Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Department of Family Medicine and Primary Care, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Front Endocrinol (Lausanne). 2022 Mar 7;13:810914. doi: 10.3389/fendo.2022.810914. eCollection 2022.
This study was conducted in order to evaluate the association between metformin use and clinical outcomes in type 2 diabetes mellitus (T2DM) patients hospitalized with coronavirus disease 2019 (COVID-19).
Patients with T2DM with confirmed diagnosis of COVID-19 and admitted between January 21, 2020, and January 31, 2021 in Hong Kong were identified in our cohort. Exposure was defined as metformin use within 90 days prior to admission until hospital discharge for COVID-19. Primary outcome was defined as clinical improvement of ≥1 point on the WHO Clinical Progression Scale (CPS). Other outcomes were hospital discharge, recovery, in-hospital death, acidosis, hyperinflammatory syndrome, length of hospitalization, and changes in WHO CPS score.
Metformin use was associated with greater odds of clinical improvement (OR = 2.74, = 0.009), hospital discharge (OR = 2.26, = 0.009), and recovery (OR = 2.54, = 0.005), in addition to lower odds of hyperinflammatory syndrome (OR = 0.71, = 0.021) and death (OR = 0.41, = 0.010) than control. Patients on metformin treatment had a shorter hospital stay (-2.76 days, = 0.017) than their control counterparts. The average WHO CPS scores were significantly lower in metformin users than non-users since day 15 ( < 0.001). However, metformin use was associated with higher odds of acidosis.
Metformin use was associated with lower mortality and lower odds for hyperinflammatory syndrome. This provides additional insights into the potential mechanisms of the benefits of metformin use in T2DM patients with COVID-19.
本研究旨在评估二甲双胍的使用与因 2019 年冠状病毒病（COVID-19）住院的 2 型糖尿病（T2DM）患者的临床结局之间的关系。
在我们的队列中，鉴定了 2020 年 1 月 21 日至 2021 年 1 月 31 日期间在香港确诊 COVID-19 并住院的 T2DM 患者。暴露定义为在 COVID-19 住院前 90 天内至出院期间使用二甲双胍。主要结局定义为世界卫生组织临床进展量表（CPS）评分提高≥1 分。其他结局包括出院、康复、住院死亡、酸中毒、高炎症综合征、住院时间以及 WHO CPS 评分的变化。
与对照组相比，二甲双胍组更有可能出现临床改善（OR=2.74， =0.009）、出院（OR=2.26， =0.009）和康复（OR=2.54， =0.005），并且出现高炎症综合征（OR=0.71， =0.021）和死亡（OR=0.41， =0.010）的可能性较低。二甲双胍治疗组的住院时间比对照组短（-2.76 天， =0.017）。与非使用者相比，二甲双胍使用者的平均 WHO CPS 评分从第 15 天开始明显降低（ < 0.001）。然而，二甲双胍的使用与酸中毒的发生几率增加有关。
二甲双胍的使用与降低死亡率和降低高炎症综合征的几率有关。这为二甲双胍在 COVID-19 合并 T2DM 患者中的潜在获益机制提供了更多的见解。
