Is metformin use associated with low mortality in patients with type 2 diabetes mellitus hospitalized for COVID-19? a multivariable and propensity score-adjusted meta-analysis
Ma et al.
, Is metformin use associated with low mortality in patients with type 2 diabetes mellitus hospitalized for..
, PLOS ONE, doi:10.1371/journal.pone.0282210
Meta analysis of 22 metformin studies, showing significantly lower mortality with metformin use prior to hospitalization.
Currently there are 61 metformin studies
and meta analysis shows:
Ma et al., 23 Feb 2023, peer-reviewed, 2 authors.
Abstract: PLOS ONE
Is metformin use associated with low
mortality in patients with type 2 diabetes
mellitus hospitalized for COVID-19? a
multivariable and propensity score-adjusted
Zhiyuan Ma ID, Mahesh Krishnamurthy ID*
Department of Medicine, St Luke’s University Health Network-Easton Campus, Easton, Pennsylvania, United
States of America
Citation: Ma Z, Krishnamurthy M (2023) Is
metformin use associated with low mortality in
patients with type 2 diabetes mellitus hospitalized
for COVID-19? a multivariable and propensity
score-adjusted meta-analysis. PLoS ONE 18(2):
Editor: Jennifer A. Hirst, University of Oxford,
Coronavirus disease 2019 (COVID-19) is a new pandemic that the entire world is facing
since December of 2019. Increasing evidence has shown that metformin is linked to favorable outcomes in patients with COVID-19. The aim of this study was to address whether outpatient or inpatient metformin therapy for type 2 diabetes mellitus is associated with low inhospital mortality in patients hospitalized for COVID-19.
Received: November 29, 2021
Accepted: February 6, 2023
Published: February 23, 2023
Peer Review History: PLOS recognizes the
benefits of transparency in the peer review
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Copyright: © 2023 Ma, Krishnamurthy. This is an
open access article distributed under the terms of
the Creative Commons Attribution License, which
permits unrestricted use, distribution, and
reproduction in any medium, provided the original
author and source are credited.
Data Availability Statement: All relevant data are
within the paper and its Supporting Information
We searched studies published in PubMed, Embase, Google Scholar and Cochrane Library
up to November 1, 2022. Raw event data extracted from individual study were pooled using
the Mantel-Haenszel approach. Odds ratio (OR) or hazard ratio (HR) adjusted for covariates
that potentially confound the association using multivariable regression or propensity score
matching was pooled by the inverse-variance method. Random effect models were applied
for meta-analysis due to variance among studies.
Twenty-two retrospective observational studies were selected. The pooled unadjusted OR
for outpatient metformin therapy and in-hospital mortality was 0.48 (95% CI, 0.37–0.62) and
the pooled OR adjusted with multivariable regression or propensity score matching was
0.71 (95% CI, 0.50–0.99). The pooled unadjusted OR for inpatient metformin therapy and
in-hospital mortality was 0.18 (95% CI, 0.10–0.31), whereas the pooled adjusted HR was
1.10 (95% CI, 0.38–3.15).
PLOS ONE | https://doi.org/10.1371/journal.pone.0282210 February 23, 2023
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Funding: The author(s) received no specific
funding for this work.
Competing interests: The authors have declared
that no competing interests exist.
Metformin in patients with Type 2 diabetes mellitus hospitalized for COVID-19
Our results suggest that there is a significant association between the reduction of in-hospital mortality and outpatient metformin..
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