Metformin Treatment Was Associated with Decreased Mortality in COVID-19 Patients with Diabetes in a Retrospective Analysis
Luo et al.,
Metformin Treatment Was Associated with Decreased Mortality in COVID-19 Patients with Diabetes in a..,
The American Journal of Tropical Medicine and Hygiene, doi:10.4269/ajtmh.20-0375
Retrospective 283 COVID-19+ diabetes patients in China, showing non-statistically significant lower mortality with HCQ/CQ treatment.
risk of death, 32.4% lower, OR 0.68, p = 0.72, treatment 19, control 264, inverted to make OR<1 favor treatment, multivariate, RR approximated with OR.
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Luo et al., 21 May 2020, retrospective, China, peer-reviewed, 9 authors.
Abstract: Am. J. Trop. Med. Hyg., 103(1), 2020, pp. 69–72
doi:10.4269/ajtmh.20-0375
Copyright © 2020 by The American Society of Tropical Medicine and Hygiene
Metformin Treatment Was Associated with Decreased Mortality in COVID-19 Patients with
Diabetes in a Retrospective Analysis
Pan Luo,1† Lin Qiu,1† Yi Liu,1 Xiu-lan Liu,1 Jian-ling Zheng,1 Hui-ying Xue,1 Wen-hua Liu,2 Dong Liu,1* and Juan Li1*
1
Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; 2Clinical
Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Abstract. Metformin was proposed to be a candidate for host-directed therapy for COVID-19. However, its efficacy
remains to be validated. In this study, we compared the outcome of metformin users and nonusers in hospitalized COVID19 patients with diabetes. Hospitalized diabetic patients with confirmed COVID-19 in the Tongji Hospital of Wuhan, China,
from January 27, 2020 to March 24, 2020, were grouped into metformin and no-metformin groups according to the
diabetic medications used. The demographics, characteristics, laboratory parameters, treatments, and clinical outcome
in these patients were retrospectively assessed. A total of 283 patients (104 in the metformin and 179 in the no-metformin
group) were included in this study. There were no significant differences between the two groups in gender, age,
underlying diseases, clinical severity, and oxygen-support category at admission. The fasting blood glucose level of the
metformin group was higher than that of the no-metformin group at admission and was under effective control in both
groups after admission. Other laboratory parameters at admission and treatments after admission were not different
between the two groups. The length of hospital stay did not differ between the two groups (21.0 days for metformin versus
19.5 days for no metformin, P = 0.74). However, in-hospital mortality was significantly lower in the metformin group (3/104
(2.9%) versus 22/179 (12.3%), P = 0.01). Antidiabetic treatment with metformin was associated with decreased mortality
compared with diabetics not receiving metformin. This retrospective analysis suggests that metformin may offer benefits
in patients with COVID-19 and that further study is indicated.
Ethical Committee of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (No.
TJ-IRB20200338).
The diagnosis procedures of COVID-19 were referred to the
Diagnosis and Treatment of Pneumonia Infected by Novel
Coronavirus issued by the National Health Commission of
China. Briefly, epidemiological history or clinical symptoms
are needed. Exposure history referred to any form of body
contact with confirmed cases within 14 days. Clinical features
include symptoms like fever, computed tomography (CT) images with signs like patchy ground-glass opacities, and laboratory examination showing decrease in both leukocytes
and lymphocytes. One with exposure history can be considered
as a suspected patient if any two of the clinical features show
up, but only when an exposure-free patient represents all three
clinical features can he/she be suspected. The suspected patients with a positive result of any nuclear acid test or IgM–IgG
test will be confirmed with COVID-19. Patients with body
temperature returns to normal for more than 3 days, respiratory
symptoms and lung imaging improved significantly, and..
Late treatment
is less effective
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