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Is there an association between metformin use and clinical outcomes in diabetes patients with COVID-19? - 12/08/21

Doi : 10.1016/j.diabet.2020.10.006 
Jun Young Do a, Sang Won Kim b, Jong Won Park a, Kyu Hyang Cho a, Seok Hui Kang a,
a Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea 
b Medical Research Centre, College of Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea 

Corresponding author at: Department of Internal Medicine, College of Medicine, Yeungnam University, 317-1 Daemyung-Dong, Nam-Ku, Daegu 705-717, Republic of Korea.Department of Internal MedicineCollege of MedicineYeungnam University317-1 Daemyung-Dong, Nam-KuDaegu705-717Republic of Korea

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Highlights

At present, the association between metformin use and mortality in DM patients with COVID-19 remains uncertain.
Our data have revealed more favourable survival in patients not taking DM drugs compared with patients taking DM drugs other than metformin.
This study showed no definite association between metformin use and clinical outcomes, including survival.
Further studies are needed to determine whether the use of metformin may have favourable or unfavourable effects in DM patients with COVID-19.

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Abstract

Aim

Previous studies have reported inconsistent results regarding the association between metformin use and clinical outcomes in diabetes mellitus (DM) patients with coronavirus disease 2019 (COVID-19). This study aimed to evaluate the association between metformin use and clinical outcomes in DM patients with COVID-19.

Methods

This retrospective study was based on claims data. All diseases, including COVID-19, were defined using International Classification of Diseases 10th Revision (ICD-10) codes. Patients were divided into three groups depending on metformin use: CON (those not taking DM medication); N-MFOM (those taking DM medications other than metformin); and MFOM (those taking metformin for DM). Ultimately, 1865 patients were included; CON, N-MFOM and MFOM groups comprised 1301, 95 and 469 patients, respectively.

Results

Kaplan–Meier analyses showed that MFOM patients had poorer survival rates than those in the CON group, but there were no significant differences in survival rates between MFOM and N-MFOM groups. Multivariate Cox regression analyses revealed more favourable survival in CON than in N-MFOM patients, but there was no statistically significant difference in MFOM vs the other groups. Also, there were no significant differences in rates of use of inotropes, extracorporeal membrane oxygenation, conventional oxygen therapy, high-flow nasal cannulas or mechanical ventilators, nor in the rates of acute kidney injury or cardiac events across all study groups.

Conclusion

No definite association could be found between metformin use and clinical outcomes, including survival. However, given the disproportionate participant numbers in our groups and small number of events, further studies are needed to determine whether the use of metformin has favourable or unfavourable effects in DM patients with COVID-19.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Clinical outcome, Coronavirus disease, COVID-19, Diabetes mellitus, Metformin


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Vol 47 - N° 4

Articolo 101208- luglio 2021 Ritorno al numero
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