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0 0.5 1 1.5 2+ Mortality -10% Improvement Relative Risk Pérez-Belmonte et al. Metformin for COVID-19 Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? PSM retrospective 498 patients in Spain No significant difference in mortality Pérez-Belmonte et al., BMC Medicine, doi:10.1186/s12916-020-01832-2 Favors metformin Favors control
Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study
Pérez-Belmonte et al., BMC Medicine, doi:10.1186/s12916-020-01832-2
Pérez-Belmonte et al., Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in.., BMC Medicine, doi:10.1186/s12916-020-01832-2
Nov 2020   Source   PDF  
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Retrospective 2,666 type 2 diabetes COVID-19 patients in Spain, showing higher mortality with existing metformin use (not statistically significant).
risk of death, 10.4% higher, RR 1.10, p = 0.48, treatment 79 of 249 (31.7%), control 79 of 249 (31.7%), adjusted per study, odds ratio converted to relative risk, mixed effect logistic regression, propensity score matching.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Pérez-Belmonte et al., 16 Nov 2020, retrospective, propensity score matching, Spain, peer-reviewed, 26 authors.
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Abstract: Pérez-Belmonte et al. BMC Medicine (2020) 18:359 RESEARCH ARTICLE Open Access Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study Luis M. Pérez-Belmonte1*, José David Torres-Peña2,3, María D. López-Carmona1, M. Mar. Ayala-Gutiérrez1, Francisco Fuentes-Jiménez2,3, Lucía Jorge Huerta4, Jaime Alonso Muñoz5, Manuel Rubio-Rivas6, Manel Madrazo7, Marcos Guzmán Garcia8, Beatriz Vicente Montes9, Joaquim Fernández Sola10, Javier Ena11, Ruth Gonzalez Ferrer12, Carmen Mella Pérez13, Carlos Jorge Ripper14, Jose Javier Napal Lecumberri15, Iris El Attar Acedo16, Susana Plaza Canteli17, Sara Fuente Cosío18, Francisco Amorós Martínez19, Begoña Cortés Rodríguez20, Pablo Pérez-Martínez2,3*, José Manuel Ramos-Rincón21, Ricardo Gómez-Huelgas1 and for the SEMI-COVID-19 Network Abstract Background: Limited evidence exists on the role of glucose-lowering drugs in patients with COVID-19. Our main objective was to examine the association between in-hospital death and each routine at-home glucose-lowering drug both individually and in combination with metformin in patients with type 2 diabetes mellitus admitted for COVID-19. We also evaluated their association with the composite outcome of the need for ICU admission, invasive and non-invasive mechanical ventilation, or in-hospital death as well as on the development of in-hospital complications and a long-time hospital stay. (Continued on next page) * Correspondence:; A complete list of the SEMI-COVID-19 Network members is provided in the Appendix. 1 Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), Avenida de Carlos Haya, s/n, 29010 Málaga, Spain 2 Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Córdoba, Spain Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data. Pérez-Belmonte et al. BMC Medicine (2020) 18:359 Page 2 of 10 (Continued from previous page) Methods: We selected all patients with type 2 diabetes mellitus in the Spanish Society of Internal Medicine’s registry of COVID-19..
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