Metformin use and mortality and length of stay among hospitalized patients with type 2 diabetes and COVID-19: A multiracial, multiethnic, urban observational study.
Metformin use and mortality and length of stay among hospitalized patients with type 2 diabetes and COVID-19: A multiracial, multiethnic, urban observational study.
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DOI：
10.3389/fendo.2022.1002834
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发表时间：
2022
影响因子：
5.2
通讯作者：
George, Claudene J.
中科院分区：
文献类型：
--
作者：
Miao, Emily;Zhang, Kaleena;Liu, Jianyou;Lin, Juan;Yoo, Donna;George, Claudene J.
糖尿病是2019冠状病毒病（COVID-19）患者的常见合并症。与普通人群相比，患有COVID-19的糖尿病患者的死亡风险增加了两倍，并且往往具有更严重的感染。二甲双胍是糖尿病管理的一线药物，具有抗炎和免疫调节作用。以往关于二甲双胍和COVID-19临床结局的研究结果喜忧参半，有些研究显示使用二甲双胍可降低死亡率或减少并发症。到目前为止，很少有研究分析这样的结果在一个多样化的，多种族的社区。这是对2020年1月1日至2020年5月7日在城市学术医疗中心住院的确诊COVID-19感染的2型糖尿病患者的回顾性审查。收集基线特征。研究的主要结果是住院死亡率和住院时间（LOS）。共确定了4462名确诊COVID-19的2型糖尿病患者。41.3%是黑人，41.5%是西班牙裔。二甲双胍组有1021例患者，非二甲双胍组有3441例患者。值得注意的是，二甲双胍组中有更多的参与者患有合并症和/或晚期糖尿病。我们发现二甲双胍组和非二甲双胍组在住院死亡率（28.1% vs 25.3%，P=0.08）或住院天数（7.3 vs 7.5，P=0.59）方面无统计学显著差异，即使在各种因素匹配患者后（29.3% vs 29.6%，P=0.87; 7.7 vs 8.1，P=0.23）。虽然二甲双胍组患者的合并症和晚期糖尿病更多，但与非二甲双胍组相比，COVID-19导致的住院死亡率或住院时间无显著差异。需要进行前瞻性研究，以确定在因COVID-19住院的患者中开始、继续或重新开始二甲双胍治疗是否有临床获益。
Diabetes mellitus is a common comorbidity among patients with coronavirus disease 2019 (COVID-19). Diabetic patients with COVID-19 have a two-fold increased risk of death and tend to have more severe infection compared to the general population. Metformin, a first-line medication for diabetes management, has anti-inflammatory and immunomodulatory effects. Previous studies focusing on metformin and COVID-19 clinical outcomes have had mixed results, with some showing a mortality benefit or decreased complications with metformin use. To date, few studies have analyzed such outcomes among a diverse, multiracial community. This was a retrospective review of patients with Type 2 diabetes and a confirmed COVID-19 infection admitted to an urban academic medical center from January 1, 2020 to May 7, 2020. Baseline characteristics were collected. The primary outcomes of the study were in-hospital mortality and length of stay (LOS). A total of 4462 patients with Type 2 diabetes and confirmed COVID-19 were identified. 41.3% were Black, and 41.5% were Hispanic. There were 1021 patients in the metformin group and 3441 in the non-metformin group. Of note, more participants in the metformin group had comorbid disease and/or advanced diabetes. We found no statistically significant differences between the metformin and non-metformin group in in-hospital mortality (28.1% vs 25.3%, P=0.08) or length of hospital stay in days (7.3 vs. 7.5, P=0.59), even after matching patients on various factors (29.3% vs. 29.6%, P=0.87; 7.7 vs. 8.1, P=0.23). While patients had more comorbid disease and advanced diabetes in the metformin group, there were no significant differences with regard to in-hospital mortality or length of stay due to COVID-19 compared to the non-metformin group. Prospective studies are needed to determine if there is clinical benefit for initiating, continuing, or re-initiating metformin in patients hospitalized with COVID-19.
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影响因子：
5.2
作者：
Crouse AB;Grimes T;Li P;Might M;Ovalle F;Shalev A
通讯作者：
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影响因子：
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影响因子：
3.8
作者：
Heald, Adrian H.;Jenkins, David A.;Williams, Richard;Sperrin, Matthew;Mudaliar, Rajshekhar N.;Syed, Akheel;Naseem, Asma;Davies, Kelly A. Bowden;Peng, Yonghong;Peek, Niels;Ollier, William;Anderson, Simon G.;Delanerolle, Gayathri;Gibson, J. Martin
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Gibson, J. Martin
影响因子：
29
作者：
Zhu, Lihua;She, Zhi-Gang;Li, Hongliang
通讯作者：
Li, Hongliang
影响因子：
5.1
作者：
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