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Metformin use is associated with a reduced risk of mortality in patients with diabetes hospitalised for COVID-19
AIMS: Metformin exerts anti-inflammatory and immunosuppressive effects. We addressed the impact of prior metformin use on prognosis in patients with type 2 diabetes hospitalised for COVID-19. METHODS: CORONADO is a nationwide observational study that included patients with diabetes hospitalised for...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Masson SAS.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7832745/ https://www.ncbi.nlm.nih.gov/pubmed/33309936 http://dx.doi.org/10.1016/j.diabet.2020.101216 |
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author | Lalau, Jean-Daniel Al-Salameh, Abdallah Hadjadj, Samy Goronflot, Thomas Wiernsperger, Nicolas Pichelin, Matthieu Allix, Ingrid Amadou, Coralie Bourron, Olivier Duriez, Thierry Gautier, Jean-François Dutour, Anne Gonfroy, Céline Gouet, Didier Joubert, Michael Julier, Ingrid Larger, Etienne Marchand, Lucien Marre, Michel Meyer, Laurent Olivier, Frédérique Prevost, Gaëtan Quiniou, Pascale Raffaitin-Cardin, Christelle Roussel, Ronan Saulnier, Pierre-Jean Seret-Begue, Dominique Thivolet, Charles Vatier, Camille Desailloud, Rachel Wargny, Matthieu Gourdy, Pierre Cariou, Bertrand |
author_facet | Lalau, Jean-Daniel Al-Salameh, Abdallah Hadjadj, Samy Goronflot, Thomas Wiernsperger, Nicolas Pichelin, Matthieu Allix, Ingrid Amadou, Coralie Bourron, Olivier Duriez, Thierry Gautier, Jean-François Dutour, Anne Gonfroy, Céline Gouet, Didier Joubert, Michael Julier, Ingrid Larger, Etienne Marchand, Lucien Marre, Michel Meyer, Laurent Olivier, Frédérique Prevost, Gaëtan Quiniou, Pascale Raffaitin-Cardin, Christelle Roussel, Ronan Saulnier, Pierre-Jean Seret-Begue, Dominique Thivolet, Charles Vatier, Camille Desailloud, Rachel Wargny, Matthieu Gourdy, Pierre Cariou, Bertrand |
author_sort | Lalau, Jean-Daniel |
collection | PubMed |
description | AIMS: Metformin exerts anti-inflammatory and immunosuppressive effects. We addressed the impact of prior metformin use on prognosis in patients with type 2 diabetes hospitalised for COVID-19. METHODS: CORONADO is a nationwide observational study that included patients with diabetes hospitalised for COVID-19 between March 10 and April 10, 2020 in 68 French centres. The primary outcome combined tracheal intubation and/or death within 7 days of admission. A Kaplan-Meier survival curve was reported for death up to day 28. The association between metformin use and outcomes was then estimated in a logistic regression analysis after applying a propensity score inverse probability of treatment weighting approach. RESULTS: Among the 2449 patients included, 1496 were metformin users and 953 were not. Compared with non-users, metformin users were younger with a lower prevalence of diabetic complications, but had more severe features of COVID-19 on admission. The primary endpoint occurred in 28.0% of metformin users (vs 29.0% in non-users, P = 0.6134) on day 7 and in 32.6% (vs 38.7%, P = 0.0023) on day 28. The mortality rate was lower in metformin users on day 7 (8.2 vs 16.1%, P < 0.0001) and on day 28 (16.0 vs 28.6%, P < 0.0001). After propensity score weighting was applied, the odds ratios for primary outcome and death (OR [95%CI], metformin users vs non-users) were 0.838 [0.649−1.082] and 0.688 [0.470−1.007] on day 7, then 0.783 [0.615−0.996] and 0.710 [0.537−0.938] on day 28, respectively. CONCLUSION: Metformin use appeared to be associated with a lower risk of death in patients with diabetes hospitalised for COVID-19. |
format | Online Article Text |
id | pubmed-7832745 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier Masson SAS. |
record_format | MEDLINE/PubMed |
