Association of Metformin with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis

DOI record: { "DOI": "10.1055/s-0042-1760353", "ISSN": [ "0379-038X", "2454-5635" ], "URL": "http://dx.doi.org/10.1055/s-0042-1760353", "abstract": "<jats:title>Abstract</jats:title><jats:p>Studies have demonstrated high prevalence of mortality in coronavirus disease (COVID-19) patients with type 2 diabetes mellitus; however, the effects of antidiabetic pharmacotherapy on COVID-19 complications need further exploration. The aim of the study was to explore the association of metformin use and mortality in COVID-19 patients. A literature search was conducted using the databases Medline (via PubMed) and Cochrane Central Register of Controlled Trials until February 09, 2021. Nine studies were included in the meta-analysis, including 12,684 COVID-19 patients. The meta-analysis suggested 37% lower risk of mortality in patients receiving metformin (risk ratio: 0.63; 95% confidence interval: 0.50–0.78; p &lt; 0.001). However, no significant difference in hospitalization days between the two groups (p = 0.197) was observed. The analysis revealed significantly lower risk of having obesity (p &lt; 0.001), hypertension (p &lt; 0.001), heart failure (p &lt; 0.001), and cerebrovascular disease (p = 0.015) in the group receiving metformin. The analysis also demonstrated significantly lower risk of using anticoagulants (p = 0.015), diuretics (p &lt; 0.001), and antiplatelets (p = 0.010) in patients receiving metformin. Our findings suggest that metformin use decreases mortality in COVID-19 patients. However, randomized studies demonstrating the consequences of metformin use are needed to understand the magnitude of the beneficial effects of metformin.</jats:p>", "author": [ { "affiliation": [ { "name": "Centre for Translational and Clinical Research, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi, India" } ], "family": "Parveen", "given": "Rizwana", "sequence": "additional" }, { "affiliation": [ { "name": "Centre for Translational and Clinical Research, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi, India" } ], "family": "Mishra", "given": "Pinki", "sequence": "additional" }, { "affiliation": [ { "name": "Centre for Translational and Clinical Research, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi, India" } ], "family": "Luthra", "given": "Reva", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0002-1227-2703", "affiliation": [ { "name": "School of Medicine, Keele University, Staffordshire, United Kingdom" } ], "authenticated-orcid": false, "family": "Bajpai", "given": "Ram", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0002-2509-3026", "affiliation": [ { "name": "Centre for Translational and Clinical Research, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi, India" } ], "authenticated-orcid": false, "family": "Agarwal", "given": "Nidhi", "sequence": "additional" } ], "container-title": "Annals of the National Academy of Medical Sciences (India)", "container-title-short": "Ann Natl Acad Med Sci", "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2023, 2, 23 ] ], "date-time": "2023-02-23T00:00:45Z", "timestamp": 1677110445000 }, "deposited": { "date-parts": [ [ 2023, 3, 25 ] ], "date-time": "2023-03-25T00:18:14Z", "timestamp": 1679703494000 }, "indexed": { "date-parts": [ [ 2023, 3, 25 ] ], "date-time": "2023-03-25T00:41:07Z", "timestamp": 1679704867854 }, "is-referenced-by-count": 0, "issue": "01", "issued": { "date-parts": [ [ 2023, 1 ] ] }, "journal-issue": { "issue": "01", "published-online": { "date-parts": [ [ 2023, 3, 24 ] ] }, "published-print": { "date-parts": [ [ 2023, 1 ] ] } }, "language": "en", "license": [ { "URL": "https://creativecommons.org/licenses/by-nc-nd/4.0/", "content-version": "vor", "delay-in-days": 52, "start": { "date-parts": [ [ 2023, 2, 22 ] ], "date-time": "2023-02-22T00:00:00Z", "timestamp": 1677024000000 } } ], "link": [ { "URL": "http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0042-1760353.pdf", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "194", "original-title": [], "page": "013-020", "prefix": "10.1055", "published": { "date-parts": [ [ 2023, 1 ] ] }, "published-online": { "date-parts": [ [ 2023, 2, 22 ] ] }, "published-print": { "date-parts": [ [ 2023, 1 ] ] }, "publisher": "Georg Thieme Verlag KG", "reference": [ { "DOI": "10.1016/j.diabres.2020.108295", 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