Association of metformin with mortality or ARDS in patients with COVID-19 and type 2 diabetes: A retrospective cohort study. (March 2021)

• Record Type: Journal Article
• Authors: Jiang, Nan; Chen, Zhenyuan; Liu, Li; Yin, Xiaoxv; Yang, Heping; Tan, Xiangping; Wang, Jing; Li, Hui; Tian, Mengge; Lu, Zuxun; Xiong, Nian; Gong, Yanhong
• Is Part Of: Diabetes research and clinical practice. Volume 173(2021)
• Publication Date: 2021-03
• Subjects: COVID-19 -- Metformin -- Mortality -- Diabetes mellitus; COVID-19 Coronavirus disease 2019 -- SARS-CoV-2 Severe Acute Respiratory Syndrome Coronavirus 2 -- ARDS acute respiratory distress syndrome -- AMPK AMP-activated protein kinase -- RR respiratory rate -- SpO2 pulse oxygen saturation -- CHD coronary heart disease -- FBG fasting blood glucose -- HbA1c hemoglobin A1c -- DDI D-dimer -- CRP C-reaction protein -- LDH lactic dehydrogenase -- AST aspartate aminotransferase -- ALT alanine aminotransferase -- IQR inter-quartile range -- MICE Multivariate Imputation Using Chained Equations -- NF-kB nuclear factor-kB -- mTORC1 mechanistic target of rapamycin complex 1 -- TNF-α tumor necrosis factor-alpha -- DIO diet induced obesity -- IL-10 interleukin-10; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2020.108619
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aims: To determine the association between metformin use and mortality and ARDS incidence in patients with COVID-19 and type 2 diabetes. Methods: This study was a multi-center retrospective analysis of COVID-19 patients with type 2 diabetes and admitted to four hospitals in Hubei province, China from December 31st, 2019 to March 31st, 2020. Patients were divided into two groups according to their exposure to metformin during hospitalization. The outcomes of interest were 30-day all-cause mortality and incidence of ARDS. We used mixed-effect Cox model and random effect logistic regression to evaluate the associations of metformin use with outcomes, adjusted for baseline characteristics. Results: Of 328 patients with COVID-19 and type 2 diabetes included in the study cohort, 30.5% (100/328) were in the metformin group. In the mixed-effected model, metformin use was associated with the lower incidence of ARDS. There was no significant association between metformin use and 30-day all-cause mortality. Propensity score-matched analysis confirmed the results. In the subgroup analysis, metformin use was associated with the lower incidence of ARDS in females. Conclusions: Metformin may have potential benefits in reducing the incidence of ARDS in patients with COVID-19 and type 2 diabetes. However, this benefit differs significantly by gender.