Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity.
Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity.
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DOI：
10.1002/jmv.26873
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发表时间：
2021-07
影响因子：
12.7
通讯作者：
Tignanelli CJ
中科院分区：
文献类型：
--
作者：
Bramante CT;Buse J;Tamaritz L;Palacio A;Cohen K;Vojta D;Liebovitz D;Mitchell N;Nicklas J;Lingvay I;Clark JM;Aronne LJ;Anderson E;Usher M;Demmer R;Melton GB;Ingraham N;Tignanelli CJ
观察性研究表明，门诊使用二甲双胍与冠状病毒病- 2019 （COVID - 19）的死亡率降低有关。已知二甲双胍可降低白细胞介素- 6和肿瘤坏死因子- α，这似乎与COVID - 19的发病率有关。我们试图了解门诊二甲双胍的使用是否与美国大型医疗数据集中严重COVID - 19疾病的发生率降低相关。对2020年3月4日至2020年12月4日期间来自中西部12家医院和60家初级保健诊所的多个EHR系统的电子健康记录（EHR）数据进行回顾性队列分析。纳入标准：体重指数(BMI)≥25 kg/m2， SARS - CoV - 2聚合酶链反应阳性；年龄≥30岁，≤85岁。排除标准：患者选择退出研究。二甲双胍是暴露感兴趣，死亡、入院和重症监护病房入院是暴露感兴趣的结果。二甲双胍与COVID - 19死亡率降低相关，OR为0.32 （0.15,0.66;p =）。002)，在倾向匹配的队列中，OR为0.38 （0.16,0.91;p = 0.030）。在整个队列中，二甲双胍与COVID - 19住院率的无显著降低相关，OR为0.78 （0.58-1.04,p = 0.087）。在可获得血红蛋白HbA1c的亚组中（n = 1193），二甲双胍使用者住院（包括HbA1c调整）的调整几率为OR 0.75 （0.53-1.06, p = 0.105）。门诊使用二甲双胍与较低的死亡率和COVID - 19住院率下降趋势相关。鉴于二甲双胍的低成本、已确定的安全性以及越来越多的证据表明可以降低COVID - 19疾病的严重程度，应该对二甲双胍进行前瞻性评估，用于门诊治疗COVID - 19。迫切需要对SARS - CoV - 2感染进行口服门诊治疗。二甲双胍具有抗炎和抗病毒作用的历史。在这项对超重或肥胖患者的回顾性队列分析中，门诊二甲双胍的使用与较低的死亡率相关。与住院减少无显著关联。
Observational studies suggest outpatient metformin use is associated with reduced mortality from coronavirus disease‐2019 (COVID‐19). Metformin is known to decrease interleukin‐6 and tumor‐necrosis factor‐α, which appear to contribute to morbidity in COVID‐19. We sought to understand whether outpatient metformin use was associated with reduced odds of severe COVID‐19 disease in a large US healthcare data set. Retrospective cohort analysis of electronic health record (EHR) data that was pooled across multiple EHR systems from 12 hospitals and 60 primary care clinics in the Midwest between March 4, 2020 and December 4, 2020. Inclusion criteria: data for body mass index (BMI) > 25 kg/m2 and a positive SARS‐CoV‐2 polymerase chain reaction test; age ≥ 30 and ≤85 years. Exclusion criteria: patient opt‐out of research. Metformin is the exposure of interest, and death, admission, and intensive care unit admission are the outcomes of interest. Metformin was associated with a decrease in mortality from COVID‐19, OR 0.32 (0.15, 0.66; p = .002), and in the propensity‐matched cohorts, OR 0.38 (0.16, 0.91; p = .030). Metformin was associated with a nonsignificant decrease in hospital admission for COVID‐19 in the overall cohort, OR 0.78 (0.58–1.04, p = .087). Among the subgroup with a hemoglobin HbA1c available (n = 1193), the adjusted odds of hospitalization (including adjustment for HbA1c) for metformin users was OR 0.75 (0.53–1.06, p = .105). Outpatient metformin use was associated with lower mortality and a trend towards decreased admission for COVID‐19. Given metformin's low cost, established safety, and the mounting evidence of reduced severity of COVID‐19 disease, metformin should be prospectively assessed for outpatient treatment of COVID‐19. Oral outpatient therapies for SARS‐CoV‐2 infection are desperately needed. Metformin has a history of anti‐inflammatory and anti‐viral effects. In this retrospective cohort analysis in persons with overweight or obesity outpatient metformin use was associated with lower lower mortality. There was no significant association with reduced hospitalization.
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影响因子：
2.2
作者：
Afshari, Khashayar;Dehdashtian, Amir;Dehpour, Ahmad Reza
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影响因子：
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影响因子：
14.2
作者：
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