2 型糖尿病合并 COVID-19 患者应用抗糖尿病药物的死亡风险：一项系统评价和荟萃分析。
Mortality Risk of Antidiabetic Agents for Type 2 Diabetes With COVID-19: A Systematic Review and Meta-Analysis.
机构信息
Department of Endocrinology, Affiliated Hospital of Weifang Medical University, Weifang, China.
Clinical Research Center, Affiliated Hospital of Weifang Medical University, Weifang, China.
出版信息
Front Endocrinol (Lausanne). 2021 Sep 16;12:708494. doi: 10.3389/fendo.2021.708494. eCollection 2021.
AIMS
We conducted a systematic review and meta-analysis to assess various antidiabetic agents' association with mortality in patients with type 2 diabetes (T2DM) who have coronavirus disease 2019 (COVID-19).
METHODS
We performed comprehensive literature retrieval from the date of inception until February 2, 2021, in medical databases (PubMed, Web of Science, Embase, and Cochrane Library), regarding mortality outcomes in patients with T2DM who have COVID-19. Pooled OR and 95% CI data were used to assess relationships between antidiabetic agents and mortality.
RESULTS
Eighteen studies with 17,338 patients were included in the meta-analysis. Metformin (pooled OR, 0.69; =0.001) and sulfonylurea (pooled OR, 0.80; =0.016) were associated with lower mortality risk in patients with T2DM who had COVID-19. However, patients with T2DM who had COVID-19 and received insulin exhibited greater mortality (pooled OR, 2.20; =0.002). Mortality did not significantly differ (pooled OR, 0.72; =0.057) between DPP-4 inhibitor users and non-users.
CONCLUSIONS
Metformin and sulfonylurea could be associated with reduced mortality risk in patients with T2DM who have COVID-19. Furthermore, insulin use could be associated with greater mortality, while DPP-4 inhibitor use could not be. The effects of antidiabetic agents in patients with T2DM who have COVID-19 require further exploration.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO (identifier, CRD42021242898).
目的
我们进行了一项系统评价和荟萃分析，以评估在患有 2 型糖尿病（T2DM）并感染 2019 年冠状病毒病（COVID-19）的患者中，各种抗糖尿病药物与死亡率的关系。
方法
我们从研究开始日期到 2021 年 2 月 2 日，在医学数据库（PubMed、Web of Science、Embase 和 Cochrane Library）中全面检索了有关 T2DM 患者 COVID-19 死亡率的文献。使用合并 OR 和 95%CI 数据评估抗糖尿病药物与死亡率之间的关系。
结果
共有 18 项研究纳入了 17338 名患者进行荟萃分析。在患有 COVID-19 的 T2DM 患者中，二甲双胍（合并 OR，0.69；P=0.001）和磺酰脲类（合并 OR，0.80；P=0.016）与较低的死亡率风险相关。然而，患有 COVID-19 并接受胰岛素治疗的 T2DM 患者死亡率更高（合并 OR，2.20；P=0.002）。DPP-4 抑制剂使用者和非使用者之间的死亡率无显著差异（合并 OR，0.72；P=0.057）。
结论
二甲双胍和磺酰脲类药物可能与 COVID-19 合并 T2DM 患者的死亡率降低相关。此外，胰岛素的使用可能与更高的死亡率相关，而 DPP-4 抑制剂的使用则不能。抗糖尿病药物在 COVID-19 合并 T2DM 患者中的作用需要进一步探索。
系统评价注册
PROSPERO（标识符，CRD42021242898）。
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