PMID- 35321338 OWN - NLM STAT- MEDLINE DCOM- 20220401 LR - 20221207 IS - 1664-2392 (Print) IS - 1664-2392 (Electronic) IS - 1664-2392 (Linking) VI - 13 DP - 2022 TI - Metformin Use in Relation to Clinical Outcomes and Hyperinflammatory Syndrome Among COVID-19 Patients With Type 2 Diabetes: A Propensity Score Analysis of a Territory-Wide Cohort. PG - 810914 LID - 10.3389/fendo.2022.810914 [doi] LID - 810914 AB - AIM: This study was conducted in order to evaluate the association between metformin use and clinical outcomes in type 2 diabetes mellitus (T2DM) patients hospitalized with coronavirus disease 2019 (COVID-19). METHODS: Patients with T2DM with confirmed diagnosis of COVID-19 and admitted between January 21, 2020, and January 31, 2021 in Hong Kong were identified in our cohort. Exposure was defined as metformin use within 90 days prior to admission until hospital discharge for COVID-19. Primary outcome was defined as clinical improvement of >/=1 point on the WHO Clinical Progression Scale (CPS). Other outcomes were hospital discharge, recovery, in-hospital death, acidosis, hyperinflammatory syndrome, length of hospitalization, and changes in WHO CPS score. RESULTS: Metformin use was associated with greater odds of clinical improvement (OR = 2.74, p = 0.009), hospital discharge (OR = 2.26, p = 0.009), and recovery (OR = 2.54, p = 0.005), in addition to lower odds of hyperinflammatory syndrome (OR = 0.71, p = 0.021) and death (OR = 0.41, p = 0.010) than control. Patients on metformin treatment had a shorter hospital stay (-2.76 days, p = 0.017) than their control counterparts. The average WHO CPS scores were significantly lower in metformin users than non-users since day 15 (p < 0.001). However, metformin use was associated with higher odds of acidosis. CONCLUSIONS: Metformin use was associated with lower mortality and lower odds for hyperinflammatory syndrome. This provides additional insights into the potential mechanisms of the benefits of metformin use in T2DM patients with COVID-19. CI - Copyright (c) 2022 Wong, Lui, Lui, Low, Kwok, Lau, Au, Xiong, Chung, Lau and Cowling. FAU - Wong, Carlos K H AU - Wong CKH AD - Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China. AD - Department of Family Medicine and Primary Care, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China. AD - Laboratory of Data Discovery for Health Limited, Hong Kong SAR, China. FAU - Lui, David T W AU - Lui DTW AD - Division of Endocrinology and Metabolism, Department of Medicine, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China. FAU - Lui, Angel Y C AU - Lui AYC AD - Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China. FAU - Low, Marshall C H AU - Low MCH AD - Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China. FAU - Kwok, Ashley C Y AU - Kwok ACY AD - Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China. FAU - Lau, Kristy T K AU - Lau KTK AD - Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China. FAU - Au, Ivan C H AU - Au ICH AD - Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China. FAU - Xiong, Xi AU - Xiong X AD - Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China. FAU - Chung, Matthew S H AU - Chung MSH AD - Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China. FAU - Lau, Eric H Y AU - Lau EHY AD - Laboratory of Data Discovery for Health Limited, Hong Kong SAR, China. AD - World Health Organization (WHO) Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China. FAU - Cowling, Benjamin J AU - Cowling BJ AD - Laboratory of Data Discovery for Health Limited, Hong Kong SAR, China. AD - World Health Organization (WHO) Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China. LA - eng PT - Journal Article DEP - 20220307 PL - Switzerland TA - Front Endocrinol (Lausanne) JT - Frontiers in endocrinology JID - 101555782 RN - 9100L32L2N (Metformin) SB - IM MH - *COVID-19/complications/epidemiology MH - *Diabetes Mellitus, Type 2/complications/drug therapy MH - Hospital Mortality MH - Humans MH - *Metformin/therapeutic use MH - Propensity Score MH - *COVID-19 Drug Treatment PMC - PMC8935075 OTO - NOTNLM OT - COVID-19 OT - SARS-CoV-2 OT - hyperinflammatory syndrome OT - in-hospital mortality OT - metformin OT - type 2 diabetes COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/03/25 06:00 MHDA- 2022/04/02 06:00 PMCR- 2022/03/07 CRDT- 2022/03/24 05:12 PHST- 2021/11/08 00:00 [received] PHST- 2022/01/25 00:00 [accepted] PHST- 2022/03/24 05:12 [entrez] PHST- 2022/03/25 06:00 [pubmed] PHST- 2022/04/02 06:00 [medline] PHST- 2022/03/07 00:00 [pmc-release] AID - 10.3389/fendo.2022.810914 [doi] PST - epublish SO - Front Endocrinol (Lausanne). 2022 Mar 7;13:810914. doi: 10.3389/fendo.2022.810914. eCollection 2022.