Metformin and Covid-19: a systematic review of systematic reviews with meta-analysis
Fabio Petrelli, Iolanda Grappasonni, Cuc Thi, Thu Nguyen, Marina Tesauro, Paola Pantanetti, Sonila Xhafa, Giovanni Cangelosi
doi:10.23750/abm.v94iS3.14405
Introduction: the COVID-19 infection, caused by severe Coronavirus 2 syndrome (Sars-Cov-2), immediately appeared to be the most tragic global pandemic event of the twentieth century. Right from the start of the pandemic, diabetic patients treated with metformin experienced a reduction in mortality and complications from COVID-19 compared to those with different treatments or no treatment. Objective: The main objective of the study was to observe the effects of metformin in diabetic hospitalized subjects infected with COVID-19. Specifically, the outcomes of hospitalization in Intensive Care Units or death were examined. Materials and Methods: A specific research PICOS was developed and the Pubmed, Embase and Scopus databases were consulted down to April 30, 2022. To estimate the extent of the metformin effect and risk of severity in SARS-CoV-2 infection, the Odd Ratio (OR) with 95% Confidence Interval (CI) published by the authors of the selected systematic reviews was used. Results: from five systematic reviews 36 studies were selected. The final meta-analysis showed that thanks to treatment with metformin, Type II Diabetes (DM2) patients affected by COVID-19 had protection against risk of disease severity, complications (SE 0.80; CI 95%: 0.61 -0.78; I 2 : 70.5%) and mortality (SE 0.69; CI 95%: 0.65 -0.98; I 2 : 53,6%). Conclusions: More indepth studies on the use of metformin, compared to other molecules, may be required to understand the real protective potential of the drug against negative outcomes caused by
Conflict of Interest statement: Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article.
Ethics approval and consent to participate: Not applicable Consent for publication: All the authors have read the paper and agreed to submit the paper.
Competing interests: The authors declare no competing interests.
Funding: Not applicable Authors' contributions : FP and GC designed and conducted research, analyzed data and wrote the paper. All authors approved the final manuscript.
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doi:10.1016/j.diabres.2021.108977{ 'type': 'article-journal',
'language': 'eng',
'author': [ {'family': 'Petrelli', 'given': 'Fabio'}, {'family': 'Grappasonni', 'given': 'Iolanda'},
{'family': 'Nguyen', 'given': 'Cuc Thi Thu'}, {'family': 'Tesauro', 'given': 'Marina'},
{'family': 'Pantanetti', 'given': 'Paola'}, {'family': 'Xhafa', 'given': 'Sonila'},
{'family': 'Cangelosi', 'given': 'Giovanni'}],
'issued': {'date-parts': [[2023, 8, 30]]},
'abstract': 'Abstract Introduction: the COVID-19 infection, caused by severe Coronavirus 2 syndrome '
'(Sars-Cov-2), immediately appeared to be the most tragic global pandemic event of the '
'twentieth century. Right from the start of the pandemic, diabetic patients treated with '
'metformin experienced a reduction in mortality and complications from COVID-19 compared to '
'those with different treatments or no treatment. Objective The main objective of the study '
'was to observe the effects of metformin in hospitalized subjects infected with COVID-19. '
'Specifically, the outcomes of hospitalization in Intensive Care Units or death were examined. '
'Materials and Methods A specific research PICOS was developed and the Pubmed, Embase and '
'Scopus databases were consulted down to April 30, 2022. To estimate the extent of the '
'metformin effect and risk of severity in SARS-CoV-2 infection, the Odd Ratio (OR) with 95% '
'Confidence Interval (CI) published by the authors of the selected systematic reviews was '
'used. Results from five systematic reviews 36 studies were selected. The final meta-analysis '
'showed that thanks to treatment with metformin, DM2 patients affected by COVID-19 had '
'protection against risk of disease severity, complications (ES 0.80; 95% CI) and mortality '
'(ES 0.69; 95% CI). Conclusions More in-depth studies on the use of metformin, compared to '
'other molecules, may be required to understand the real protective potential of the drug '
'against negative outcomes caused by COVID-19 infection in DM2 patients.',
'container-title': 'Acta Biomedica Atenei Parmensis',
'DOI': '10.23750/abm.v94iS3.14405',
'ISSN': '2531-6745, 0392-4203',
'issue': 'S3',
'medium': 'JB',
'page': 'e2023138',
'page-first': 'e2023138',
'publisher': 'Mattioli 1885 srl',
'publisher-place': 'IT',
'title': 'Metformin and Covid-19: a systematic review of systematic reviews with meta-analysis',
'URL': 'https://doi.org/10.23750/abm.v94iS3.14405',
'volume': '94'}
