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Metformin is Associated with Reduced COVID-19 Severity in Patients with Prediabetes
BACKGROUND: With the continuing COVID-19 pandemic, identifying medications that improve COVID-19 outcomes is crucial. Studies suggest that use of metformin, an oral antihyperglycemic, is associated with reduced COVID-19 severity in individuals with diabetes compared to other antihyperglycemic medica...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cold Spring Harbor Laboratory
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9460973/ https://www.ncbi.nlm.nih.gov/pubmed/36093353 http://dx.doi.org/10.1101/2022.08.29.22279355 |
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author | Chan, Lauren E. Casiraghi, Elena Laraway, Bryan Coleman, Ben Blau, Hannah Zaman, Adnin Harris, Nomi Wilkins, Kenneth Gargano, Michael Valentini, Giorgio Sahner, David Haendel, Melissa Robinson, Peter N. Bramante, Carolyn Reese, Justin |
author_facet | Chan, Lauren E. Casiraghi, Elena Laraway, Bryan Coleman, Ben Blau, Hannah Zaman, Adnin Harris, Nomi Wilkins, Kenneth Gargano, Michael Valentini, Giorgio Sahner, David Haendel, Melissa Robinson, Peter N. Bramante, Carolyn Reese, Justin |
author_sort | Chan, Lauren E. |
collection | PubMed |
description | BACKGROUND: With the continuing COVID-19 pandemic, identifying medications that improve COVID-19 outcomes is crucial. Studies suggest that use of metformin, an oral antihyperglycemic, is associated with reduced COVID-19 severity in individuals with diabetes compared to other antihyperglycemic medications. Some patients without diabetes, including those with polycystic ovary syndrome (PCOS) and prediabetes, are prescribed metformin for off-label use, which provides an opportunity to further investigate the effect of metformin on COVID-19. PARTICIPANTS: In this observational, retrospective analysis, we leveraged the harmonized electronic health record data from 53 hospitals to construct cohorts of COVID-19 positive, metformin users without diabetes and propensity-weighted control users of levothyroxine (a medication for hypothyroidism that is not known to affect COVID-19 outcome) who had either PCOS (n = 282) or prediabetes (n = 3136). The primary outcome of interest was COVID-19 severity, which was classified as: mild, mild ED (emergency department), moderate, severe, or mortality/hospice. RESULTS: In the prediabetes cohort, metformin use was associated with a lower rate of COVID-19 with severity of mild ED or worse (OR: 0.630, 95% CI 0.450 – 0.882, p < 0.05) and a lower rate of COVID-19 with severity of moderate or worse (OR: 0.490, 95% CI 0.336 – 0.715, p < 0.001). In patients with PCOS, we found no significant association between metformin use and COVID-19 severity, although the number of patients was relatively small. CONCLUSIONS: Metformin was associated with less severe COVID-19 in patients with prediabetes, as seen in previous studies of patients with diabetes. This is an important finding, since prediabetes affects between 19 and 38% of the US population, and COVID-19 is an ongoing public health emergency. Further observational and prospective studies will clarify the relationship between metformin and COVID-19 severity in patients with prediabetes, and whether metformin usage may reduce COVID-19 severity. |
format | Online Article Text |
id | pubmed-9460973 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Cold Spring Harbor Laboratory |
record_format | MEDLINE/PubMed |
spelling | pubmed-94609732022-09-10 Metformin is Associated with Reduced COVID-19 Severity in Patients with Prediabetes Chan, Lauren E. Casiraghi, Elena Laraway, Bryan Coleman, Ben Blau, Hannah Zaman, Adnin Harris, Nomi Wilkins, Kenneth Gargano, Michael Valentini, Giorgio Sahner, David Haendel, Melissa Robinson, Peter N. Bramante, Carolyn Reese, Justin medRxiv Article BACKGROUND: With the continuing COVID-19 pandemic, identifying medications that improve COVID-19 outcomes is crucial. Studies suggest that use of metformin, an oral antihyperglycemic, is associated with reduced COVID-19 severity in individuals with diabetes compared to other antihyperglycemic medications. Some patients without diabetes, including those with polycystic ovary syndrome (PCOS) and prediabetes, are prescribed metformin for off-label use, which provides an opportunity to further investigate the effect of metformin on COVID-19. PARTICIPANTS: In this observational, retrospective analysis, we leveraged the harmonized electronic health record data from 53 hospitals to construct cohorts of COVID-19 positive, metformin users without diabetes and propensity-weighted control users of levothyroxine (a medication for hypothyroidism that is not known to affect COVID-19 outcome) who had either PCOS (n = 282) or prediabetes (n = 3136). The primary outcome of interest was COVID-19 severity, which was classified as: mild, mild ED (emergency department), moderate, severe, or mortality/hospice. RESULTS: In the prediabetes cohort, metformin use was associated with a lower rate of COVID-19 with severity of mild ED or worse (OR: 0.630, 95% CI 0.450 – 0.882, p < 0.05) and a lower rate of COVID-19 with severity of moderate or worse (OR: 0.490, 95% CI 0.336 – 0.715, p < 0.001). In patients with PCOS, we found no significant association between metformin use and COVID-19 severity, although the number of patients was relatively small. CONCLUSIONS: Metformin was associated with less severe COVID-19 in patients with prediabetes, as seen in previous studies of patients with diabetes. This is an important finding, since prediabetes affects between 19 and 38% of the US population, and COVID-19 is an ongoing public health emergency. Further observational and prospective studies will clarify the relationship between metformin and COVID-19 severity in patients with prediabetes, and whether metformin usage may reduce COVID-19 severity. Cold Spring Harbor Laboratory 2022-08-30 /pmc/articles/PMC9460973/ /pubmed/36093353 http://dx.doi.org/10.1101/2022.08.29.22279355 Text en https://creativecommons.org/publicdomain/zero/1.0/This article is a US Government work. It is not subject to copyright under 17 USC 105 and is also made available for use under a CC0 license (https://creativecommons.org/publicdomain/zero/1.0/) . |
spellingShingle | Article Chan, Lauren E. Casiraghi, Elena Laraway, Bryan Coleman, Ben Blau, Hannah Zaman, Adnin Harris, Nomi Wilkins, Kenneth Gargano, Michael Valentini, Giorgio Sahner, David Haendel, Melissa Robinson, Peter N. Bramante, Carolyn Reese, Justin Metformin is Associated with Reduced COVID-19 Severity in Patients with Prediabetes |
title | Metformin is Associated with Reduced COVID-19 Severity in Patients with Prediabetes |
title_full | Metformin is Associated with Reduced COVID-19 Severity in Patients with Prediabetes |
title_fullStr | Metformin is Associated with Reduced COVID-19 Severity in Patients with Prediabetes |
title_full_unstemmed | Metformin is Associated with Reduced COVID-19 Severity in Patients with Prediabetes |
title_short | Metformin is Associated with Reduced COVID-19 Severity in Patients with Prediabetes |
title_sort | metformin is associated with reduced covid-19 severity in patients with prediabetes |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9460973/ https://www.ncbi.nlm.nih.gov/pubmed/36093353 http://dx.doi.org/10.1101/2022.08.29.22279355 |
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