Metformin reduces the risk of death for COVID-19, diabetics

New studies suggest that the use of the diabetes drug metformin prior to the diagnosis of coronavirus disease 2019 (COVID-19) reduces mortality in patients with type 2 diabetes.

Diabetes is a serious comorbidity of COVID-19, and researchers do not yet know how metformin improves the prognosis of COVID-19, but research results suggest that the mechanism is obese glycemic control. It suggests that it may exceed the improvement. Researchers found that surviving metformin users were not lower in body mass index, blood glucose, or hemoglobin A1C than those who died.

“The mechanism may involve the previously described anti-inflammatory and antithrombotic effects of metformin,” research leader Anas Sharev, MD, said in a press release.

The study included 25,326 patients who were tested for COVID-19 at the Tertiary Medical College of Birmingham Hospital, Alabama, from February 25 to June 22, 2020. Of the 604 patients tested positive, 311 were black. The primary outcome was the mortality rate of COVID-19-positive patients, and the researchers examined the characteristics of the subjects or their potential association with comorbidities.

Researchers found that African Americans, who make up only 26% of Alabama’s population, make up 52% ​​of COVID-19-positive people and only 30% of those who are negative. In contrast, 36% of COVID-19-positive subjects were Caucasian, while 56% of negative subjects were Caucasian. Although these findings reveal significant racial disparities, the researchers noted that no significant racial disparities were observed in mortality after the diagnosis of COVID-19.

“In our cohort, being African-American seemed to be primarily a risk factor for infection with COVID-19, not mortality,” Shalev said in a press release. “This suggests that the observed racial disparity is likely due to exposure risk and external socio-economic factors, including access to appropriate health care.”

The overall mortality rate for COVID-19 patients was 11%, and researchers found that 93% of deaths occurred in patients over the age of 50, whereas males or hypertension was associated with a significantly increased risk of death. I found that I was doing it. Diabetes is associated with a dramatic increase in mortality, with an odds ratio of 3.62. In particular, 67% of deaths in this study occurred in diabetic subjects.

Researchers have investigated the effect of diabetes treatment on the adverse consequences of COVID-19, with a particular focus on insulin and metformin as the two most common drugs for type 2 diabetes. They found that previous insulin use did not affect the risk of death.

However, previous use of metformin has significantly reduced the chance of death. The 11% mortality rate of metformin users was not only comparable to the mortality rate of the general COVID-19 positive population, but also dramatically lower than the 23% mortality rate of diabetic patients who did not use metformin. .. After controlling other covariates, age, gender, and metformin use were independent factors affecting COVID-19-related mortality.

“This is due to the risk of death associated with the use of metformin in subjects with type 2 diabetes and COVID-19, as similar results have been obtained in different populations around the world, including analysis from China, France and UnitedHealth Care. It suggests an observed decrease in the disease, which could be generalized, “said Shalev.

In particular, researchers found that patients with type 2 diabetes who were taking metformin were significantly less likely to die than those who were not taking metformin, even after controlling covariates. Did. Researchers said future studies need to investigate how metformin is protected and evaluate the risks and benefits of metformin treatment and its indications for use during the COVID-19 pandemic.

“These results suggest that while diabetes is an independent risk factor for COVID-19-related mortality, this risk is dramatically reduced in subjects taking metformin. We are increasing the likelihood of providing a protective approach to this high-risk group, “Shalev concludes.

reference
Metformin use reduces the risk of death in patients with COVID-19 and diabetes [news release].. University of Alabama at Birmingham; January 14, 2021. https://www.uab.edu/news/research/item/11795-metformin-use-reduces-risk-of-death-for-patients-with-covid-19-and-diabetes.. Accessed on January 19, 2021.