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Metformin use is associated with a decrease in the risk of hospitalization and mortality in COVID-19 patients with

Luisa Ojeda-Fernández1, Andreana Foresta1, Giulia Macaluso1

  • 1Laboratory of Cardiovascular Prevention, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.

Diabetes, Obesity & Metabolism
|January 11, 2022
PubMed

Insights

Metformin use in patients with diabetes was associated with a significantly lower risk of severe outcomes from coronavirus disease 2019 (COVID-19). This suggests metformin may offer a protective effect against severe COVID-19, warranting further investigation.

Area of Science:

  • Endocrinology and Metabolism
  • Infectious Diseases
  • Pharmacology

Background:

  • Diabetes mellitus is a significant risk factor for severe coronavirus disease 2019 (COVID-19) outcomes.
  • Metformin is a first-line antidiabetic medication with potential anti-inflammatory and antiviral properties.
  • Understanding the impact of metformin on COVID-19 prognosis in diabetic patients is crucial for clinical management.

Purpose of the Study:

  • To investigate the association between metformin use and clinical outcomes in a large cohort of patients with diabetes and COVID-19.
  • To compare the risk of mortality, hospitalization, and intensive care unit (ICU) admission in metformin users versus non-users.

Main Methods:

  • A retrospective cohort study utilizing a regional administrative database in Lombardy, Italy.
  • Inclusion criteria: patients with diabetes, aged 40 years or older, with at least two antidiabetic drug prescriptions in 2019 and a positive severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) test between February 2020 and March 2021.
  • Statistical analyses included multivariable logistic regression and propensity score matching (PSM).

Main Results:

  • Metformin use was significantly associated with a reduced risk of all-cause mortality (OR 0.70), in-hospital mortality (OR 0.68), COVID-19 hospitalization (OR 0.86), and ICU admission (OR 0.81) compared to non-users.
  • These findings remained consistent after propensity score matching, reinforcing the protective association of metformin.

Conclusions:

  • Metformin use demonstrated a protective effect against severe clinical outcomes in patients with diabetes and COVID-19.
  • While these observational findings are promising, randomized controlled trials are necessary to confirm metformin's efficacy in preventing severe COVID-19.
  • Clinicians are advised to continue prescribing metformin to diabetic patients with COVID-19 while awaiting further evidence.
Abstract

Keywords:
COVID-19diabetesmetforminoutcomes

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