Department of Cardiology, Zhongnan Hospital, School of Basic Medical Science, Wuhan University, Wuhan, China; Institute of Model Animal, Wuhan University, Wuhan, China.
Institute of Model Animal, Wuhan University, Wuhan, China; Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.
Cell Metab. 2020 Oct 6;32(4):537-547.e3. doi: 10.1016/j.cmet.2020.08.013. Epub 2020 Aug 20.
The safety and efficacy of anti-diabetic drugs are critical for maximizing the beneficial impacts of well-controlled blood glucose on the prognosis of individuals with COVID-19 and pre-existing type 2 diabetes (T2D). Metformin is the most commonly prescribed first-line medication for T2D, but its impact on the outcomes of individuals with COVID-19 and T2D remains to be clarified. Our current retrospective study in a cohort of 1,213 hospitalized individuals with COVID-19 and pre-existing T2D indicated that metformin use was significantly associated with a higher incidence of acidosis, particularly in cases with severe COVID-19, but not with 28-day COVID-19-related mortality. Furthermore, metformin use was significantly associated with reduced heart failure and inflammation. Our findings provide clinical evidence in support of continuing metformin treatment in individuals with COVID-19 and pre-existing T2D, but acidosis and kidney function should be carefully monitored in individuals with severe COVID-19.
抗糖尿病药物的安全性和疗效对于将血糖良好控制对 COVID-19 合并有 2 型糖尿病（T2D）个体预后的有益影响最大化至关重要。二甲双胍是 T2D 最常开的一线药物，但它对 COVID-19 合并 T2D 个体结局的影响仍有待阐明。我们目前在一项包含 1213 例 COVID-19 合并有 T2D 住院个体的回顾性研究中发现，二甲双胍的使用与酸中毒发生率升高显著相关，尤其是在 COVID-19 重症病例中，但与 28 天 COVID-19 相关死亡率无关。此外，二甲双胍的使用与心衰和炎症减少显著相关。我们的研究结果为 COVID-19 合并有 T2D 的个体继续使用二甲双胍治疗提供了临床证据，但在 COVID-19 重症个体中应仔细监测酸中毒和肾功能。
