In a recent study at the University of Alabama at Birmingham, researchers found that the use of the diabetes drug metformin—before a diagnosis of COVID-19—is linked to a threefold decrease in mortality in COVID-19 patients with Type 2 diabetes.
Similar results have now been obtained in different populations from around the world—including China, France and a UnitedHealthcare analysis.
This suggests that the reduction in mortality risk linked to metformin use in people with Type 2 diabetes and COVID-19 might be generalizable.
The study is published in Frontiers in Endocrinology. One author is Anath Shalev, M.D., the director of UAB’s Comprehensive Diabetes Center.
Diabetes is big comorbidity for COVID-19, and how metformin improves prognosis in the context of COVID-19 is not known.
In the study, the team included 25,326 patients tested for COVID-19 at the tertiary care UAB Hospital. Of the 604 patients found to be COVID-19-positive, 311 were African Americans.
The team found that the overall mortality for COVID-19-positive patients was 11%. About 93% of deaths occurred in people over the age of 50, and being male or having high blood pressure was linked to a much higher risk of death.
Diabetes was linked to a dramatic increase in mortality, with an odds ratio of 3.62. Overall, 67% of deaths in the study occurred in people with diabetes.
The researchers looked at the effects of diabetes treatment on adverse COVID-19 outcomes, focusing on insulin and metformin as the two most common medications for Type 2 diabetes.
They found that prior insulin use did not affect mortality risk.
However, prior metformin use was a different matter.
Metformin use strongly reduced the odds of dying, and the 11% mortality for metformin users was not only comparable to that of the general COVID-19-positive population, but it was also dramatically lower than the 23% mortality for diabetes patients not on metformin.
Interestingly, even after controlling for all these other covariates, death was much less likely for Type 2 diabetes patients taking metformin, compared with those who did not take metformin.
These results suggest that diabetes is an independent risk factor for COVID-19-related mortality.
But this risk is dramatically reduced in people taking metformin—raising the possibility that metformin may provide a protective approach in this high-risk population.
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