Outcome and death risk of diabetes patients with Covid-19 receiving pre-hospital and in-hospital metformin therapies

DOI record: { "DOI": "10.1186/s13098-021-00695-8", "ISSN": [ "1758-5996" ], "URL": "http://dx.doi.org/10.1186/s13098-021-00695-8", "abstract": "<jats:title>Abstract</jats:title><jats:sec>\n <jats:title>Background</jats:title>\n <jats:p>COVID-19 has stroke Brazil harshly, deaths by COVID-19 in Brazil represent almost 13% of the total deaths by COVID-19 in the world, even though Brazilian population represents only 2.6% of the world population. Our aim in this study was to evaluate death and intubation outcomes and risk factors associated with COVID-19, and treatment options focusing on diabetes patients and the use of metformin pre-admission and during hospitalization.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Methods</jats:title>\n <jats:p>In this Brazilian single-center study we evaluated 1170 patients hospitalized due to COVID-19. Diabetes patients (n = 188) were divided based on their use of pre-hospital and in-hospital metformin (non-met-group and met-group).</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Results</jats:title>\n <jats:p>In the total cohort most comorbidities were risk factors for orotracheal intubation and death. The use of chloroquine/hydroxychloroquine was significantly associated with increased death and intubation risk in uni- and multivariate analysis. Diabetes patients showed worst clinical feature compared with non-diabetes patients. In-hospital non-met-group had increased mortality (20.5%) compared to met-group (3.5%) (p = 0.0002) and univariable cox proportion hazard regression indicated in-hospital metformin reduced mortality (HR = 0.325, p = 0.035). Patients that used pre-hospital metformin showed lower severity parameters at hospital admission. (met-group: 2.45 ± 2.5; non-met-group: 4.25 ± 3.4). In all the groups older patients showed more severe clinical conditions and high risk of death and intubation.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Conclusion</jats:title>\n <jats:p>Even though this is a single-center study, results from other reports have shown a similar trend, indicating that patients that used metformin during hospitalization have a better prognosis and reduced risk of death.</jats:p>\n </jats:sec>", "alternative-id": [ "695" ], "article-number": "76", "assertion": [ { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Received", "name": "received", "order": 1, "value": "4 June 2021" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Accepted", "name": "accepted", "order": 2, "value": "29 June 2021" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "First Online", "name": "first_online", "order": 3, "value": "13 July 2021" }, { "group": { "label": "Declarations", "name": "EthicsHeading" }, "name": "Ethics", "order": 1 }, { "group": { "label": "Ethics approval and consent to participate", "name": "EthicsHeading" }, "name": "Ethics", "order": 2, "value": "This study was approved by the Ethical Committee of the Santa Catarina Hospital and UNIFESP (CAAE 43014721.7.0000. 5505)." }, { "group": { "label": "Consent for publication", "name": "EthicsHeading" }, "name": "Ethics", "order": 3, "value": "All authors consent the publication." }, { "group": { "label": "Competing interests", "name": "EthicsHeading" }, "name": "Ethics", "order": 4, "value": "There are no competing interests." } ], "author": [ { "affiliation": [], "family": "Tamura", "given": "Rodrigo Esaki", "sequence": "first" }, { "affiliation": [], "family": "Said", "given": "Said Muhammad", "sequence": "additional" }, { "affiliation": [], "family": "de Freitas", "given": "Leticia Mussin", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0003-4779-4533", "affiliation": [], "authenticated-orcid": false, "family": "Rubio", "given": "Ileana Gabriela Sanchez", "sequence": "additional" } ], "container-title": [ "Diabetology & Metabolic Syndrome" ], "content-domain": { "crossmark-restriction": false, "domain": [ "link.springer.com" ] }, "created": { "date-parts": [ [ 2021, 7, 13 ] ], "date-time": "2021-07-13T08:03:25Z", "timestamp": 1626163405000 }, "deposited": { "date-parts": [ [ 2021, 7, 13 ] ], "date-time": "2021-07-13T09:14:33Z", "timestamp": 1626167673000 }, "funder": [ { "DOI": "10.13039/501100001807", "award": [ "2019/15619-2; 2020/08271-7" ], "doi-asserted-by": "publisher", "name": "Fundação de Amparo à Pesquisa do Estado de São Paulo" } ], "indexed": { "date-parts": [ [ 2022, 2, 5 ] ], "date-time": "2022-02-05T16:05:04Z", "timestamp": 1644077104124 }, "is-referenced-by-count": 3, "issn-type": [ { "type": "electronic", "value": "1758-5996" } ], "issue": "1", "issued": { "date-parts": [ [ 2021, 7, 13 ] ] }, "journal-issue": { "issue": "1", "published-print": { "date-parts": [ [ 2021, 12 ] ] } }, "language": "en", "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "tdm", "delay-in-days": 0, "start": { "date-parts": [ [ 2021, 7, 13 ] ], "date-time": "2021-07-13T00:00:00Z", "timestamp": 1626134400000 } }, { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2021, 7, 13 ] ], "date-time": "2021-07-13T00:00:00Z", "timestamp": 1626134400000 } } ], "link": [ { "URL": "https://link.springer.com/content/pdf/10.1186/s13098-021-00695-8.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/article/10.1186/s13098-021-00695-8/fulltext.html", "content-type": "text/html", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/content/pdf/10.1186/s13098-021-00695-8.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "297", "original-title": [], "prefix": "10.1186", "published": { "date-parts": [ [ 2021, 7, 13 ] ] }, "published-online": { "date-parts": [ [ 2021, 7, 13 ] ] }, "published-print": { "date-parts": [ [ 2021, 12 ] ] }, "publisher": "Springer Science and Business Media LLC", "reference": [ { "DOI": "10.1590/1678-4685-gmb-2020-0212", "author": "FM Simabuco", "doi-asserted-by": "publisher", "first-page": "e20200212", "issue": "1 Suppl 1", "journal-title": "Genet Mol Biol.", "key": "695_CR1", "unstructured": "Simabuco FM, Tamura RE, Pavan ICB, Morale MG, Ventura AM. 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