Preadmission Metformin Use Is Associated with Reduced Mortality in Patients with Diabetes Mellitus Hospitalized with COVID-19
Abstract
BACKGROUND: Observational studies have reported an association between metformin and improved outcomes in COVID-19, but most have been small and with significant limitations.
OBJECTIVE: To evaluate the association between preadmission metformin exposure and mortality in patients with diabetes mellitus hospitalized with coronavirus disease 2019 (COVID-19) infection.
DESIGN: Retrospective cohort analysis using electronic health records extracted from the American Heart Association COVID-19 Registry.
PARTICIPANTS: Adults (n = 11,993) with diabetes mellitus but without chronic kidney disease (CKD) or need for hemodialysis who were hospitalized with COVID-19 between January 25, 2020, and February 9, 2022.
MAIN MEASURES: We used propensity score modeling to address differences between metformin and non-metformin users prior to multivariable log-binomial models to examine the association between metformin use at time of hospital admission for COVID-19 infection and in-hospital death; composite of in-hospital death or discharge to hospice; composite of in-hospital death, discharge to hospice, or ICU admission; and composite of in-hospital death, discharge to hospice, ICU admission, or mechanical ventilation.
KEY RESULTS: Compared to metformin non-use, pre-admission metformin use was associated with lower risk of in-hospital death (risk ratio (RR) 0.81 [95% CI 0.75-0.90]); composite of in-hospital death or discharge to hospice (RR 0.79 [95% CI 0.74-0.87]); composite of in-hospital…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 11,993 participants or records.
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