Is Metformin Use Associated With a Decreased Mortality for COVID-19 Diabetic Patients? A Meta-Analysis

{ 'indexed': {'date-parts': [[2022, 3, 29]], 'date-time': '2022-03-29T03:01:15Z', 'timestamp': 1648522875113}, 'reference-count': 0, 'publisher': 'The Endocrine Society', 'issue': 'Supplement_1', 'license': [ { 'start': { 'date-parts': [[2021, 5, 3]], 'date-time': '2021-05-03T00:00:00Z', 'timestamp': 1620000000000}, 'content-version': 'vor', 'delay-in-days': 2, 'URL': 'http://creativecommons.org/licenses/by-nc-nd/4.0/'}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'published-print': {'date-parts': [[2021, 5, 3]]}, 'abstract': '<jats:title>Abstract</jats:title>\n' ' <jats:p>Introduction: Coronavirus disease 2019 (COVID-19) has been spreading ' 'globally for more than half a year. Previous studies remain controversial regarding whether ' 'metformin is associated with reduced risk for COVID-19 diabetic patients. Thus, this ' 'meta-analysis is performed. Method: A comprehensive literature search on PubMed and Web of ' 'Science was conducted to identify all relevant studies published prior to October 2020 ' 'according to the established inclusion criteria. This meta-analysis was reported in ' 'conformity to the Preferred Reporting Project declared by the Systematic Review and ' 'Meta-Analysis (PRISMA). The quality assessment was performed by the Newcastle-Ottawa Scale ' '(NOS). The pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated to ' 'estimate the association between metformin use and mortality for COVID-19 patients. A ' 'random-effect or fixed-effect model was used based on heterogeneity significance. Subgroup ' 'analysis was performed based on in-hospital-use or home-use, and different sample sizes. ' 'Sensitivity analysis and publication bias detection were also performed. All statistical ' 'analyses were performed using RevMan software (version 5.3; Cochrane library) and STATA 12.0 ' 'statistical software (Stata Corp., College Station, TX), and all P values were two-tailed, ' 'the test level was 0.05. Result: 97 articles were obtained from the database search, and 5 ' 'articles obtained from other sources. 8 articles involving 11,169 participants were included. ' 'Most studies were considered moderate quality. A statistically significant association ' 'between metformin use and decreased mortality of COVID-19 patients was found (OR 0.53, 95%CI: ' '0.34, 0.83, P=0.005, I2=77%). In the subgroup analyses, home-use of metformin was also ' 'associated with a reduced risk of mortality (OR 0.54, 95%CI: 0.35, 0.84, P=0.006, I2=66%), ' 'and one study reporting in-hospital use did not find reduced mortality among COVID-19 ' 'patients taking metformin (OR 1.65, 95%CI: 0.71, 3.86, P=0.247). For sample size ' '&amp;gt;1,000, no statistically significant reduced risk of mortality (OR 0.84, 95%CI: 0.57, ' '1.26, P=0.41, I2=73%) was found, however, for sample ≤1,000, a statistically significant ' 'reduced risk of mortality (OR 0.29, 95%CI: 0.19, 0.44 P&amp;lt;0.00001, I2=0%) was found. ' 'Sensitivity analysis by change fixed-effect models to random-effect models and by omitting ' 'each study at a time confirmed the relative stability of the result. Begg’s test (z=0.37, ' 'P=0.711) and Egger’s test (t=-1.98, P=0.096) did not detect a significant risk of publication ' 'bias. Conclusion: The current meta-analysis demonstrates that metformin use is associated ' 'with decreased mortality for COVID-19 diabetic patients. However, only one study ' 'investigating the in-hospital use of metformin. More high-quality original studies are needed ' 'to further explore the association between metformin use and mortality risk of ' 'COVID-19.</jats:p>', 'DOI': '10.1210/jendso/bvab048.709', 'type': 'journal-article', 'created': {'date-parts': [[2021, 5, 3]], 'date-time': '2021-05-03T05:01:45Z', 'timestamp': 1620018105000}, 'page': 'A348-A348', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Is Metformin Use Associated With a Decreased Mortality for COVID-19 Diabetic Patients? A ' 'Meta-Analysis', 'prefix': '10.1210', 'volume': '5', 'author': [ { 'given': 'Chenyu', 'family': 'Sun', 'sequence': 'first', 'affiliation': [{'name': 'AMITA Health Saint Joseph Hospital Chicago, Chicago, IL, USA'}]}, { 'given': 'Ce', 'family': 'Cheng', 'sequence': 'additional', 'affiliation': [ { 'name': 'University of Arizona College of Medicine at South Campus, ' 'Tucson, AZ, USA'}]}, { 'given': 'Keun Young', 'family': 'Kim', 'sequence': 'additional', 'affiliation': [{'name': 'AMITA Health Saint Joseph Hospital Chicago, Chicago, IL, USA'}]}, { 'given': 'Mubashir Ayaz', 'family': 'Ahmed', 'sequence': 'additional', 'affiliation': [{'name': 'AMITA Health Saint Joseph Hospital Chicago, Chicago, IL, USA'}]}, { 'given': 'Reveena', 'family': 'Manem', 'sequence': 'additional', 'affiliation': [{'name': 'AMITA Health Saint Joseph Hospital Chicago, Chicago, IL, USA'}]}], 'member': '80', 'published-online': {'date-parts': [[2021, 5, 3]]}, 'container-title': 'Journal of the Endocrine Society', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'http://academic.oup.com/jes/article-pdf/5/Supplement_1/A348/37204936/bvab048.709.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'syndication'}, { 'URL': 'http://academic.oup.com/jes/article-pdf/5/Supplement_1/A348/37204936/bvab048.709.pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2021, 7, 10]], 'date-time': '2021-07-10T06:49:10Z', 'timestamp': 1625899750000}, 'score': 1, 'resource': {'primary': {'URL': 'https://academic.oup.com/jes/article/5/Supplement_1/A348/6241444'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2021, 5, 1]]}, 'references-count': 0, 'journal-issue': {'issue': 'Supplement_1', 'published-print': {'date-parts': [[2021, 5, 3]]}}, 'URL': 'http://dx.doi.org/10.1210/jendso/bvab048.709', 'relation': {}, 'ISSN': ['2472-1972'], 'subject': [], 'published-other': {'date-parts': [[2021, 5, 1]]}, 'published': {'date-parts': [[2021, 5, 1]]}}