期刊
DIABETES & METABOLISM
卷 47, 期 5, 页码 -出版社
MASSON EDITEUR
DOI: 10.1016/j.diabet.2020.101216
关键词
COVID-19; Death; Mechanical ventilation; Metformin; Propensity score; Type 2 diabetes
资金
- Fondation Francophone pour la Recherche sur le Diabe te (FFRD) - Novo Nordisk
- Fondation Francophone pour la Recherche sur le Diabe te (FFRD) - Merck Sharpe Dome
- Fondation Francophone pour la Recherche sur le Diabe te (FFRD) - Abbott
- Fondation Francophone pour la Recherche sur le Diabe te (FFRD) - AstraZeneca
- Fondation Francophone pour la Recherche sur le Diabe te (FFRD) - Lilly and FFD (Federation Francaise des Diabetiques) CORONADO initiative emergency grant
- Societe Francophone du Diabete (SFD) CORONADO initiative emergency grant
- Fonds de dotation du CHU de Nantes (CORONADO project)
Prior metformin use is associated with a lower risk of death in patients with diabetes hospitalized for COVID-19, suggesting potential benefits of metformin in this population.
Aims. - Metformin exerts anti-inflammatory and immunosuppressive effects. We addressed the impact of prior metformin use on prognosis in patients with type 2 diabetes hospitalised for COVID-19. Methods. - CORONADO is a nationwide observational study that included patients with diabetes hospitalised for COVID-19 between March 10 and April 10, 2020 in 68 French centres. The primary outcome combined tracheal intubation and/or death within 7 days of admission. A Kaplan-Meier survival curve was reported for death up to day 28. The association between metformin use and outcomes was then estimated in a logistic regression analysis after applying a propensity score inverse probability of treatment weighting approach. Results. - Among the 2449 patients included, 1496 were metformin users and 953 were not. Compared with non-users, metformin users were younger with a lower prevalence of diabetic complications, but had more severe features of COVID-19 on admission. The primary endpoint occurred in 28.0% of metformin users (vs 29.0% in non-users, P = 0.6134) on day 7 and in 32.6% (vs 38.7%, P = 0.0023) on day 28. The mortality rate was lower in metformin users on day 7 (8.2 vs 16.1%, P < 0.0001) and on day 28 (16.0 vs 28.6%, P < 0.0001). After propensity score weighting was applied, the odds ratios for primary outcome and death (OR [95%CI], metformin users vs non-users) were 0.838 [0.649-1.082] and 0.688 [0.470-1.007] on day 7, then 0.783 [0.615-0.996] and 0.710 [0.537-0.938] on day 28, respectively. Conclusion. - Metformin use appeared to be associated with a lower risk of death in patients with diabetes hospitalised for COVID-19. (C) 2020 Elsevier Masson SAS. All rights reserved.
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