spelling | pubmed-78327452021-01-26 Metformin use is associated with a reduced risk of mortality in patients with diabetes hospitalised for COVID-19 Lalau, Jean-Daniel Al-Salameh, Abdallah Hadjadj, Samy Goronflot, Thomas Wiernsperger, Nicolas Pichelin, Matthieu Allix, Ingrid Amadou, Coralie Bourron, Olivier Duriez, Thierry Gautier, Jean-François Dutour, Anne Gonfroy, Céline Gouet, Didier Joubert, Michael Julier, Ingrid Larger, Etienne Marchand, Lucien Marre, Michel Meyer, Laurent Olivier, Frédérique Prevost, Gaëtan Quiniou, Pascale Raffaitin-Cardin, Christelle Roussel, Ronan Saulnier, Pierre-Jean Seret-Begue, Dominique Thivolet, Charles Vatier, Camille Desailloud, Rachel Wargny, Matthieu Gourdy, Pierre Cariou, Bertrand Diabetes Metab Original Article AIMS: Metformin exerts anti-inflammatory and immunosuppressive effects. We addressed the impact of prior metformin use on prognosis in patients with type 2 diabetes hospitalised for COVID-19. METHODS: CORONADO is a nationwide observational study that included patients with diabetes hospitalised for COVID-19 between March 10 and April 10, 2020 in 68 French centres. The primary outcome combined tracheal intubation and/or death within 7 days of admission. A Kaplan-Meier survival curve was reported for death up to day 28. The association between metformin use and outcomes was then estimated in a logistic regression analysis after applying a propensity score inverse probability of treatment weighting approach. RESULTS: Among the 2449 patients included, 1496 were metformin users and 953 were not. Compared with non-users, metformin users were younger with a lower prevalence of diabetic complications, but had more severe features of COVID-19 on admission. The primary endpoint occurred in 28.0% of metformin users (vs 29.0% in non-users, P = 0.6134) on day 7 and in 32.6% (vs 38.7%, P = 0.0023) on day 28. The mortality rate was lower in metformin users on day 7 (8.2 vs 16.1%, P < 0.0001) and on day 28 (16.0 vs 28.6%, P < 0.0001). After propensity score weighting was applied, the odds ratios for primary outcome and death (OR [95%CI], metformin users vs non-users) were 0.838 [0.649−1.082] and 0.688 [0.470−1.007] on day 7, then 0.783 [0.615−0.996] and 0.710 [0.537−0.938] on day 28, respectively. CONCLUSION: Metformin use appeared to be associated with a lower risk of death in patients with diabetes hospitalised for COVID-19. Elsevier Masson SAS. 2021-09 2020-12-10 /pmc/articles/PMC7832745/ /pubmed/33309936 http://dx.doi.org/10.1016/j.diabet.2020.101216 Text en © 2020 Elsevier Masson SAS. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Original Article Lalau, Jean-Daniel Al-Salameh, Abdallah Hadjadj, Samy Goronflot, Thomas Wiernsperger, Nicolas Pichelin, Matthieu Allix, Ingrid Amadou, Coralie Bourron, Olivier Duriez, Thierry Gautier, Jean-François Dutour, Anne Gonfroy, Céline Gouet, Didier Joubert, Michael Julier, Ingrid Larger, Etienne Marchand, Lucien Marre, Michel Meyer, Laurent Olivier, Frédérique Prevost, Gaëtan Quiniou, Pascale Raffaitin-Cardin, Christelle Roussel, Ronan Saulnier, Pierre-Jean Seret-Begue, Dominique Thivolet, Charles Vatier, Camille Desailloud, Rachel Wargny, Matthieu Gourdy, Pierre Cariou, Bertrand Metformin use is associated with a reduced risk of mortality in patients with diabetes hospitalised for COVID-19 |
title | Metformin use is associated with a reduced risk of mortality in patients with diabetes hospitalised for COVID-19 |
title_full | Metformin use is associated with a reduced risk of mortality in patients with diabetes hospitalised for COVID-19 |
title_fullStr | Metformin use is associated with a reduced risk of mortality in patients with diabetes hospitalised for COVID-19 |
title_full_unstemmed | Metformin use is associated with a reduced risk of mortality in patients with diabetes hospitalised for COVID-19 |
title_short | Metformin use is associated with a reduced risk of mortality in patients with diabetes hospitalised for COVID-19 |
title_sort | metformin use is associated with a reduced risk of mortality in patients with diabetes hospitalised for covid-19 |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7832745/ https://www.ncbi.nlm.nih.gov/pubmed/33309936 http://dx.doi.org/10.1016/j.diabet.2020.101216 |
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