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The Effect of Metformin Consumption on Mortality in Hospitalized COVID-19 patients: a systematic review and meta-analysis

Lukito et al., Diabetes & Metabolic Syndrome: Clinical Research & Reviews, doi:10.1016/j.dsx.2020.11.006
Nov 2020  
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Mortality 36% Improvement Relative Risk Metformin for COVID-19  Lukito et al.  META ANALYSIS c19early.org Favorsmetformin Favorscontrol 0 0.5 1 1.5 2+
Metformin for COVID-19
3rd treatment shown to reduce risk in July 2020
 
*, now with p < 0.00000000001 from 91 studies.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 75 treatments. c19early.org
Meta analysis of 9 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 91 metformin for COVID-19 studies, showing 34% lower mortality [29‑39%], 33% lower ventilation [17‑46%], 17% lower ICU admission [6‑26%], 18% lower hospitalization [11‑23%], and 5% fewer cases [-4‑13%].
risk of death, 36.0% lower, OR 0.64, p = 0.03, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Lukito et al., 11 Nov 2020, peer-reviewed, 6 authors.
This PaperMetforminAll
The Effect of Metformin Consumption on Mortality in Hospitalized COVID-19 patients: a systematic review and meta-analysis
Antonia Anna Lukito, Raymond Pranata, Joshua Henrina, Michael Anthonius Lim, Sherly Lawrensia, Ketut Suastika
Diabetes & Metabolic Syndrome: Clinical Research & Reviews, doi:10.1016/j.dsx.2020.11.006
Background and aims: Diabetes is one of the most common comorbidities, and it is associated with poorer outcomes in patients with coronavirus disease 2019 . Preliminary findings showed that mortality was reduced in those who consume metformin compared to those who did not, and given its low cost and widespread availability; metformin is an attractive and potential agent to mitigate excessive risk in diabetic populations. Methods: Several medical databases (Pubmed, EuropePMC, EBSCOhost, Proquest, Cochrane library) and two health-science preprint servers (preprint.org and Medrxiv) were systematically searched for relevant literature. Results: Nine studies with 10,233 subjects were included in the qualitative and quantitative synthesis. Meta-analysis showed that metformin is associated with lower mortality in pooled non-adjusted model (OR 0.45 [0.25, 0.81], p ¼ 0.008; I 2: 63.9%, p ¼ 0.026) and pooled adjusted model (OR 0.64 [0.43, 0.97], p ¼ 0.035; I 2 : 52.1%, p ¼ 0.064). Conclusion: The analysis showed that metformin consumption was associated with lower mortality. Randomized controlled trials are needed to confirm this finding.
Ethics approval and consent to participate Not Applicable. Consent for publication Not Applicable. Conflicts of interest The authors declare that they have no competing interests. Abbreviations ACE2 Angiotensin
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