Outcome and death risk of diabetes patients with Covid-19 receiving pre-hospital and in-hospital metformin therapies
Tamura et al.,
Outcome and death risk of diabetes patients with Covid-19 receiving pre-hospital and in-hospital metformin..,
Diabetology & Metabolic Syndrome, doi:10.1186/s13098-021-00695-8
Retrospective 188 hospitalized patients in Brazil, showing lower risk of mortality with metformin use. Authors note that, although pre-hospital metformin use improved clinical parameters at admission, continuous use during hospitalization is essential. Patients that used pre-hospital metformin therapy but interrupted the treatment during hospitalization showed higher mortality than those that continued metformin therapy.
risk of death, 96.6% lower, OR 0.03, p = 0.02, treatment 115, control 73, adjusted per study, in-hospital use, multivariable, RR approximated with OR.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Tamura et al., 13 Jul 2021, retrospective, Brazil, peer-reviewed, 4 authors, study period 10 March, 2020 - 13 November, 2020.
Abstract: (2021) 13:76
Tamura et al. Diabetol Metab Syndr
https://doi.org/10.1186/s13098-021-00695-8
Diabetology &
Metabolic Syndrome
Open Access
RESEARCH
Outcome and death risk of diabetes
patients with Covid‑19 receiving pre‑hospital
and in‑hospital metformin therapies
Rodrigo Esaki Tamura1,3, Said Muhammad Said2,4, Leticia Mussin de Freitas1 and
Ileana Gabriela Sanchez Rubio1,2,3*
Abstract
Background: 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.
Methods: 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).
Results: 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; nonmet-group: 4.25 ± 3.4). In all the groups older patients showed more severe clinical conditions and high risk of death
and intubation.
Conclusion: 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.
Keywords: COVID-19, Diabetes, Metformin, Brazil, Survival
Background
The COVID-19 pandemic is caused by SARS-CoV-2, a
member of the Betacoronavirus genus of the Nidovirales order, its single stranded positive polarity RNA
encodes non-structural and structural proteins, one
important structural protein is the Spike, which mediates
*Correspondence: ilerubio@gmail.com; ileana.rubio@unifesp.br
1
Department of Biological Sciences, Federal University of São Paulo, Rua
Pedro de Toledo 669, 11º Andar, Diadema, SP, Brazil
Full list of author information is available at the end of the article
recognition of the ACE2 cell receptor. The non-structural
proteins play pivotal role in cell regulation, that impacts
host response to viral infection [1]. Data from the World
Health Organization (WHO) points to over 178 million
confirmed cases and 3,864,180 deaths until June, 21st
2021 (https://covid19.who.int/). Deaths by COVID-19 in
Brazil has reached the number of 501,825 on June, 21st
2021 (https://covid.saude.gov.br/).
Diabetes is one of the main risk factors for COVID19, promoting a harmful pro-inflammatory state [2].
© The Author(s) 2021. 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..
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