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CC BY-NC-ND 4.0 · Ann Natl Acad Med Sci 2023; 59(01): 013-020
DOI: 10.1055/s-0042-1760353
Review Article

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

Rizwana Parveen
1   Centre for Translational and Clinical Research, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi, India
,
Pinki Mishra
1   Centre for Translational and Clinical Research, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi, India
,
Reva Luthra
1   Centre for Translational and Clinical Research, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi, India
,
Ram Bajpai 
2   School of Medicine, Keele University, Staffordshire, United Kingdom
,
Nidhi Agarwal 
1   Centre for Translational and Clinical Research, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi, India
› Author Affiliations Funding None.
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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.

Keywords

COVID-19 - hospitalization - metformin - mortality - meta-analysis - type 2 diabetes - SARS-CoV-2

Authors Contribution

All the authors contributed in conception or design. RP, PM, and RL contributed in acquisition of data. RB and NA contributed in data analysis and interpretation. All the authors contributed to the preparation of manuscript or critically revising the manuscript and gave their final approval for the manuscript.


Supplementary Material



Publication History

Article published online:
22 February 2023

© 2023. National Academy of Medical Sciences (India). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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