Sugimoto Mari, Kikuchi Hiroaki, Sohara Eisei, Mizutani Koji, Limbutara Kavee, Hirakawa Akihiro, Mori Takayasu, Susa Koichiro, Oya Shuichiro, Suzuki Takefumi, Naito Shotaro, Iimori Soichiro, Rai Tatemitsu, Fushimi Kiyohide, Uchida Shinichi
Department of Periodontology, Institutes of Science Tokyo, Tokyo, Japan.
Department of Nephrology, Institutes of Science Tokyo, Tokyo, Japan.
Clin Exp Nephrol. 2025 Aug 27. doi: 10.1007/s10157-025-02755-z.
The most prescribed oral glucose-lowering medication worldwide is biguanide (BG), which shows potential for further therapeutic applications. The coronavirus disease 2019 (COVID-19) pandemic is a global public health emergency. Nevertheless, low-cost treatments against COVID-19 have not been established, with varying morbidity and mortality rates in each country.
From the inpatient databases in Japan from September 2021 to March 2023, which includes the era following the development of COVID-19 vaccines, we extracted data from 168,370 patients with COVID-19 aged 20- < 80 years with diabetes mellitus treated with oral antidiabetic agents. The primary and secondary outcomes were 100-day in-hospital mortality and incidence of acute kidney injury (AKI) during hospitalisation, respectively. We compared outcomes in patients who received BG with those who did not using a logistic regression analysis and Cox proportional hazards under both propensity score-unmatched and matched cohorts.
The incidence of in-hospital death was significantly lower in the BG group (1.18%) compared with the non-BG group (2.41%) (P < 0.001). Similarly, the incidence of AKI during hospitalisation was significantly lower in the BG group (0.66%) compared to the non-BG group (1.12%) (P < 0.001). Kaplan-Meier analysis from the propensity score-matched cohort showed a significantly better survival rate in the BG group (adjusted HR, 0.619; 95% CI, 0.545-0.702; P < 0.001).
In patients with COVID-19, oral biguanide use may be associated with reduced in-hospital mortality and AKI risk.
全球处方量最大的口服降糖药物是双胍类药物（BG），其显示出进一步治疗应用的潜力。2019年冠状病毒病（COVID-19）大流行是一场全球公共卫生突发事件。然而，针对COVID-19的低成本治疗方法尚未确立，各国的发病率和死亡率各不相同。
从日本2021年9月至2023年3月的住院患者数据库中，该数据库涵盖了COVID-19疫苗研发后的时期，我们提取了168370例年龄在20至<80岁、使用口服抗糖尿病药物治疗的COVID-19糖尿病患者的数据。主要和次要结局分别为100天住院死亡率和住院期间急性肾损伤（AKI）的发生率。我们在倾向得分未匹配和匹配队列中，使用逻辑回归分析和Cox比例风险模型比较了接受BG治疗的患者与未接受BG治疗的患者的结局。
BG组的住院死亡率（1.18%）显著低于非BG组（2.41%）（P<0.001）。同样，BG组住院期间AKI的发生率（0.66%）显著低于非BG组（1.12%）（P<0.001）。倾向得分匹配队列的Kaplan-Meier分析显示，BG组的生存率显著更好（调整后的HR，0.619；95%CI，0.545-0.702；P<0.001）。
在COVID-19患者中，使用口服双胍类药物可能与降低住院死亡率和AKI风险相关。
