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

DOI record: { "DOI": "10.1371/journal.pone.0282210", "ISSN": [ "1932-6203" ], "URL": "http://dx.doi.org/10.1371/journal.pone.0282210", "abstract": "<jats:sec id=\"sec001\">\n<jats:title>Background</jats:title>\n<jats:p>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 in-hospital mortality in patients hospitalized for COVID-19.</jats:p>\n</jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods</jats:title>\n<jats:p>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.</jats:p>\n</jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results</jats:title>\n<jats:p>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).</jats:p>\n</jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions</jats:title>\n<jats:p>Our results suggest that there is a significant association between the reduction of in-hospital mortality and outpatient metformin therapy for type 2 diabetes mellitus in patients hospitalized for COVID-19.</jats:p>\n</jats:sec>", "author": [ { "ORCID": "http://orcid.org/0000-0002-0381-7804", "affiliation": [], "authenticated-orcid": true, "family": "Ma", "given": "Zhiyuan", "sequence": "first" }, { "ORCID": "http://orcid.org/0000-0002-1132-1788", "affiliation": [], "authenticated-orcid": true, "family": "Krishnamurthy", "given": "Mahesh", "sequence": "additional" } ], "container-title": "PLOS ONE", "container-title-short": "PLoS ONE", "content-domain": { "crossmark-restriction": false, "domain": [ "www.plosone.org" ] }, "created": { "date-parts": [ [ 2023, 2, 23 ] ], "date-time": "2023-02-23T18:31:15Z", "timestamp": 1677177075000 }, "deposited": { "date-parts": [ [ 2023, 2, 23 ] ], "date-time": "2023-02-23T18:31:42Z", "timestamp": 1677177102000 }, "editor": [ { "affiliation": [], "family": "Hirst", "given": "Jennifer A.", "sequence": "first" } ], "indexed": { "date-parts": [ [ 2023, 2, 24 ] ], "date-time": "2023-02-24T05:21:00Z", "timestamp": 1677216060751 }, "is-referenced-by-count": 0, "issue": "2", "issued": { "date-parts": [ [ 2023, 2, 23 ] ] }, "journal-issue": { "issue": "2", "published-online": { "date-parts": [ [ 2023, 2, 23 ] ] } }, "language": "en", "license": [ { "URL": "http://creativecommons.org/licenses/by/4.0/", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2023, 2, 23 ] ], "date-time": "2023-02-23T00:00:00Z", "timestamp": 1677110400000 } } ], "link": [ { "URL": "https://dx.plos.org/10.1371/journal.pone.0282210", "content-type": "unspecified", 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