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Preadmission usage of metformin and mortality in COVID-19 patients including the post-discharge period.
Saygili, Emre Sedar; Karakiliç, Ersen; Mert, Erdal; Sener, Alper; Mirci, Arzu.
  • Saygili ES; Department of Internal Medicine, Division of Endocrinology and Metabolism, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, 17020, Turkey. emre.saygili@comu.edu.tr.
  • Karakiliç E; Department of Internal Medicine, Division of Endocrinology and Metabolism, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, 17020, Turkey.
  • Mert E; Department of Internal Medicine, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey.
  • Sener A; Department of Infections Disease, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey.
  • Mirci A; Department of Pulmonary Disease, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey.
Ir J Med Sci ; 191(2): 569-575, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1491362
ABSTRACT

BACKGROUND:

The effect of preadmission metformin usage (PMU) on the mortality of coronavirus disease-2019 (COVID-19) patients with diabetes is conflicting. Most studies have focused on in-hospital mortality; however, mortality after discharge also increases in COVID-19 patients.

AIMS:

Examining the effect of PMU on all-cause mortality, including the post-discharge period.

METHODS:

Patients with diabetes who were hospitalised in 2020 due to COVID-19 were included in the study. They were divided into two groups those with a history of metformin use (MF( +)) and those without such history (MF( -)). Propensity score matching (PSM) was performed at a ratio of 11 for age and sex. COX regression analyses were used to demonstrate risk factors for mortality.

RESULTS:

We investigated 4103 patients hospitalised for COVID-19. After excluding those without diabetes or with chronic liver/kidney disease, we included the remaining 586 patients, constituting 293 women (50%) with an overall mean age of 66 ± 11.9 years. After PSM analysis, the in-hospital and post-discharge mortality rates were higher in the MF( -) group though not significantly different. However, overall mortality was higher in the MF( -) group (51 (42.5%) vs. 35 (29.2%), p = 0.031). For overall mortality, the adjusted HR was 0.585 (95% CI 0.371 - 0.920, p = 0.020) in the MF( +) group.

CONCLUSION:

PMU is associated with reducing all-cause mortality. This effect starts from the in-hospital period and becomes more significant with the post-discharge period. The main limitations were the inability to evaluate the compliance with metformin and the effects of other medications due to retrospective nature.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus, Type 2 / COVID-19 Drug Treatment / Metformin Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Aged / Female / Humans / Middle aged Language: English Journal: Ir J Med Sci Year: 2022 Document Type: Article Affiliation country: S11845-021-02823-9

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus, Type 2 / COVID-19 Drug Treatment / Metformin Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Aged / Female / Humans / Middle aged Language: English Journal: Ir J Med Sci Year: 2022 Document Type: Article Affiliation country: S11845-021-02823-9