Metformin drug reduces mortality in COVID-19 patients with type 2 diabetes

The use of the diabetes drug metformin – before the diagnosis of COVID-19 – is associated with a threefold reduction in mortality in COVID-19 patients with Type 2 diabetes, according to a study between ethnic mix at the University of Alabama in Birmingham. Diabetes is a major comorbidity for COVID-19.

This beneficial effect was present, even after correction for age, sex, ethnicity, obesity, and hip-tolerance or renal failure and heart failure. “

Anath Shalev, MD, Principal Research Author and Director of the Center for Comprehensive Diabetes, University of Alabama at Birmingham

“Given that similar results have now been achieved in different communities from around the world – including China, France and the UnitedHealthcare study – this suggests that the decline seen is the risk of mortality associated with metformin use in subjects with Type 2 diabetes and COVID-19 may be common, ”Shalev said.

It is not known how metformin improves prognosis in the context of COVID-19, Shalev says. UAB findings suggest that the mechanisms may go beyond any expected improvement in glycemic control or obesity, as body index, blood glucose or hemoglobin A1C were not lower in the metformin users who survived compared to those who died.

“The devices may have anti-inflammatory and anti-thrombotic effects previously described with metformin,” Shalev said.

The study – originally available in MedRxiv and now published in the peer-reviewed journal Frontiers in Endocrinology – included 25,326 patients diagnosed for COVID-19 at UAB Tertiary Care Hospital between February 25 and June 22 last year. Of the 604 patients diagnosed as COVID-19-positive, 311 were African Americans.

The main outcome in the study was mortality in COVID-19-post subjects, and the possible association with subject characteristics or comorbidities was investigated.

The researchers found that Blacks, who make up only 26 percent of the Alabama population, 52 percent of those who tested positive for COVID-19, and only 30 percent of those who tested negative. In comparison, only 36 percent of COVID-19-post subjects were white, and white people made up 56 percent of those who tested negative, confirming the racial difference. But once COVID-19-positive, no significant racial difference in mortality was observed.

“In our group,” Shalev said, “African Americans seemed to be a major risk factor for contracting COVID-19, rather than for mortality. This indicates that there appears to be a any racial discrimination due to exposure risk and external socio-economic factors, including access to proper health care. “

Overall mortality for COVID-19-positive patients was 11 percent. The study found that 93 percent of deaths occurred in subjects older than 50, and being male or with high blood pressure was associated with a very high risk of death. Diabetes was associated with a significant increase in mortality, with a staggering ratio of 3.62. Overall, 67 percent of deaths in the study occurred in subjects with diabetes.

The researchers looked at the effect of diabetes treatment on the adverse effects of COVID-19, targeting insulin and metformin as the two most common medications for Type 2 diabetes. They found that prior insulin use affects the risk of mortality.

However, prior metformin use was a different issue. Metformin use significantly reduced mortality rates, and the 11 percent mortality for metformin users alone compared to the general COVID-19-post population was significantly higher. lower mortality rates 23 percent for non-metformin-free diabetes patients.

After controlling for other covariates, age, sex and metformin use emerged as independent factors influencing COVID-19-related mortality. Interestingly, even after controlling these other covariates, death was significantly more likely – with an odd ratio of 0.33 – for Type 2 diabetes subjects taking metformin, compared to those who did not. took metformin.

“These results suggest that while diabetes is an independent risk factor for COVID-19-related mortality,” Shalev said, “this risk is significantly reduced in subjects taking metformin – increases the chance that metformin may provide a means of protection in this high-risk population. “

The researchers say future studies need to examine how protective metformin is, as well as assess the risks and benefits of metformin treatment and the indications for its use against the disease. COVID-19 pandemic.