Metformin use is associated with a reduced risk of mortality in patients with diabetes hospitalised for COVID-19 - Inserm - Institut national de la santé et de la recherche médicale
Journal Articles Diabetes & Metabolism Year : 2021

Metformin use is associated with a reduced risk of mortality in patients with diabetes hospitalised for COVID-19

1 CHU Amiens-Picardie
2 UPJV - Université de Picardie Jules Verne
3 PERITOX - Périnatalité et Risques Toxiques - UMR INERIS_I 1 UPJV
4 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
5 ITX - ITX - unité de recherche de l'institut du thorax
6 CIC Nantes - Centre d’Investigation Clinique de Nantes
7 Association REMEDES [Ville-sur-Jarnioux]
8 CHU Angers - Centre Hospitalier Universitaire d'Angers
9 Centre Hospitalier Sud Francilien
10 CRC (UMR_S_1138 / U1138) - Centre de Recherche des Cordeliers
11 CH Cholet - Centre Hospitalier de Cholet
12 Hôpital Lariboisière-Fernand-Widal [APHP]
13 Hôpital Nord [CHU - APHM]
14 Centre Hospitalier René Dubos [Pontoise]
15 Centre Hospitalier de La Rochelle (CHR)
16 CHU Caen
17 CHAC - Centre Hospitalier Alès-Cévennes
18 Hôpital Cochin [AP-HP]
19 CH St Joseph - Centre Hospitalier Saint Joseph
20 Hôpital Ambroise Paré [AP-HP]
21 HUS - Les Hôpitaux Universitaires de Strasbourg
22 Centre Hospitalier Cahors
23 Service d'Endocrinologie, Diabétologie et Maladies Métaboliques [CHU Rouen]
24 UNIROUEN - Université de Rouen Normandie
25 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
26 Centre Hospitalier Libourne
27 CIC 1402 - CIC Poitiers – Centre d'investigation clinique de Poitiers
28 CHU Gonesse - Centre Hospitalier de Gonesse
29 CarMeN - Cardiovasculaire, métabolisme, diabétologie et nutrition
30 CHU Saint-Antoine [AP-HP]
31 I2MC - Institut des Maladies Métaboliques et Cardiovasculaires
C. Amadou
M. Joubert
  • Function : Author
M. Wargny

Abstract

AIMS: Metformin exerts anti-inflammatory and immunosuppressive effects. We addressed the impact of prior metformin use on prognosis in patients with type 2 diabetes hospitalised for COVID-19. METHODS: CORONADO is a nationwide observational study that included patients with diabetes hospitalised for COVID-19 between March 10 and April 10, 2020 in 68 French centres. The primary outcome combined tracheal intubation and/or death within 7 days of admission. A Kaplan-Meier survival curve was reported for death up to day 28. The association between metformin use and outcomes was then estimated in a logistic regression analysis after applying a propensity score inverse probability of treatment weighting approach. RESULTS: Among the 2449 patients included, 1496 were metformin users and 953 were not. Compared with non-users, metformin users were younger with a lower prevalence of diabetic complications, but had more severe features of COVID-19 on admission. The primary endpoint occurred in 28.0% of metformin users (vs 29.0% in non-users, P =  0.6134) on day 7 and in 32.6% (vs 38.7%, P = 0.0023) on day 28. The mortality rate was lower in metformin users on day 7 (8.2 vs 16.1%, P \textless  0.0001) and on day 28 (16.0 vs 28.6%, P \textless 0.0001). After propensity score weighting was applied, the odds ratios for primary outcome and death (OR [95%CI], metformin users vs non-users) were 0.838 [0.649-1.082] and 0.688 [0.470-1.007] on day 7, then 0.783 [0.615-0.996] and 0.710 [0.537-0.938] on day 28, respectively. CONCLUSION: Metformin use appeared to be associated with a lower risk of death in patients with diabetes hospitalised for COVID-19.
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inserm-03269072 , version 1 (23-06-2021)

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Jean-Daniel Lalau, Abdallah Al-Salameh, S. Hadjadj, T. Goronflot, N. Wiernsperger, et al.. Metformin use is associated with a reduced risk of mortality in patients with diabetes hospitalised for COVID-19. Diabetes & Metabolism, 2021, 47 (5), pp.101216. ⟨10.1016/j.diabet.2020.101216⟩. ⟨inserm-03269072⟩
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