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Mortality risk with preadmission metformin use in patients with COVID-19 and diabetes: A meta-analysis

Kow et al., Journal of Medical Virology, doi:10.1002/jmv.26498
Sep 2020  
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Metformin for COVID-19
3rd treatment shown to reduce risk in July 2020, now with p < 0.00000000001 from 97 studies.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19early.org
Meta analysis of 5 studies showing lower mortality with metformin use.
22 meta analyses show significant improvements with metformin for mortality1-21, hospitalization7,13, progression1, and severity8,9,13.
Currently there are 97 metformin for COVID-19 studies, showing 35% lower mortality [31‑39%], 33% lower ventilation [17‑46%], 17% lower ICU admission [6‑26%], 18% lower hospitalization [11‑23%], and 5% fewer cases [-4‑13%].
Kow et al., 30 Sep 2020, peer-reviewed, 2 authors.
This PaperMetforminAll
Chia Siang Kow, Shahzad Syed, Hasan
Newcastle-Ottawa Scale; OR, odds ratio. a The adjusted estimate was extracted in the analysis among patients with confirmed COVID-19 by polymerase chain reaction assay.
CONFLICT OF INTERESTS The authors declare that there are no conflict of interests. Chia Siang Kow 1 Syed Shahzad Hasan
References
Bramante, Ingraham, Murray, Observational study of metformin and risk of mortality in patients hospitalized with Covid-19
Cariou, Hadjadj, Wargny, Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes: the COR-ONADO study, Diabetologia
Chen, Yang, Cheng, Clinical Characteristics and outcomes of patients with diabetes and COVID-19 in association with glucose-lowering medication, Diabetes Care
Crouse, Grimes, Li, Might, Ovalle et al., Metformin use is associated with reduced mortality in a diverse population with COVID-19 and diabetes
Davis, Xie, Viollet, Zou, Activation of the AMP-activated kinase by antidiabetes drug metformin stimulates nitric oxide synthesis in vivo by promoting the association of heat shock protein 90 and endothelial nitric oxide synthase, Diabetes
Diabetes, Association. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes-2020, Diabetes Care43
El-Arabey, Abdalla, Metformin and COVID-19: a novel deal of an old drug
Esam, A proposed mechanism for the possible therapeutic potential of metformin in COVID-19, Diabetes Res Clin Pract
Hassan, Didari, Khan, Niaz, Mojtahedzadeh et al., A review on the protective effects of metformin in sepsis-induced organ failure, Cell J
Hattori, Suzuki, Hattori, Kasai, Metformin inhibits cytokineinduced nuclear factor kappaB activation via AMP-activated protein kinase activation in vascular endothelial cells, Hypertension
Koh, Kim, Kim, Ko, Kim, Anti-inflammatory mechanism of metformin and its effects in intestinal inflammation and colitis-associated colon cancer, J Gastroenterol Hepatol
Li, Huang, Zou, Epidemiology of COVID-19: a systematic review and meta-analysis of clinical characteristics, risk factors and outcomes
Liang, Ding, Li, Association of preadmission metformin use and mortality in patients with sepsis and diabetes mellitus: a systematic review and meta-analysis of cohort studies, Crit Care
Luo, Qiu, Liu, Metformin treatment was associated with decreased mortality in COVID-19 patients with diabetes in a retrospective analysis, Am J Trop Med Hyg
Moher, Liberati, Tetzlaff, Altman, Group, Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement, PLoS Med
Sharma, Ray, Sadasivam, Metformin in COVID-19: a possible role beyond diabetes, Diabetes Res Clin Pract
Singh, Singh, Is metformin ahead in the race as a repurposed host-directed therapy for patients with diabetes and COVID-19?, Diabetes Res Clin Pract
Ursini, Ciaffi, Landini, Meliconi, COVID-19 and diabetes: is metformin a friend or foe?, Diabetes Res Clin Pract
Wells, Shea, Connell, The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in metaanalyses
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