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Association Between Anti-diabetic Agents and Clinical Outcomes of COVID-19 in Patients with Diabetes: A Systematic Review and Meta-Analysis.
Han, Tiantian; Ma, Shaodi; Sun, Chenyu; Zhang, Huimei; Qu, Guangbo; Chen, Yue; Cheng, Ce; Chen, Eric L; Ayaz Ahmed, Mubashir; Kim, Keun Young; Manem, Raveena; Chen, Mengshi; Guo, Zhichun; Yang, Hongru; Yan, Yue; Zhou, Qin.
  • Han T; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui Province, China.
  • Ma S; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui Province, China.
  • Sun C; Internal Medicine, AMITA Health Saint Joseph Hospital Chicago, Chicago, Illinois, USA. Electronic address: drsunchenyu@yeah.net.
  • Zhang H; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui Province, China.
  • Qu G; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Anhui Province, China.
  • Chen Y; Department of Clinical Medicine, School of the First Clinical Medicine, Anhui Medical University, Hefei, Anhui Province, China.
  • Cheng C; The University of Arizona College of Medicine at South Campus, Tucson, AZ, USA.
  • Chen EL; Internal Medicine, AMITA Health Saint Joseph Hospital Chicago, Chicago, Illinois, USA.
  • Ayaz Ahmed M; Internal Medicine, AMITA Health Saint Joseph Hospital Chicago, Chicago, Illinois, USA.
  • Kim KY; Internal Medicine, AMITA Health Saint Joseph Hospital Chicago, Chicago, Illinois, USA.
  • Manem R; Internal Medicine, AMITA Health Saint Joseph Hospital Chicago, Chicago, Illinois, USA.
  • Chen M; Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, China.
  • Guo Z; Massachusetts college of Pharmacy and Health sciences, Boston, MA, USA.
  • Yang H; Massachusetts college of Pharmacy and Health sciences, Boston, MA, USA.
  • Yan Y; Massachusetts college of Pharmacy and Health sciences, Boston, MA, USA.
  • Zhou Q; Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA.
Arch Med Res ; 53(2): 186-195, 2022 02.
Article in English | MEDLINE | ID: covidwho-1347493
ABSTRACT
BACKGROUND AND

AIMS:

During the current Coronavirus Disease 2019 (COVID-19) pandemic, patients with diabetes face disproportionately more. This study was performed to clarify anti-inflammatory effects of anti-diabetic agents on COVID-19 in patients with diabetes. METHODS AND

RESULTS:

Relevant literature was searched on 15 databases up to November 14, 2020 and was updated on April 13, 2021. The pooled ORs along with 95% CIs were calculated to evaluate combined effects. 31 studies with 66,914 patients were included in qualitative and quantitative synthesis. Meta-analysis showed that metformin was associated with a statistically significant lower mortality (pooled OR = 0.62, 95% CI, 0.50-0.76, p = 0.000) and poor composite outcomes (pooled OR = 0.83, 95% CI, 0.71-0.97, p = 0.022) in diabetic patients with COVID-19. Significance of slight lower mortality remained in sulfonylurea/glinides (pooled OR = 0.93, 95% CI, 0.89-0.98, p = 0.004), but of poor composite outcomes was not (pooled OR = 1.48, 95% CI, 0.61-3.60, p = 0.384). Dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors) were associated with statistically non-significant lower mortality (pooled OR = 0.95, 95% CI, 0.72-1.26, p = 0.739) or poor composite outcomes (pooled OR = 1.27, 95% CI, 0.91-1.77, p = 0.162) of COVID-19 in diabetic patients.

CONCLUSION:

Metformin might be beneficial in decreasing mortality and poor composite outcomes in diabetic patients infected with SARS-CoV-2. DPP-4 inhibitors, sulfonylurea/glinides, SGLT-2 inhibitors, and GLP-1RA would not seem to be adverse. There was insufficient evidence to conclude effects of other anti-diabetic agents. Limited by retrospective characteristics, with relative weak capability to verify causality, more prospective studies, especially RCTs are needed. REGISTRATION NUMBER PROSPERO-CRD42020221951.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus, Type 2 / Dipeptidyl-Peptidase IV Inhibitors / COVID-19 Drug Treatment Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Humans Language: English Journal: Arch Med Res Journal subject: Medicine Year: 2022 Document Type: Article Affiliation country: J.arcmed.2021.08.002

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus, Type 2 / Dipeptidyl-Peptidase IV Inhibitors / COVID-19 Drug Treatment Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Qualitative research / Reviews / Systematic review/Meta Analysis Topics: Long Covid Limits: Humans Language: English Journal: Arch Med Res Journal subject: Medicine Year: 2022 Document Type: Article Affiliation country: J.arcmed.2021.08.002