Metformin use and its association with various outcomes in COVID-19 patients with diabetes mellitus: a retrospective cohort study in a tertiary care facility

Metformin use and its association with various outcomes in COVID-19 patients with diabetes mellitus: a retrospective cohort study in a tertiary care facility

Background Evidence shows that diabetes raises the probability of contracting COVID-19 and associated complications. We hypothesize that metformin, being pleiotropic, may improve COVID-19 in diabetics.Methods A retrospective cohort study was conducted with 421 COVID-19 patients with diabetes, hospit...

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Main Authors: Muhilvannan Somasundaram, Sanjay Kurian Mathew, Soumyajeet Paul, Shilia Jacob Kurian, Vijayanarayana Kunhikatta, Shubhada Karanth, Sahana Shetty, Chandrashekar Udyavara Kudru, Mohan K. Manu, Kavitha Saravu, Mazhuvancherry Kesavan Unnikrishnan, Mahadev Rao, Sonal Sekhar Miraj
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Annals of Medicine
Subjects:
COVID-19
diabetes
metformin
mortality
SARS-CoV-2
Online Access:https://www.tandfonline.com/doi/10.1080/07853890.2024.2425829
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Summary:Background Evidence shows that diabetes raises the probability of contracting COVID-19 and associated complications. We hypothesize that metformin, being pleiotropic, may improve COVID-19 in diabetics.Methods A retrospective cohort study was conducted with 421 COVID-19 patients with diabetes, hospitalized between 1st April 2020 and 31st March 2022 in a tertiary-care hospital. Patients with metformin or its combination constituted the study cohort (SC; n = 221), while other antidiabetics constituted the reference cohort (RC; n = 200).Results SC and RC were matched for mean age ± SD (SC: 53.3 ± 5.7 vs. RC: 54.3 ± 8.2 years). The mean length of hospitalization (days) was significantly shorter in SC (9.0 ± 5.7) than in RC (12.7 ± 6) (p < 0.02). Metformin use was associated with reduction in mortality risk (OR: 0.106, 95% CI = 0.039–0.287; p < 0.001). Moreover, SC also improved levels of LDH (OR: 0.243, 95% CI = 0.104–0.566; p < 0.001), CRP (OR: 0.281, 95% CI = 0.120–0.659; p < 0.004), and D-dimer (OR: 0.220, 95% CI = 0.089–0.539; p < 0.001) than RC. The calculated number needed to treat for metformin was 3.1.Conclusion Metformin users have a decrease in hospital stay and mortality rates and improvement in LDH, CRP, and D-dimer levels. Therefore, metformin might protect against mortality in COVID-19 with diabetes.
ISSN:0785-3890
1365-2060

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