomes ' 'after SARS-CoV-2 infection in adults with T2DM.</jats:p>\n' ' </jats:sec>', 'DOI': '10.2337/dca24-0032', 'type': 'journal-article', 'created': {'date-parts': [[2024, 9, 17]], 'date-time': '2024-09-17T17:58:16Z', 'timestamp': 1726595896000}, 'update-policy': 'http://dx.doi.org/10.2337/ada-journal-policies', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Prevalent Metformin Use in Adults With Diabetes and the Incidence of Long COVID: An EHR-Based ' 'Cohort Study From the RECOVER Program', 'prefix': '10.2337', 'author': [ { 'ORCID': 'http://orcid.org/0000-0002-2983-6384', 'authenticated-orcid': False, 'given': 'Steven G.', 'family': 'Johnson', 'sequence': 'first', 'affiliation': [ { 'name': '1Institute for Health Informatics, University of Minnesota, ' 'Minneapolis, MN'}]}, { 'given': 'Sajjad', 'family': 'Abedian', 'sequence': 'additional', 'affiliation': [ { 'name': '2Information Technologies and Services Department, Weill Cornell ' 'Medicine, New York, NY'}]}, { 'given': 'Til', 'family': 'Stürmer', 'sequence': 'additional', 'affiliation': [ { 'name': '3Department of Epidemiology, Gillings School of Global Public ' 'Health, University of North Carolina at Chapel Hill, Chapel ' 'Hill, NC'}]}, { 'given': 'Jared D.', 'family': 'Huling', 'sequence': 'additional', 'affiliation': [ { 'name': '4Division of Biostatistics and Health Data Science, University ' 'of Minnesota School of Public Health, Minneapolis, MN'}]}, { 'given': 'Colby', 'family': 'Lewis V', 'sequence': 'additional', 'affiliation': [ { 'name': '5Department of Population Health Sciences, Weill Cornell ' 'Medicine, New York, NY'}]}, { 'ORCID': 'http://orcid.org/0000-0002-9723-3876', 'authenticated-orcid': False, 'given': 'John B.', 'family': 'Buse', 'sequence': 'additional', 'affiliation': [ { 'name': '6Division of Endocrinology, Department of Medicine, University ' 'of North Carolina School of Medicine, Chapel Hill, NC'}]}, { 'given': 'Shari B.', 'family': 'Brosnahan', 'sequence': 'additional', 'affiliation': [ { 'name': '7Department of Medicine, New York University Grossman School of ' 'Medicine, New York, NY'}]}, { 'given': 'Praveen C.', 'family': 'Mudumbi', 'sequence': 'additional', 'affiliation': [ { 'name': '8Department of Population Health, New York University Grossman ' 'School of Medicine, New York, NY'}]}, { 'given': 'Kristine M.', 'family': 'Erlandson', 'sequence': 'additional', 'affiliation': [{'name': '9University of Colorado, Anschutz Medical Campus, Aurora, CO'}]}, { 'given': 'Grace A.', 'family': 'McComsey', 'sequence': 'additional', 'affiliation': [{'name': '10Case Western Reserve University, Cleveland, OH'}]}, { 'given': 'Jonathan', 'family': 'Arnold', 'sequence': 'additional', 'affiliation': [ { 'name': '11Division of General Internal Medicine, University of ' 'Pittsburgh School of Medicine, Pittsburgh, PA'}]}, { 'given': 'Talia D.', 'family': 'Wiggen', 'sequence': 'additional', 'affiliation': [ { 'name': '1Institute for Health Informatics, University of Minnesota, ' 'Minneapolis, MN'}]}, { 'given': 'Rachel', 'family': 'Wong', 'sequence': 'additional', 'affiliation': [ { 'name': '12Department of Biomedical Informatics and the Department of ' 'Internal Medicine, Stony Brook University, Stony Brook, NY'}]}, { 'given': 'Shawn', 'family': 'Murphy', 'sequence': 'additional', 'affiliation': [{'name': '13Mass General Brigham, Boston, MA'}]}, { 'given': 'Clifford', 'family': 'Rosen', 'sequence': 'additional', 'affiliation': [{'name': '14MaineHealth Institute for Research, Scarborough, ME'}]}, { 'given': 'Rainu', 'family': 'Kaushal', 'sequence': 'additional', 'affiliation': [ { 'name': '5Department of Population Health Sciences, Weill Cornell ' 'Medicine, New York, NY'}]}, { 'given': 'Mark G.', 'family': 'Weiner', 'sequence': 'additional', 'affiliation': [ { 'name': '5Department of Population Health Sciences, Weill Cornell ' 'Medicine, New York, NY'}]}, { 'given': 'Carolyn', 'family': 'Bramante', 'sequence': 'additional', 'affiliation': [ { 'name': '15Division of General Internal Medicine, Department of Medicine, ' 'University of Minnesota Medical School, Minneapolis, MN'}]}, { 'name': 'RECOVER PCORnet EHR Cohort and the N3C Consortium', 'sequence': 'additional', 'affiliation': []}], 'member': '1167', 'published-online': {'date-parts': [[2024, 9, 17]]}, 'container-title': 'Diabetes Care', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://diabetesjournals.org/care/article-pdf/doi/10.2337/DCa24-0032/781872/dca240032.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'syndication'}, { 'URL': 'https://diabetesjournals.org/care/article-pdf/doi/10.2337/DCa24-0032/781872/dca240032.pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2024, 9, 17]], 'date-time': '2024-09-17T17:58:18Z', 'timestamp': 1726595898000}, 'score': 1, 'resource': { 'primary': { 'URL': 'https://diabetesjournals.org/care/article/doi/10.2337/DCa24-0032/157171/Prevalent-Metformin-Use-in-Adults-With-Diabetes'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2024, 9, 17]]}, 'references-count': 0, 'URL': 'http://dx.doi.org/10.2337/DCa24-0032', 'relation': {}, 'ISSN': ['0149-5992', '1935-5548'], 'subject': [], 'published': {'date-parts': [[2024, 9, 17]]}}