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Association of Metformin with Susceptibility to COVID-19 in People with Type 2 Diabetes

journal contribution
posted on 08.07.2021, 14:19 by Jingya Wang, Jennifer M Cooper, Krishna Gokhale, Dionisio Acosta-Mena, Samir Dhalla, Nathan Byne, Joht Singh Chandan, Astha Anand, Kelvin Okoth, Anuradhaa Subramanian, Mansoor N Bangash, Thomas Jackson, Dawit Zemedikun, Tom Taverner, Wasim Hanif, Sandip Ghosh, Parth Narendran, Konstantinos Toulis, Abd Tahrani, Rajendira Surenthirakumaran, Nicola J Adderley, Shamil Haroon, Kamlesh Khunti, Christopher Sainsbury, G Neil Thomas, Krishnarajah Nirantharakumar
Objective
Diabetes has emerged as an important risk factor for mortality from COVID-19. Metformin, the most commonly prescribed glucose-lowering agent, has been proposed to influence susceptibility to and outcomes of COVID-19 via multiple mechanisms. We investigated whether, in patients with diabetes, metformin is associated with susceptibility to COVID-19 and its outcomes.

Research Design and Methods
We performed a propensity score–matched cohort study with active comparators using a large UK primary care dataset. Adults with type 2 diabetes patients and a current prescription for metformin and other glucose-lowering agents (MF+) were compared to those with a current prescription for glucose-lowering agents that did not include metformin (MF−). Outcomes were confirmed COVID-19, suspected/confirmed COVID-19, and associated mortality. A negative control outcome analysis (back pain) was also performed.

Results
There were 29 558 and 10 271 patients in the MF+ and MF− groups, respectively, who met the inclusion criteria. In the propensity score–matched analysis, the adjusted hazard ratios for suspected/confirmed COVID-19, confirmed COVID-19, and COVID-19-related mortality were 0.85 (95% CI 0.67, 1.08), 0.80 (95% CI 0.49, 1.30), and 0.87 (95% CI 0.34, 2.20) respectively. The negative outcome control analysis did not suggest unobserved confounding.

Conclusion
Current prescription of metformin was not associated with the risk of COVID-19 or COVID-19-related mortality. It is safe to continue prescribing metformin to improve glycemic control in patients with.

History

Citation

The Journal of Clinical Endocrinology & Metabolism, Volume 106, Issue 5, May 2021, Pages 1255–1268, https://doi.org/10.1210/clinem/dgab067

Author affiliation

Diabetes Research Centre, College of Life Sciences

Version

AM (Accepted Manuscript)

Published in

The Journal of Clinical Endocrinology & Metabolism

Volume

106

Issue

5

Pagination

1255 - 1268

Publisher

OUP

issn

0021-972X

eissn

1945-7197

Acceptance date

28/01/2021

Copyright date

2021

Available date

09/02/2022

Notes

Deposited in Birmingham repository

Spatial coverage

United States

Language

eng