Metformin Use in Diabetes Prior to Hospitalization: Effects on Mortality in Covid-19.
Metformin Use in Diabetes Prior to Hospitalization: Effects on Mortality in Covid-19.
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DOI：
10.4158/ep-2020-0466
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发表时间：
2020-10
期刊：
影响因子：
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通讯作者：
Malhotra A
中科院分区：
文献类型：
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作者：
Li J;Wei Q;Li WX;McCowen KC;Xiong W;Liu J;Jiang W;Marin T;Thomas RL;He M;Gongol B;Hepokoski M;Yuan JX;Shyy JY;Xiong N;Malhotra A
目的：尽管2型糖尿病（T2DM）已被报道为2019冠状病毒病（COVID-19）的危险因素，但用于治疗T2DM的药物（如二甲双胍）对COVID-19结局的影响尚不清楚。二甲双胍增加血管紧张素转换酶2的表达，这是一种已知的严重急性呼吸综合征冠状病毒2的受体。来自因COVID-19住院的T2DM患者的数据用于验证二甲双胍使用与该人群生存率提高相关的假设。方法：回顾性分析中国武汉某大医院近期因COVID-19住院的T2DM患者的去识别临床资料。131例诊断为COVID-19和T2DM的患者参与了这项研究。主要结局是死亡率。人口统计、临床特征、实验室数据、糖尿病药物和呼吸治疗数据也包括在分析中。结果：131例患者中，37例合并或不合并其他抗糖尿病药物使用二甲双胍。37例服用二甲双胍的患者中，存活35例（94.6%），死亡2例（5.4%）。二甲双胍组与非二甲双胍组的死亡率分别为5.4%（2/37）和22.3%（21/94）。通过多变量分析，发现二甲双胍是该队列中生存的独立预测因子（P = 0.02）。结论：本研究揭示了诊断为COVID-19的T2DM患者使用二甲双胍与生存之间的显著关联。这些临床数据与使用二甲双胍治疗COVID-19合并T2DM患者的潜在益处是一致的。
Objective: Although type 2 diabetes mellitus (T2DM) has been reported as a risk factor for coronavirus disease 2019 (COVID-19), the effect of pharmacologic agents used to treat T2DM, such as metformin, on COVID-19 outcomes remains unclear. Metformin increases the expression of angiotensin converting enzyme 2, a known receptor for severe acute respiratory syndrome coronavirus 2. Data from people with T2DM hospitalized for COVID-19 were used to test the hypothesis that metformin use is associated with improved survival in this population. Methods: Retrospective analyses were performed on de-identified clinical data from a major hospital in Wuhan, China, that included patients with T2DM hospitalized for COVID-19 during the recent epidemic. One hundred and thirty-one patients diagnosed with COVID-19 and T2DM were used in this study. The primary outcome was mortality. Demographic, clinical characteristics, laboratory data, diabetes medications, and respiratory therapy data were also included in the analysis. Results: Of these 131 patients, 37 used metformin with or without other antidiabetes medications. Among the 37 metformin-taking patients, 35 (94.6%) survived and 2 (5.4%) did not survive. The mortality rates in the metformin-taking group versus the non-metformin group were 5.4% (2/37) versus 22.3% (21/94). Using multivariate analysis, metformin was found to be an independent predictor of survival in this cohort (P = .02). Conclusion: This study reveals a significant association between metformin use and survival in people with T2DM diagnosed with COVID-19. These clinical data are consistent with potential benefits of the use of metformin for COVID-19 patients with T2DM.