Metformin use and mortality and length of stay among hospitalized patients with type 2 diabetes and COVID-19: A multiracial, multiethnic, urban observational study

DOI record: { "DOI": "10.3389/fendo.2022.1002834", "ISSN": [ "1664-2392" ], "URL": "http://dx.doi.org/10.3389/fendo.2022.1002834", "abstract": "<jats:sec><jats:title>Introduction</jats:title><jats:p>Diabetes mellitus is a common comorbidity among patients with coronavirus disease 2019 (COVID-19). Diabetic patients with COVID-19 have a two-fold increased risk of death and tend to have more severe infection compared to the general population. Metformin, a first-line medication for diabetes management, has anti-inflammatory and immunomodulatory effects. Previous studies focusing on metformin and COVID-19 clinical outcomes have had mixed results, with some showing a mortality benefit or decreased complications with metformin use. To date, few studies have analyzed such outcomes among a diverse, multiracial community.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This was a retrospective review of patients with Type 2 diabetes and a confirmed COVID-19 infection admitted to an urban academic medical center from January 1, 2020 to May 7, 2020. Baseline characteristics were collected. The primary outcomes of the study were in-hospital mortality and length of stay (LOS).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 4462 patients with Type 2 diabetes and confirmed COVID-19 were identified. 41.3% were Black, and 41.5% were Hispanic. There were 1021 patients in the metformin group and 3441 in the non-metformin group. Of note, more participants in the metformin group had comorbid disease and/or advanced diabetes. We found no statistically significant differences between the metformin and non-metformin group in in-hospital mortality (28.1% vs 25.3%, P=0.08) or length of hospital stay in days (7.3 vs. 7.5, P=0.59), even after matching patients on various factors (29.3% vs. 29.6%, P=0.87; 7.7 vs. 8.1, P=0.23).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>While patients had more comorbid disease and advanced diabetes in the metformin group, there were no significant differences with regard to in-hospital mortality or length of stay due to COVID-19 compared to the non-metformin group. Prospective studies are needed to determine if there is clinical benefit for initiating, continuing, or re-initiating metformin in patients hospitalized with COVID-19.</jats:p></jats:sec>", "alternative-id": [ "10.3389/fendo.2022.1002834" ], "author": [ { "affiliation": [], "family": "Miao", "given": "Emily", "sequence": "first" }, { "affiliation": [], "family": "Zhang", "given": "Kaleena", "sequence": "additional" }, { "affiliation": [], "family": "Liu", "given": "Jianyou", "sequence": "additional" }, { "affiliation": [], "family": "Lin", "given": "Juan", "sequence": "additional" }, { "affiliation": [], "family": "Yoo", "given": "Donna", "sequence": "additional" }, { "affiliation": [], "family": "George", "given": "Claudene J.", "sequence": "additional" } ], "container-title": "Frontiers in Endocrinology", "container-title-short": "Front. Endocrinol.", "content-domain": { "crossmark-restriction": true, "domain": [ "frontiersin.org" ] }, "created": { "date-parts": [ [ 2022, 11, 9 ] ], "date-time": "2022-11-09T05:49:00Z", "timestamp": 1667972940000 }, "deposited": { "date-parts": [ [ 2022, 11, 9 ] ], "date-time": "2022-11-09T05:49:02Z", "timestamp": 1667972942000 }, "funder": [ { "DOI": "10.13039/100000002", "doi-asserted-by": "publisher", "name": "National Institutes of Health" } ], "indexed": { "date-parts": [ [ 2022, 11, 10 ] ], "date-time": "2022-11-10T05:58:39Z", "timestamp": 1668059919194 }, "is-referenced-by-count": 0, "issued": { "date-parts": [ [ 2022, 11, 9 ] ] }, "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0/", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2022, 11, 9 ] ], "date-time": "2022-11-09T00:00:00Z", "timestamp": 1667952000000 } } ], "link": [ { "URL": "https://www.frontiersin.org/articles/10.3389/fendo.2022.1002834/full", "content-type": "unspecified", 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