Association of Metformin with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis

Parveen, Rizwana; Mishra, Pinki; Luthra, Reva; Bajpai, Ram; Agarwal, Nidhi

Abstract

Studies have demonstrated high prevalence of mortality in coronavirus disease (COVID-19) patients with type 2 diabetes mellitus; however, the effects of antidiabetic pharmacotherapy on COVID-19 complications need further exploration. The aim of the study was to explore the association of metformin use and mortality in COVID-19 patients. A literature search was conducted using the databases Medline (via PubMed) and Cochrane Central Register of Controlled Trials until February 09, 2021. Nine studies were included in the meta-analysis, including 12,684 COVID-19 patients. The meta-analysis suggested 37% lower risk of mortality in patients receiving metformin (risk ratio: 0.63; 95% confidence interval: 0.50–0.78; p < 0.001). However, no significant difference in hospitalization days between the two groups (p = 0.197) was observed. The analysis revealed significantly lower risk of having obesity (p < 0.001), hypertension (p < 0.001), heart failure (p < 0.001), and cerebrovascular disease (p = 0.015) in the group receiving metformin. The analysis also demonstrated significantly lower risk of using anticoagulants (p = 0.015), diuretics (p < 0.001), and antiplatelets (p = 0.010) in patients receiving metformin. Our findings suggest that metformin use decreases mortality in COVID-19 patients. However, randomized studies demonstrating the consequences of metformin use are needed to understand the magnitude of the beneficial effects of metformin.

Citation

Parveen, R., Mishra, P., Luthra, R., Bajpai, R., & Agarwal, N. (2023). Association of Metformin with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis. Annals of the National Academy of Medical Sciences (India), 59(01), 013-020. https://doi.org/10.1055/s-0042-1760353

• Journal Article Type: Article
• Acceptance Date: Feb 22, 2023
• Online Publication Date: Feb 22, 2023
• Publication Date: 2023-01
• Deposit Date: Jun 1, 2023
• Journal: Annals of the National Academy of Medical Sciences (India)
• Print ISSN: 0379-038X
• Electronic ISSN: 2454-5635
• Publisher: Thieme Gruppe
• Peer Reviewed: Peer Reviewed
• Volume: 59
• Issue: 01
• Pages: 013-020
• DOI: https://doi.org/10.1055/s-0042-1760353
• Keywords: Automotive Engineering
• Public URL: https://keele-repository.worktribe.com/output/433348