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Metformin use before COVID-19 vaccination and the risks of COVID-19 incidence, medical utilization, and all-cause mortality in patients with type 2 diabetes mellitus

Yen et al., Diabetes Research and Clinical Practice, doi:10.1016/j.diabres.2023.110692
May 2023  
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Mortality 25% Improvement Relative Risk Ventilation 25% ICU admission 19% Hospitalization 15% Case -2% Metformin for COVID-19  Yen et al.  Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? PSM retrospective 123,709 patients in multiple countries (Jan 2020 - Nov 2022) Lower mortality (p=0.0011) and ventilation (p=0.014) c19early.org Yen et al., Diabetes Research and Clin.., May 2023 Favorsmetformin Favorscontrol 0 0.5 1 1.5 2+
Metformin for COVID-19
3rd treatment shown to reduce risk in July 2020, now with p < 0.00000000001 from 99 studies.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 112 treatments. c19early.org
TriNetX retrospective 123,709 vaccinated patients with type 2 diabetes, showing significantly lower risk of COVID-19 mortality, mechanical ventilation, and hospitalization with metformin use. There was no significant difference for cases. The increasing benefit for more serious outcomes matches the results of studies to date.
risk of death, 25.0% lower, HR 0.75, p = 0.001, treatment 232 of 20,894 (1.1%), control 295 of 20,894 (1.4%), NNT 332, propensity score matching, Kaplan–Meier.
risk of mechanical ventilation, 25.0% lower, HR 0.75, p = 0.01, treatment 133 of 20,894 (0.6%), control 168 of 20,894 (0.8%), NNT 597, propensity score matching, Kaplan–Meier.
risk of ICU admission, 19.0% lower, HR 0.81, p = 0.005, treatment 332 of 20,894 (1.6%), control 390 of 20,894 (1.9%), NNT 360, propensity score matching, Kaplan–Meier.
risk of hospitalization, 15.0% lower, HR 0.85, p < 0.001, treatment 2,820 of 20,894 (13.5%), control 3,139 of 20,894 (15.0%), NNT 65, propensity score matching, Kaplan–Meier.
risk of case, 2.0% higher, HR 1.02, p = 0.63, treatment 1,467 of 20,894 (7.0%), control 1,364 of 20,894 (6.5%), propensity score matching, Kaplan–Meier.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Yen et al., 6 May 2023, retrospective, multiple countries, peer-reviewed, 4 authors, study period 1 January, 2020 - 22 November, 2022. Contact: yenfushun@gmail.com, shiowing0107@gmail.com, sylin@vghtc.gov.tw, jccwei@gmail.com.
This PaperMetforminAll
Metformin use before COVID-19 vaccination and the risks of COVID-19 incidence, medical utilization, and all-cause mortality in patients with type 2 diabetes mellitus
Fu-Shun Yen, Shiow-Ing Wang, Shih-Yi Lin, James Cheng-Chung Wei
Diabetes Research and Clinical Practice, doi:10.1016/j.diabres.2023.110692
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Authors' contribution FSY: study concept and design, drafting of the manuscript, critical revision of the manuscript for important intellectual content. SIW: data acquisition, analysis, and interpretation; statistical analysis and drafting of the manuscript. SYL: study concept and design, data interpretation, critical revision of the manuscript for important intellectual content. JCCW: critical revision of the manuscript for important intellectual content, technical and material support, and study supervision. Appendix A. Supplementary material Supplementary data to this article can be found online at https://doi.org/•••. Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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